A “Second Life” for gross anatomy: Applications for multiuser virtual environments in teaching the anatomical sciences

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    A Second Life for Gross Anatomy: Applicationsfor Multiuser Virtual Environments in Teachingthe Anatomical Sciences

    April Richardson,1* Matthew Hazzard,2 Sandra D. Challman,3 Aaron M. Morgenstein,4

    Jennifer K. Brueckner1,51Department of Anatomy and Neurobiology, College of Medicine, University of Kentucky, Lexington, Kentucky2Teaching and Academic Support Center (TASC), University of Kentucky, Lexington, Kentucky3Curriculum Development Center, Dentistry Academic Affairs, College of Dentistry, University of Kentucky,Lexington, Kentucky4College of Medicine, University of Kentucky, Lexington, Kentucky5Department of Anatomical Sciences and Neurobiology, University of Louisville, School of Medicine,Louisville, Kentucky

    This article describes the emerging role of educational multiuser virtual environments,specically Second LifeTM, in anatomical sciences education. Virtual worlds promote in-quiry-based learning and conceptual understanding, potentially making them applicablefor teaching and learning gross anatomy. A short introduction to Second Life as an ana-tomical educational tool is provided, along with description of existing anatomy applica-tions and future directions for this innovative teaching modality. Anat Sci Educ 4:3943. 2011 American Association of Anatomists.

    Key words: anatomy education; Second Life; virtual technology; avatar; online learning;computer-assisted learning; gross anatomy; virtual anatomy laboratory; innovations


    With the introduction and maturation of broadband internet,wireless computing, and advanced video and audio technolo-gies, virtual immersive environments are becoming morepractical and useable in higher education (Bers, 2008; Gron-stedt, 2008; Trelease, 2008; Bell, 2009). A virtual world pro-vides an experience set within a technological environmentthat gives the user a strong sense of being there (Warburton,2009). Multiple virtual world environments exist, includingOLIVETM (OLIVE, 2010), Croquet Consortium (Croquet

    Consortium, 2010), Protosphere1 (Protosphere, 2010), andSecond LifeTM (Second Life, 2010a). Currently, Second Life isthe most mature and popular multiuser virtual world plat-form used in higher education, providing a three-dimensional(3D) environment that mimics real life (Second Life, 2010c).


    First launched by Linden LabTM in 2003, Second Life is a 3Dsocial network in which participants can interact with oneanother and with existing objects in the virtual world, as wellas collaboratively create and edit objects (Boulos et al.,2010). It consists of a at earth simulation of nearly two bil-lion square meters (Wiecha et al., 2010). Users enter SecondLife (Second Life, 2010a) through a free client program calledSecond Life Viewer (Second Life, 2010b) and subsequentlyfollow instructions for creating a customized avatar, or onlinepersona, to represent themselves in the virtual world. Newavatars are directed to navigate to Second Lifes OrientationIsland, where they learn to modify their appearance, commu-nicate with others, and transport themselves to desired loca-tions by walking, running, ying, or teleporting. Communica-tion between avatars occurs either via a chat interface (text

    The Teaching and Academic Support Center (TASC) is now referredto as UK Teaching and Learning. Matt Hazzard is specicallyafliated with the division of Graphics and Multimedia Production.

    *Correspondence to: Dr. April Richardson, Department of Anatomyand Neurobiology, MN212 Chandler Medical Center, 800 Rose Street,Lexington, KY 40536, USA. E-mail: arich3@uky.edu

    Received 18 May 2010; Revised 23 November 2010; Accepted 24November 2010.

    Published online 3 January 2011 in Wiley Online Library(wileyonlinelibrary.com). DOI 10.1002/ase.195

    2011 American Association of Anatomists

    Anatomical Sciences Education JANUARY/FEBRUARY 2011 Anat Sci Educ 4:3943 (2011)

  • messaging) or using the voice features (Baker et al., 2009).After this basic training, avatars are ready to interact withone another and with their surroundings on plots of virtualland known as islands that can be designated as public or pri-vate, if a more secure environment is needed for a particularaudience.

