The Inevitable Room - Edtec 670 Fall 2007

Name: Future avatars will have 'everynames' such 'Bill,' 'Sue,' 'Joe,' 'Alice,' and so forth.
Age: Avatars will range in age from 67 to 89, and will vary in appearnace accordingly.
Weight/build: Avatars will come in several sizes, including overweight, thin, and healthy bodies.
Mobility: Some avatars will need to navigate terrain in a wheel chair. Others will need assistance from a cane (and will have a matching animation). Others will move about unaided, but move slowly and cannot fly. Each avatar will have a unique constellation of mobility limitations.
Vision: The player's HUD will take on a blurred effect that simulates myopia, presbyopia, hyperopia, glaucoma, or a combination of conditions.
Accesories: Avatars will have accesories such as canes or wheelchairs that match their mobility limitations. Avatars may also have small animal avatars, such as dogs or cats, that follow them as companions.
Clothing: All avatars will wear variations of the same outfit. Male avatars will all wear the same white shirt and brown slacks, and all female avatars will dress in the outfit pictured below. This 'uniform' will reduce the chances of users selecting their avatars based on cosmetic differences.

The receptionist will also give the player a note card containing a brief series of complaints and instructions on how to approach the doctor's appointment. The coach will record the player's interactions with the receptionist and other waiting room characters and analyze them with the player later in the simulation. When the coach and player are ready, the coach will privately change their avatar into a doctor and invite the player into their office.

The Player in the Waiting Room

A sample notecard given to the player at the end of the doctor's visit

The wheelchair will not allow the player up stairs.

     The nightclubs in Second Life are packed with youthful avatars. The
     player will have an opportunity to see how this youth-centered
     environment treats the old, and connect their observations to age
     prejudices in the real world.

               Not all avatars will have limited mobility,
               as is true in the real world. However, this will
               definitely give the player a sense of standing out
               due to their age.

The player in Morocco talking with monkeys. The player at the Moroccan market.

At the Moroccan market, the player will have the opportunity to interact with other individuals from different cultures. Francophones, Arabic speakers, and English speakers frequent this location and may give the player a better feel for how people across the world approach aging.

The player performs diagnoses problems with an elderly avatar,
played by the coach.


The Inevitable Room Authors: Koreen Corbett Daniel Novak Yong Chen
Overview The American population is getting older. The signs are everywhere. In October of 2007, the oldest child of the Baby Boom generation retired and applied for social security. The aging post-war generation will face many challenges in the coming decade, especially in a society that values youth. Ageism, or discrimination based on age, could prove a major obstacle for older Americans as younger employees enter the workforce. Ageism, more so than any other problem, is insidious. People unfamiliar with the concept and its ramifications have difficulty understanding the issue. Yet ageism has high stakes, especially in medical professions. Some patients that complain of problems are often undertreated because they are perceived as hypochondriacs. Worse still, some older people refuse to acknowledge that they are aging. They seek out doctors who will alter their physical appearance to keep them looking young. They deny the changes in their bodies and minds, and look at aging with repulsion. The majority of individuals enjoy a healthy adjustment to getting older but still require guidance about their new needs and limitations. They do not view aging as a process of decay, nor as a period of weakness. Still, it is a time of many challenges and many unknowns. American doctors and health care professionals must work to understand the physical, psychological, and social changes that occur with age. Second Life can help us teach health care workers about issues surrounding the aging process. The Inevitable Room is an aging simulator. It represents the convergence of virtual role-playing, e-coaching, and field exposure. Our simulation will present a participant with an senior citizen avatar that they must wear through a series of scenarios. First, the participant will explore a house and feel the age-related limitations imposed by their avatar. These may include myopia, as well as a lack of flight, decreased speed, decreased height, decreased hearing ability, and decreased dexterity. Next, players will visit a doctor. The doctor (a real-life ageism coach who is recording the session) may present them with false or misleading medical advice about how to handle the aging process. The player must negotiate through this scenario and obtain the best medical advice possible. The player will then leave the doctor's office and teleport to an area populated by younger avatars. They will be asked to perform tasks, such as shopping, as they explore the area as an older avatar. A note card will instruct them to pay close attention to changes in the ways that other avatars interact with them. After they have completed their tasks, players will return to the doctor's waiting room for a debriefing and discussion about their performance in the earlier medical consultation. They may encounter and interact with other players in the 'Waiting Room' dressed as their senior citizen avatar. The coach will then find the player and change into an elderly avatar. The coach will give the player access to an avatar that relates to their position (i.e. nurse, doctor, medical assistant, administrative assistant). The two will then run a scenario based on the player's organizational role, debrief, and end this instance of the simulation.

