SHORT COMMUNICATION

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,specifically 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 4:39–43.

© 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

INTRODUCTION

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).

WHAT IS SECOND LIFE?

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 flat 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 Life’s OrientationIsland, where they learn to modify their appearance, commu-nicate with others, and transport themselves to desired loca-tions by walking, running, flying, 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 specificallyaffiliated 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 4:39–43 (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 IN HIGHER EDUCATION

Second Life has attracted the attention not only of individualusers but also of nonprofit 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 office 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 IN ANATOMYEDUCATION

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 student’s 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 student’s 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 specific 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 UK’s 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 difficult anatomical regionsto medical and dental professional students. A 3D replica ofthe pterygopalatine fossa (PPF) was constructed on the roofof the virtual anatomy laboratory on UK’s 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 ‘‘fly’’ or maneuver inand out of the boundaries of the fossa to follow the course ofthe nerves to their destination.

DISCUSSION

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 thestudent’s 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 difficult 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 (Hansen, 2008).

A second theme emerging from this qualitative feedback isthat students particularly enjoy the instantaneous feedbackprovided by their instructors, which is consistent with find-ings reported by Schmidt and Stewart (2009). Students alsoreport that the group discussion in Second Life provides amore personal interaction with their instructors that wouldnot be typically experienced in the traditional classroom. Thismay be in part due to the small group format of Second Lifeitself. These initial findings appear positive; however, futurestudies must be administered to quantifiably demonstrate theeffectiveness of Second Life in anatomy education.

A virtual laboratory in Second Life affords many advantagesas an educational tool for anatomy. One of these advantagesincludes the accessibility of the laboratory, which correlateswell with the preferences of the millennial students that popu-late our classrooms (Howe and Strauss, 2000). Although thevirtual laboratory will not serve as a substitute for future expe-riences in cadaver-based anatomy, Second Life does provide avaluable experience that may prepare students for the contentand peer learning/discussion skills they need for their futurestudies. Moreover, Second Life introduces a unique extensionto online learning, as students are not only able to view thecontent but also interact virtually with one another as theyview the same material in the same virtual room, despite thereal physical distance between them. This concept allows stu-dents to participate to a greater extent than that afforded bytypical lecture broadcasts through distance learning.

Thus, our vision for the use of Second Life in undergraduateeducation is to serve as a transition between the college envi-ronment and the medical professional programs that follow.Second Life may be used to sharpen discussion skills and to ex-pose students to a simulated anatomy laboratory environmentthat will be reflective of the level of detail and professionalismthey will encounter in their professional programs. In addition,we plan to continue to build 3D anatomical models to supple-ment lectures in medical professional courses.

NOTES ON CONTRIBUTORS

APRIL RICHARDSON, Ph.D., is an assistant professor inthe Department of Anatomy and Neurobiology at the Univer-sity of Kentucky, Lexington, Kentucky. She teaches under-graduate anatomy courses and gross anatomy to medical,

physician assistant, and physical therapy students. Herresearch interests include the use of Second LifeTM for anat-omy education.

MATT HAZZARD, B.A., is a medical illustrator in theTeaching and Academic Support Center (TASC) at the Univer-sity of Kentucky, Lexington, Kentucky. He designs three-dimensional structures and spaces in the virtual anatomy labo-ratory on the University of Kentucky Island in Second LifeTM.

SANDRA D. CHALLMAN, M.S., is the Curriculum De-velopment Director in the Dentistry Academic Affairs Depart-ment at the University of Kentucky, Lexington, Kentucky. Shefocuses on incorporating innovative technologies into thedental curriculum.

AARON M. MORGENSTEIN, M.S., is a fourth-yearmedical student at the University of Kentucky, Lexington,KY. In addition to his studies, he contributes to the curricularcontent for the virtual anatomy laboratory.

JENNIFER K. BRUECKNER, Ph.D., is a professor of ana-tomical sciences and neurobiology at the University of Louis-ville School of Medicine, where she teaches medical/dentalgross anatomy and medical embryology. In July 2010, shemoved to University of Louisville School of Medicine fromthe University of Kentucky, where she had taught in theAnatomy and Neurobiology Department for 10 years. Herscholarly work focuses on the development and evaluation ofinnovative approaches in anatomy education.

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