Abstract
Digital multi-player learning games are believed to represent an important step forward in risk management training, especially related to human factors, where they are trusted to improve the performance of a team of learners in reducing serious adverse events, near-misses and crashes in complex socio-technical systems. Team situation awareness is one of the critical factors that can lead the team to consider the situation with an erroneous mental representation. Then, inadequate decisions are likely to be made regarding the actual situation. This paper describes an innovative communication system designed to be used in digital learning games. The system aims at enabling the learners to share information and build a common representation of the situation to help them take appropriate actions, anticipate failures, identify, reduce or correct errors. This innovative system is neither based on voice-chat nor branching dialogues, but on the idea that pieces of information can be manipulated as tangible objects in a virtual environment. To that end, it provides a handful of graphic interactions allowing users to collect, memorize, exchange, listen and broadcast information, ask and answer questions, debate and vote. The communication system was experimented on a healthcare training context with students and their teacher. The training scenario is set in a virtual operating room and features latent critical events (wrong-patient or wrong-side surgery). Teams have to manage such a critical situation, detect anomalies hidden in the environment and share them to make the most suitable decision. Analyzing the results demonstrated the efficacy of the communication system as per the ability for the players to actually exchange information, build a common representation of the situation and make collaborative decisions accordingly. The communication system was considered user-friendly by the users and successfully exposed lifelike behaviors such as debate, conflict or irritation. More importantly, every matter or implicit disagreement was raised while playing the game and led to an argued discussion, although eventually the right decision was not always taken by the team. So, improving the gameplay should help theplayers to manage a conflict and to make them agree on the most suitable decision.
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References
Reason, J.: A Life in Error. Ashgate Publishing Ltd, Farnham (2013)
Reason, J.: Human error: models and management. Br. Med. J. 320(7237), 768–770 (2000)
Endsley, M.R., Robertson, M.M.: Situation awareness in aircraft maintenance teams. Int. J. Ind. Ergon. 26(2), 301–325 (2000)
Fracker, M.L.: Attention gradients in situation awareness. In: Situational awareness in aerospace operations, pp. 6/1–6/10. Nato-Agard, Neuilly Sur Seine (1990)
Sarter, N.B., Woods, D.D.: Situation awareness: a critical but ill-defined phenomenon. Int. J. Aviat. Psychol. 1(1), 45–47 (1991)
Hartel, C., Smith, K., Prince, C.: Defining aircrew coordination: searching mishaps for meaning. In: Fifth international symposium on aviation psychology. UQ Business School Publications, Ohio State University, Columbus (1989)
Halverson, A.L., Casey, J.T., Andersson, J., Anderson, K., Park, C., Rademaker, A., Moorman, D.: Communication failure in the operating room. Surgery 149(3), 305–310 (2011)
Kohn, L.T., Corrigan, J.M., Donaldson, M.S. (eds.): To Err is Human: Building a Safer Health System. National Academies Press, Washington (2000)
Lingard, L., Espin, S., Whyte, S., Regehr, G., Baker, G., Reznick, R.: Communication failure in the operating room: observational classification of reccurent types and effects. Qual. Saf. Heathc. 13(5), 330–334 (2004)
Authority, P.P.S: Pennsylvania patient safety authority 2007. Annual report, Pennsylvania (2007)