Instructional Objectives Affective: Learners will demonstrate an appreciation for common limitations associated with people aged 65 and older by listing at minimum of three physiological changes they experienced while navigating and interacting in Second Life. Learners will be able to express examples of agism to their coach after having experienced life as a senior citizen in Second Life. Cognitive: Given a phrase in reference to senior citizens, the learners will be able to correctly identify whether it is ageism. Learners will be able to eliminate prejudicial or ageist behavior while interacting with an elderly patient, in accordance with the guidelines set by their coach.

Learners The Inevitable Room is designed for health care workers to experience the effect of aging and age biases. The target group of learners are those that work as health care professionals who serve senior citizens, such as doctors, nurses, medical assistants, and administrative assistants. For them, The Inevitable Room could function as a supplementary instruction to their formal professional training and certification. Though the project currently focuses on health care professionals, other versions of the simulation could accommodate younger learners, or even older individuals.

Context of Use The learners will receive training on how to create an avatar and interact in Second Life at a training facility. From there, the learners could log on from home, the training facility, or their office if the simulation is incorporated into a staff development program. Players can log on whenever they have time. However, the coaching sessions are synchronous, so players will need to sign up for appoints based on times listed on the web. Learners need only complete the scenario once, but the existence of multiple avatars, scenarios, and positions add to the simulation's replay value. A single run through the simulation could take as little as two hours, or as long as four, depending on the learner's pace. Completion of the game could be tied with certification requirements, job placement and/or promotion. Learners would receive a certificate of completion once they've satisfied all the requirements. Future versions of the simulation could conform to the medical field's professional development standards, and so count towards the physician's recertification.

Motivation Second Life helps to resolve some of the main concerns with web-based instruction. Web-based instruction works well for people that learn well visually, through reading text and graphics. It tends to leave out auditory and kinesthetic learners. Many people learn best with a multi-faceted approach (Keller, 1999). Second Life, if designed well, provides visual, auditory, and kinesthetic learning opportunities. This will help to increase the motivation of the learner. ARCS Model of Motivation: This simulation addresses each of the ARCS categories. Attention - there is just enough incongruity and conflict (Wesselhoff, 1998) to keep the learners interest. For most of the learners, being a senior citizen will be an new experience for them. Relevance - there is a high level of future usefulness (Robles, 1998) for the health care professionals participating in the simulation. Confidence - There is a pre-requisite class that will teach the learner the ins and outs of getting around in Second Life, giving them needed confidence before beginning this simulation (Kick, 2007). Once in the simulation, there are clear learning objectives, including mini-objectives (Thompson, 2007), that will help keep the learners interest. Mini-objectives in game design provide the learner with smaller, attainable tasks/goals that will give the learner a sense of accomplishment. The simulation begins with simple exploration and increases in difficulty level as they progress through the rooms and tasks. Also, the learners will have some control over their learning by choosing an avatar they are comfortable with and having a range of tasks to choose from (Kick, 2007). Satisfaction - the simulation makes every attempt to utilize the affordances that Second Life offers to ensure a realistic experience for the learners, which will help increase the overall satisfaction (Alizadeh, 2007).

Avatars and Roles Avatars in this simulation will take an inventory item of skin and clothing when they first enter the simulation. They will get to choose from several senior citizen avatar skins and clothes. They will also need to accept and wear HUDs that will simulate blurry vision, difficulty in picking up objects and hearing. The first room they enter (see below), will allow them to choose which senior citizen avatar to be. Avatar variables: Name: Future avatars will have 'everynames' such 'Bill,' 'Sue,' 'Joe,' 'Alice,' and so forth. Age: Avatars will range in age from 67 to 89, and will vary in appearnace accordingly. Weight/build: Avatars will come in several sizes, including overweight, thin, and healthy bodies. Mobility: Some avatars will need to navigate terrain in a wheel chair. Others will need assistance from a cane (and will have a matching animation). Others will move about unaided, but move slowly and cannot fly. Each avatar will have a unique constellation of mobility limitations. Vision: The player's HUD will take on a blurred effect that simulates myopia, presbyopia, hyperopia, glaucoma, or a combination of conditions. Accesories: Avatars will have accesories such as canes or wheelchairs that match their mobility limitations. Avatars may also have small animal avatars, such as dogs or cats, that follow them as companions. Clothing: All avatars will wear variations of the same outfit. Male avatars will all wear the same white shirt and brown slacks, and all female avatars will dress in the outfit pictured below. This 'uniform' will reduce the chances of users selecting their avatars based on cosmetic differences.