    Though creating an avatar and interacting in Second Lifeis free of charge, users can conduct business with the cur-rency in Second Life (Linden dollars), purchasing virtual land(island) and consumer goods. Users may use the intrinsicbuilding capabilities of Second Life to demonstrate their ownimaginative work by creating simple geometric primitives(prims) to which various textures may be overlaid to achievethe desired detail. Importable textures (i.e., jpegs) may alsobe used to tailor the overall design of the in-world creation(i.e., the avatar with a muscle texture in Fig. 1) Once theobject is created, additional Second Life programming usingLinden Scripting Language may be used to activate theseobjects; these scripts are essential codes for movement or chatthat may be applied to the avatars and/or inanimate objectsto enhance interactive movements and communication amongavatars and other objects within the virtual environment.Thus, the Second Life users may take an active role in creat-ing their own virtual world.


    Second Life has attracted the attention not only of individualusers but also of nonprot organizations, universities, corpo-rations, and government agencies (Schmidt and Stewart,2010). Many universities and colleges have used the toolsprovided in Second Life to build replicas of their campuses,which can be used as recruiting tools to showcase their insti-tution to potential students and other important audiencessuch as donors (DeLucia et al., 2009). Live university events,including research seminars and international conferences areregular occurrences in Second Life (Leong et al., 2008). Uni-versity faculty can hold virtual ofce hours in Second Life,eliminating the necessity for travel to campus for the studentor professor (Rzewnicki, 2007).

    The body of research addressing Second Life as an educa-tional environment is relatively small, but addresses its poten-tial for both distance learning and on-campus instruction(Cobb et al., 2009; Schmidt and Stewart, 2009; Skiba, 2009).The immersive nature of Second Life allows students toexplore and discover content, such that the role of the in-structor is transformed from a sage on the stage to the roleof a mentor or coach (Welch, 2008). Second Life can simulateexpensive or potentially dangerous activities in an accessibleand safe manner (Stott, 2007; Hewitt et al., 2008; Foss,2009) and may help students overcome anxiety of makingmistakes in real life groups (Broadribb and Carter, 2009).


    Second Life has several features that make it is well suited forsupplementing anatomical education, including the ability tobuild 3D models that avatars can examine from all perspec-tives and to promote discussion and interaction amongst ava-tars. Some universities have developed anatomical models inSecond Life for use as ancillary teaching and learning tools

    for undergraduate and health professions students. NorthernMichigan University has constructed a Virtual Speech, Lan-guage and Hearing Clinic, which contains interactive larynxand middle ear models (Virtual Speech-Language & HearingClinic, 2010). The Ohio State University has built a 3D inter-active testis in which students can take a virtual tour throughsperm development (Virtual Sperm Tour, 2010).

    In 2007, the University of Kentucky established a presencein Second Life, and the College of Medicine is now utilizingthis virtual environment to serve the student population in avariety of ways.

    Virtual Anatomy Laboratory

    Because Second Life so effectively facilitates experimentallearning, role-play, and collaboration in other educational set-tings (Berge, 2008; Jarmon et al., 2008; Hew and Cheung,2010), we sought to incorporate this virtual technology intoanatomical science education by developing a virtual labora-tory experience for undergraduate and health professionalstudents alike. The University of Kentucky College of Medi-cine has constructed a multipurpose, virtual anatomy labora-tory (UKVAL, 2010) that contains a series of stations, includ-ing areas focusing on: (1) atlas/cadaver images (Fig. 1), (2) aguided tour through cross-sectional anatomy, (3) video tutori-als of cadaveric anatomy (Fig. 2), and (4) group quizzes. Ateach station, a note-card (i.e. an electronic tablet thatincludes typed text) is issued to the students inventory uponclicking on the station heading (Fig. 3); this note-cardexplains the orientation of the anatomical structure displayed,in addition to supplying basic information about this struc-

    Figure 1.

    At each station, a note-card is issued to the students inventory upon clickingon the station heading; this note-card explains the orientation of the anatomi-cal structure displayed, in addition to supplying basic information about thisstructure for their review. Station 1 in the virtual anatomy laboratory demon-strates atlas and cadaver images of the anterior compartment of the thigh.Questions are embedded in the note-card, so that the instructor can promotegroup discussion regarding the anatomy of this region. These questions rangefrom basic anatomical understanding to more complicated correlations withclinical scenarios. Student avatars are pictured here as they gather to viewthese images and to answer a series of note-card questions facilitated by theinstructor.