Joint Commission: Improving Americas hospitals: the joint commission annual report on quality and safety. Retreived February, vol. 25 (2008)
Vicente, K.: Cognitive Work Analysis. Lawrence Erlbaum Associates Inc., Mahwah (1999)
Effken, J.A.: Different lenses, improved outcomes: a new approach to the analysis and design of healthcare information systems. Int. J. Med. Inform. 65(1), 59–74 (2002)
Plasters, C.L., Seagull, F.J., Xiao, Y.: Coordination challenges in operating-room management: an in-depth field study. In: Proceedings of AMIA annual symposium (2003)
Carayon, P.: Human factors of complex sociotechnical systems. Appl. Ergon. 37(4), 525–535 (2006)
Plsek, P.E., Greenhalgh, T.: The challenge of complexity in health care. Br. Med. J. 323(7313), 625 (2001)
Keyton, J., Beck, S.J., Asbury, M.B.: Macrocognition a communication perspective. Theor. Issues Ergon. Sci. 11, 272–286 (2010)
Keyton, J., Beck, S.J.: Perspective: examining communication as macrocognition in STS. Hum. Factors J. Hum. Factors Ergon. Soc. 52(2), 335–339 (2010)
Endsley, M.R.: Toward a theory of situation awareness in dynamic systems. Hum. Factors 37(1), 32–64 (1995)
Kaber, D.B., Endsley, M.R.: Team situation awareness for process control safety and performance. Process Saf. Progr. 17(1), 43–48 (1998)
Mathieu, J.E., Heffner, T.S., Goodwin, G.F., Salas, E., Cannon-Bowers, J.A.: The influence of shared mental models on team process and performance. J. Appl. Psychol. 85(2), 273 (2000)
Devreux, G., Faure, G., Chevalier, A., Cegarra, J., Lubrano, V., Rodsphon, T.: The role of expertise and team situation awareness in a dynamic system: the case of the operating room. In: 28th international congress of applied psychology, Paris (2014)
Kolb, D.A.: Experiential Learning: Experience as the Source of Learning and Development. Pearson Education, Englewood Cliffs (1984)
Capin, T.K., Noser, H., Thalmann, D., Pandzic, I.S., Thalmann, N.M.: Virtual human representation and communication in VLNet. IEEE Comput. Graph. Appl. 2, 42–53 (1997)
Egges, A., Papagiannakis, G., Magnenat-Thalmann, N.: Presence and interaction in mixed reality environments. Vis. Comput. 23(5), 317–333 (2007)
Kopp, S., Wachsmuth, I.: Synthesizing multimodal utterances for conversational agents. Comput. Animat. Virtual worlds 15(1), 39–52 (2004)
Ma, J., Cole, R.: Animating visible speech and facial expressions. Vis. Comput. 20(2–3), 86–105 (2004). doi:10.1007/s00371-003-0234-y. http://link.springer.com/article/10.1007/s00371-003-0234-y
Grice, H.P., Cole, P., Morgan, J.L.: Syntax and semantics. Log. Conversat. 3, 41–58 (1975)
Duranti, A.: Linguistic Anthropology, 0th edn. Cambridge University Press, Cambridge (1997)
Sacks, H., Schegloff, E.A., Jefferson, G.: A simplest systematics for the organization of turn-taking for conversation. Language 50(4), 696–735 (1974)
Duncan Jr., S.: Toward a grammar for dyadic conversation. Semiotica 9(1), 29–46 (1973)
Goodwin, C.: Conversational Organization: Interaction Between Speakers and Hearers. Academic Press, New York (1981)
Herring, S.: Interactional coherence in CMC. J. Comput. Mediat. Commun. 4(4) (1999)
Fraser, N.: Assessment of Interactive Systems. Handbook on Standards and Resources for Spoken Language SystemsAssessment of Interactive Systems Handbook on Standards and Resources for Spoken Language Systems, pp. 564–615. Mouton de Gruyter, Berlin (1997)
Tear, M.F.M.: Spoken dialogue technology: enabling the conversationnal user interface. In: ACM Computing Surveys, vol. 34 (2002)
Fraser, N.M., Gilbert, G.N.: Simulating speech systems. Comput. Speech Lang. 5(1), 81–99 (1991)
Navarathna, R., Lucey, P., Dean, D., Fookes, C., Sridharan, S.: Lip detection for audio-visual speech recognition in-car environment. In: Proceedings of the 10th international conference on information science, signal processing and their applications, pp. 598–601. IEEE (2010)