Objects and Locations The learners must inhabit and navigate a home, a waiting room, a doctor’s office, and an area populated by younger avatars during the Inevitable Room simulation. In the simulated residence, learners must perform basic life tasks using common household objects such as stepladders, bottles of pills, cans of food, and television remotes. This experience will help the learner understand the difficulties that older people confront as they perform their real world tasks. The waiting room will contain a reception window with a nurse/coach, couches, chairs, simulated magazines, and other occupants. This area will provide a staging area for the doctor's office simulation, as well as a space for the coach and player to discuss the player's experience. In the doctor’s office, patients will see equipment such as stethoscopes, a blood-pressure meter, and an eye chart, though they may not necessarily interact with those objects. Instead, they will give the location a familiarity and verisimilitude that is essential to the simulation's success. In order to grasp the ramifications of ageist behavior, learners must also visit one of three public places in the Second Life world. These include a dance club, a shopping area, and a public beach. This provides the player with an opportunity to interact with others as their elderly avatars.

Game Goal The goal of The Inevitable Room is to provide learners with an opportunity to experience aging, ageist language, and ageist behaviors. Ideally, this experience will help the learner recognize and eliminate any age biases they might have, as well as improve their real-life relationships with the elderly. The simulation is intended to invert the learners’ real-world relationship with the aged, making them play the role of the senior citizens whom they serve. This simulation will help the learners to think and act from the perspectives of senior citizens, a vantage point that they may not normally consider. The transposition is designed to let the learners experience digital facsimiles of the physical, psychological, and social issues that senior citizens encounter daily.

Play by Play The Inevitable Room simulation begins in a lobby with a single notecard. Portraits of elderly avatars appear on every wall in this lobby, each one with a unique name and unique constellation of conditions. The player will follow directions on the notecard that will allow them to automatically download and wear the pictured avatars. Once the user has accepted the avatar, their clothes, appearance, HUD, and accessories will change to reflect the specifics of the avatar.

The Apartment Once the player has selected an avatar, they will proceed into the first room of the simulation. This room will have the same amenities as most one-bedroom apartments and old-age communities. These will include a television, a small kitchen, a bedroom, and a bathroom. To emphasize the difficulties associated with aging, the room will be scaled so that all surfaces and distances are one foot greater their real-world counterparts. For example, architects generally place cabinets at five feet off the floor in the real world (and in many Second Life spaces). These same cabinets would appear six feet from the floor in The Inevitable Room. The player will then need to perform some basic tasks while in the room. These tasks will come on a notecard included with an elderly avatar, and will be based on that avatar's particular constellation of physical limitations. The tasks on the notecard may include: 1) Finding a step-ladder, and using that ladder to reach a box on a high shelf. 2) Navigating from one room to another in a wheelchair. 3) Selecting a specific bottle of pills from a group while dealing with limited vision. The player having a hard time reaching things The player needs her third dose of pills!		The kitchen with the blurry HUD in place The living room The player in the room

The Doctor's Office Once the user has completed his or her tasks, they will teleport to the next room in the simulation. This second room is called 'The Waiting Room,' and it will closely resemble the waiting room in a doctor's office. It will contain magazines, chairs, and a receptionist area. After reading a note card, the player will need to confirm their appointment with the receptionist and confront the ageist attitudes of the medical staff and fellow patients. The receptionist, controlled by an ageism coach, may say ageist or condescending things to player to incite an emotional reaction.		The Player at the Receptionist Desk
The receptionist will also give the player a note card containing a brief series of complaints and instructions on how to approach the doctor's appointment. The coach will record the player's interactions with the receptionist and other waiting room characters and analyze them with the player later in the simulation. When the coach and player are ready, the coach will privately change their avatar into a doctor and invite the player into their office.		The Player in the Waiting Room
The doctor's office will contain a step-stool, an examination table, and a number of medical tools. When the player has used the step-stool to help them onto the examination table, the doctor/coach will prompt the user to open their notecard and recount their problem. Notecards will contain a brief profile of the patient written in the second person. It will provide clues and talking points for the player without revealing the entire script. Sample Notecard 1 For the last few months, your right knee has ached every time you've sat down, stood up, or walked short distances. You think the the problem may be related to the new exercise routine that you started after your daughter bought you a gym membership. This is a serious problem, as the jogging and light weight exercises you do have helped lower your blood pressure. You want to find out if you're straining yourself, and you hope to see a specialist on aging about your exercise routine. Using the Notecard above, we conducted a few tests with random avatars in Second Life. Here's how a typical conversation would play out... Sample Script 1 Doctor: So what's the problem? Patient: My left knee has been causing me all sorts of problems. It hurts everytime I stand up or sit down, and I have some trouble walking. Doctor: Well, of course! You're x years old! Knee problems are common at that age. Patient: My left knee is the same age, but it doesn't hurt! Doesn't that seem strange? Doctor: Well, when did you first notice the pain? Patient: It started about a week after my birthday, in September... Doctor: I see. And did you change your routine at all around that time? Patient: I started going to the gym to jog about four times a week and lifting some light weights. My daughter got me a membership for my birthday. Doctor: Well, there's your problem! You're too old to exercise. Don't go back to the gym for awhile. Patient: But what about my high blood pressure? Jogging helps keep that under control. Doctor: Try cutting back the intensity. You might be straining yourself somehow. Patient: Can you think of any books on fitness for older people? Or maybe a specialist I could talk to about it? Doctor: Sure! Dr. Erikson will be in today. He's a fine geriatrician. He'll be able to shed some light on this problem. I'll make you an appointment with him for half an hour from now. In the meantime, take this notecard and go hang out at one of those places. Take a walk, see how you feel, talk with some people, and socialize a bit. It'll do you a world of good! Remember: return to the Waiting Room in 30 minutes. Have a good day! Doctor leaves		The player waiting in the exam room. The Player talking with the doctor.
A sample notecard given to the player at the end of the doctor's visit