    40 Richardson et al.

  • ture for their review. Questions are embedded in the note-card, so that the instructor can promote group discussionregarding anatomical concepts. To simulate a professionalenvironment, student participants are informed about therules of the anatomy laboratory, including wearing appropri-ate attire (i.e., laboratory coat) at all times and demonstratingappropriate respect for the cadaver images, and for fellowclassmates in the context of any group discussion. Thus far,pilot sessions regarding specic anatomy topics (i.e., anteriorcompartment of the thigh) have been conducted in this virtualenvironment to test the general student response to thispotential educational tool. Future goals include the develop-ment of a virtual laboratory course that will be offered toundergraduates as a supplement to their anatomy education,consisting of weekly virtual sessions that integrate anatomicalprinciples in clinical correlates. The curriculum associatedwith this course is being completed at this time. In additionto the monthly cost to sustain the island ($200 US dollars),expenses associated with the construction of the virtual anat-omy laboratory to date total $45 US dollars, as theexchange rate for US dollars and Linden dollars is minimal($1 US dollar is equivalent to L$270 Linden dollars). In addi-tion, the number of manual hours expended to create thislaboratory thus far totals 100 hours.

    Outreach for Prospective MedicalProfessional Students

    The virtual anatomy laboratory may be used for dual pur-poses on UKs island. For example, in addition to utilizingthis unique space for anatomy instruction, it may be used asa meeting place for prospective medical professional studentswho are being actively recruited to the UK College of Medi-cine. While visiting campus, students are introduced to theSecond Life and its application in the classroom, and then

    proceed to obtain their own avatar to explore the laboratory.These students may easily keep in touch with each other fol-lowing their actual visit to UK, and in the future, administra-tors may also use this for subsequent follow-up sessions withgroups of students that may be separated by large physicaldistances.

    A 3D Construction of the PterygopalatineFossa

    The University of Kentucky is using the 3D capabilities ofSecond Life to teach conceptually difcult anatomical regionsto medical and dental professional students. A 3D replica ofthe pterygopalatine fossa (PPF) was constructed on the roofof the virtual anatomy laboratory on UKs island (UKVAL,2010). This model includes an illustration of the relevantdivisions of the maxillary nerve (V2) that course through thefossa and its associated communications between the orbit,cranial, nasal, and oral cavities. A second nearby anatomicalmodel illustrates the relative placement of the PPF and itsrelated nerves within the skull. This Second Life virtual tourcan be used in conjunction with lecture to more thoroughlyillustrate the various openings through which nerves traversethe PPF, as the avatar can essentially y or maneuver inand out of the boundaries of the fossa to follow the course ofthe nerves to their destination.


    Second Life technology has introduced a venue for an innova-tive pedagogical style that may be adapted for various disci-plines (Bente et al., 2008). Here, we describe and demon-strate various uses for Second Life in the evolving curriculumof the anatomy department at the University of Kentucky.This virtual environment not only provides a novel platform

    Figure 3.

    This illustration depicts an example of a note-card that is transferred to thestudents inventory at each station when the heading above the station isclicked. Questions are embedded in the text to facilitate group discussion ofanatomical principles.

    Figure 2.

    Stations 2 and 3 are located in the same area of the laboratory, and differentvideos may be loaded as needed for the class discussion. The video displayed inthis image includes a voice-guided tutorial through the anterior compartmentof the thigh of a cadaver. This station illustrates the potential to incorporatemultimedia presentations into the virtual anatomy environment, allowing allusers to see and respond to the same stimulus.

    Anatomical Sciences Education JANUARY/FEBRUARY 2011 41

  • that enhances opportunities for online anatomy education butalso it provides a way to construct difcult anatomical mod-els so that the students or avatars can experience them in a3D environment. This has tremendous potential for conceptu-alizing the intricacies of the human body.

    According to cursory qualitative feedback from studentswho have sampled the virtual anatomy environment in pilotsessions, several features of Second Life appeal to the millen-nial students. To begin, students report that the pseudoano-nymity" afforded by the avatars enables them to feel morecomfortable answering questions in group discussion. This isconsistent with previous work on Second Life in medical edu-cation (Wiecha et al., 2010). We have observed that studentsmore readily answer questions asked by the instructors, oftentimes polling their fellow peers for second opinions on thesubject matter. This enhanced interaction, in part due to the av-atar image, is in agreement with other studies in which theonline environments facilitate a positive, even counter-intuitive,barricade between the student and instructor, so that studentsfeel less inhibited to speak their mind...


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