Lipovic, I.: Speech and Language Technologies. InTech Open Access Publisher (2011)
Mirzaei, M.R., Ghorshi, S., Mortazavi, M.: Audio-visual speech recognition techniques in augmented reality environments. Vis. Comput. 30(3), 245–257 (2013). doi:10.1007/s00371-013-0841-1
Lelardeux, C.: Healthcare Games and the Metaphoric Approach. In: Serious games for healthcare: applications and implications: applications and implications, pp. 24–49. IGI Global (2012)
Michael, D.R., Chen, S.L.: Serious Games: Games that Educate, Train, and Inform. Muska & Lipman/Premier-Trade, Boston (2005)
Lelardeux, C.P., Galaup, M., Segonds, F., Lagarrigue, P.: Didactic study of a learning game to teach mechanical engineering. Proc. Eng. 132, 242–250 (2015)
Zichermann, G., Cunningham, C.: Gamification by Design: Implementing Game Mechanics in Web and Mobile Apps. O’Reilly Media, Inc., Sebastopol (2011)
Potier, V., Lelardeux, C.P., Lalanne, M., Lagarrigue, P.: Making complexity fun—machining procedures in mechanical engineering. Gamification Eng. Educ. 1, 1–10 (2016)
Daesign: Renault Academy (2009)
Disney Stars: The virtual sell (2012)
Rilling, S., Wechselberger, U.: A framework to meet didactical requirements for serious game design. Vis. Comput. 27(4), 287–297 (2011). doi:10.1007/s00371-011-0550-6
Csikszentmihalyi, M., Abuhamdeh, S., Nakamura, J.: Flow. In: Elliot, A.J., Dweck, C.S. (eds.) Handbook of competence and motivation, pp. 598–609. Guilford Press, New York (2005)
Sanselone, M., Sanchez, S., Sanza, C., Panzoli, D., Duthen, Y.: Control of non-playing characters in a medical learning game with Monte Carlo Tree Search (regular paper). In: IEEE conference on computational intelligence and games, pp. 208–215. IEEE Computer Society, Dortmund (2014)
Thomas, D., Vlacic, L.: Collaborative decision making amongst human and artificial beings. In: Intelligent decision making: an AI-based approach, pp. 97–133. Springer (2008)
Lepper, M.R., Malone, T.W.: Intrinsic motivation and instructional effectiveness in computer-based education. Aptit. Learn. Instruct. 3, 255–286 (1987)
Malone, T.W.: What makes things fun to learn? Heuristics for designing instructional computer games. In: Proceedings of the 3rd ACM SIGSMALL symposium and the first SIGPC symposium on small systems, pp. 162–169. ACM, New York (1980)
Malone, T.W., Lepper, M.R.: Making learning fun: a taxonomy of intrinsic motivations for learning. Aptit. Learn. Instruct. 3(1987), 223–253 (1987)
Godden, D.R., Baddeley, A.D.: Context-dependent memory in two natural environments: on land and underwater. Br. J. Psychol. 66(3), 325–331 (1975)
Cowan, B., Rojas, D., Kapralos, B., Moussa, F., Dubrowski, A.: Effects of sound on visual realism perception and task performance. Vis. Comput. 31(9), 1207–1216 (2014). doi:10.1007/s00371-014-1006-6
Poling, N.D.: Collaboration, teamwork, and team cohesion in a starcraft 2 digital game-based course. Ph.D. thesis, University of Florida (2013)
Lagarrigue, P., Lubrano, V., Minville, V., Pons-Lelardeux, C.: The 3dvor project (2012). http://3dvor.univ-jfc.fr/
Chin, T.J., You, Y., Coutrix, C., Lim, J.H., Chevallet, J.P., Nigay, L.: Mobile phone-based mixed reality. Snap2play Game 25(1), 25–37 (2009)
Liarokapis, F., Macan, L., Malone, G., Rebolledo-Mendez, G., Freitas, S.D.: Multimodal augmented reality tangible gaming. Vis. Comput. 25(12), 1109–1120 (2009). doi:10.1007/s00371-009-0388-3. http://link.springer.com/article/10.1007/s00371-009-0388-3
Pandzic, I.S., Ostermann, J., Millen, D.: User evaluation: synthetic talking faces for interactive services. Vis. Comput. 15(7), 330–340 (1999)
Parvati, D., Heinrichs, W.L.: CliniSpace: A multiperson 3d online immersive training environment accessible through a browser. Medicine Meets Virtual Reality 18: NextMed 163, 173 (2011)
Taekman, J.M., Segall, N., Hobbs, E., Wright, M.: 3diteamsHealthcare team training in a virtual environment. Anesthesiology 107(A2145), A2145 (2007)