Exploring Second Life as a Senior Citizen The player will then depart for one of the locations listed on the notecard. These will include a city-space and market, a night club, and a public beach. Each location will have have a few loosely defined tasks for the player to perform. The player may choose to visit any of these locations, or to visit more than one as they wait for their next coaching session. These tasks maximize the avatar's experience of aging in Second Life by drawing them out into the larger world.		The wheelchair will not allow the player up stairs.

The Player in Lucifer's Nightclub The Player dancing at Lucifer's Nightclub
The nightclubs in Second Life are packed with youthful avatars. The player will have an opportunity to see how this youth-centered environment treats the old, and connect their observations to age prejudices in the real world.		Not all avatars will have limited mobility, as is true in the real world. However, this will definitely give the player a sense of standing out due to their age.

The player sunbathing on Freebie Beach Freebie Beach contains a number of free items and accessories. The learner may not change their avatar, but they will see first hand how few skins, shapes, and accessories are geared towards older people. As with the night club, this youth-centered place will make the player feel slightly alienated from their environment, simulating a very real psychological effect of aging.
The player in Morocco talking with monkeys. The player at the Moroccan market.
		At the Moroccan market, the player will have the opportunity to interact with other individuals from different cultures. Francophones, Arabic speakers, and English speakers frequent this location and may give the player a better feel for how people across the world approach aging.

Returning to the Doctor's Office When the player returns to the doctor's office for their appointment, the coach will give them access to a new avatar that represents their role in the health care community. In this example, the player takes on the role of Dr. Erickson, the resident geriatrician. In this role playing scenario, the player will diagnose the patient while refraining from ageist behavior. The player will not receive any notecards or advance warning about the content of this scenario. They must use their best judgment to complete the exercise.		The player performs diagnoses problems with an elderly avatar, played by the coach.
Sample Script 2 Doctor: What seems to be the trouble? Patient: Well, I don't think its anything, but my husband has noticed that I'm going 'number one' more often these days. He says I go ten or twelve times a day, by his count. I've also been having some trouble seeing things. It's like everything is a little dark these days. Doctor: I see. Are you currently taking any medication? Patient: Well, I have two pills for my heart, and one for my arthritis. I don't really know their names or doses. Doctor: That's OK. We'll contact your previous doctor for that information. I think we should run a few blood tests to see if those can shine some light on your problem. I'll call the nurse in and she'll arrange the tests and draw the samples. She'll call you to make another appointment once we have the results of the tests. Patient: Thanks, Doctor Erickson. After this final dialogue, the player and coach will meet in the Waiting Room for a final recap of the player's performance. The coach will ask the player questions that will help them uncover any subtle ageist behavior or attitudes. They will then talk about the most common mistakes made with real-life older people. As a wrap-up, the coach will send the player an email containing links to aging related websites and books that will help support the player's anti-ageism training in the real world.

References Keller, J. (1999). Motivation in Cyber Learning Environments. Educational Technology International, v.1, n.1, pp. 7 - 30. Novak, M. (2005). Issues in Aging. New York: Allyn & Bacon. Thompson, J. (2007). Game Design Course. London: Quarto Publishing, Inc. pp. 62-63. Ageism in America Facts on Aging Quiz ARCS - Attention ARCS - Relevance ARCS - Confidence ARCS - Satisfaction Here's a link to our original wiki. It includes all the original, larger pictures and some pictures not in the website.