Mateas, M., Stern, A.: Natural language understanding in faade: surface text processing. In: Proceedings of the conference on technologies for interactive digital storytelling and entertainment (TIDSE) (2004)
Cassell, J.: Embodied conversational agents. MIT press, Cambridge (2000)
Rus, V., D’mello, S., Hu, X., Graesser, A.: Recent advances in conversational intelligent tutoring systems. AI Mag. 34(3), 42–54 (2013)
Hennigan, B.: Making the case for NLP in dialogue systems for serious games. In: 8th international conference on natural language processing (JapTAL), 1st workshop on games and NLP (2012)
Morningstar, C., Farmer, R.F.: The Lessons of Lucasfilm’s Habitat. In: Benedikt, M. (ed.) The first international conference on cyberspace. University of Texas, Austin (1990)
Johnson, M.T., Clary, M.: A second life virtual clinic for medical student training. Second Life Education Community Conference (SLEDcc’08) (2008)
Salas, E., Prince, C., David, Baker, Shrestha, L.: Situation awareness in team performance. Implic. Meas. Train. 37(1), 123–136 (1995)
Leckie, G.J., Pettigrew, K.E., Sylvain, C.: Modeling the information seeking of professionals: a general model derived from research on engineers, health care professionals, and lawyers. The Library Quarterly, pp. 161–193 (1996)
Reddy, M., Jansen, B., Spence, P.: collaborative information behavior: exploring collaboration and coordination during information seeking and retrieval activities. In: Collaborative information behavior: user engagement and communication sharing. IGI Global, Hershey (2010)
Reddy, M., Bernard, J.J.: A model for understanding collaborative information behavior in context: a study of two healthcare teams (2006)
Panzoli, D., Sanselone, M., Sanchez, S., Sanza, C., Lelardeux, C., Lagarrigue, P., Duthen, Y.: Introducing a design methodology for multi-character collaboration in immersive learning games (regular paper). In: Proceedings of the sixth international conference on virtual worlds and games for serious applications (VS-Games14), p. (electronic medium). IEEExplore digital library, University of Malta (2014)
WHO: Surgical safety checklist (2009)
Authority, P.P.S.: Pennsylvania Patient Safety Authority 2012. Annual report 2012, Pennsylvania (2012)
Seiden, S.C., Barach, P.: Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: are they preventable? Arch. Surg. 141(9), 931–939 (2006)
Busemann, A., Heidecke, C.D.: Safety checklists in the operating room. Dtsch. rztebl. Int. 109(42), 693–694 (2012). doi:10.3238/arztebl.2012.0693. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489073/
Acknowledgements
The steering committee of 3DVOR is composed of Pr. Pierre Lagarrigue, M.D. Ph.D. Vincent Lubrano, M.D. Ph.D. Vincent Minville and Catherine Pons-Lelardeux. The following authors are also grateful to contributors to the project 3D operating room: Thomas Rodsphon, Cyrielle Guimbal, Michel Galaup and Jules de Guglielmi. The experiment described in Sect. 6.3 has been conducted under the supervision of Christiane Paban (teacher) and two students of the anesthetist nurse school of Toulouse: Hoang and Amelie. These works are part of a global national innovative IT program whose partners are KTM Advance company, Novamotion company, Serious Game Research Network and University Hospital of Toulouse (France). This R&D project is supported by French National Funding : Bpifrance Financement.
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Pons Lelardeux, C., Panzoli, D., Lubrano, V. et al. Communication system and team situation awareness in a multiplayer real-time learning environment: application to a virtual operating room. Vis Comput 33, 489–515 (2017). https://doi.org/10.1007/s00371-016-1280-6
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DOI: https://doi.org/10.1007/s00371-016-1280-6