**Reflections about Learning Radiology inside the Multi-User Immersive Environment Second Life® during Confinement by Covid-19 †**

#### **Shaghayegh Ravaei \*, Juan M. Alonso-Martinez, Alberto Jimenez-Zayas and Francisco Sendra-Portero \***

Department of Radiology and Physical Medicine, School of Medicine, University of Málaga, 29071 Málaga, Spain; martin17alonso@gmail.com (J.M.A.-M.); albertojzayas@hotmail.es (A.J.-Z.)

**\*** Correspondence: shaghayegh.ravaei@gmail.com (S.R.); sendra@uma.es (F.S.-P.)

† Presented at the 3rd XoveTIC Conference, A Coruña, Spain, 8–9 October 2020.

Published: 19 August 2020

**Abstract:** The multi-user immersive virtual environment Second Life® has been used to teach radiology to third-year medical students during confinement due to the current Covid-19 pandemic. In general, the students, who are digital natives nowadays, have found it easy to adapt to the use of the 3D platform. Although there have been some technical limitations, both students and teachers involved have rated the use of Second Life® during the confinement very highly.

**Keywords:** online learning; virtual worlds; medical students; undergraduate education; radiology

#### **1. Introduction**

The state of alarm decreed in Spain by Covid-19 determined that, as of 14 March 2020, the faceto-face activities at the university would be suspended and replaced by online training. In the Radiology core course of the third year of medical studies at the University of Malaga, the virtual immersive multi-user environment, Second Life®, has been used. The aim of this work is to reflect on the advantages, disadvantages and other peculiarities of this virtual platform in this exceptional situation.

#### **2. Material and Methods**

The following activities have been performed in Second Life® during the confinement: (i) 72 twohour seminars for groups of 23–25 people, keeping the planned schedule and involving 8 teachers; (ii) 9 one-hour conferences with guest teachers; (iii) a virtual learning game, during 6 weeks, competing with students from other universities; (iv) an option to take the final oral practical exam. Several surveys have been performed with students and teachers about the ease of access to Second Life®, the cognitive load that they had to handle within the 3D environment or about the perception of the different activities carried out.

#### **3. Results**

There were 220 students enrolled in the Radiology course, 176 first-time students and 44 repeating students. The seminars were held in Second Life® by 157 students (71.4%), with 48 sporadic absences (0.4%) for various reasons. Forty-six first-time students (26.1%) voluntarily participated in the inter-university game. Fifty-four students attended the conferences given by guest professors. Sixteen students accepted to take the online oral exam in Second Life®. Five of the eight teachers of the subject and eight of the nine invited speakers had never used this platform as a teaching tool. Eleven percent of students stated that their access to Second Life® was difficult or impossible. Table 1 and Figure 1 show some results from a survey about the seminars held in Second Life®.



1 Sample: 84 out of 90 students answered these items. Data are mean ± standard deviation of scoring from 0 to 10 points.

**Figure 1.** Bar chart of the percentages of answers in a 5-point Likert scale related to questions about radiology seminars held in Second Life®. Sample: 90 students (41% enrolled in the course).

#### **4. Discussion**

Second Life® is not a new educational resource in the subject of Radiology, as it has been used since the 2011–12 academic year without interruption [1–5]. This has allowed the virtual environment to be prepared for use in this critical situation. In fact, both the conferences with guest professors and the inter-university competitive game were activities scheduled before the state of alarm. These projects and the 3D platform were explained to all students at the beginning of the course, on February 14th. A month later, students suddenly found themselves in a situation of uncertainty, confined to their homes, not knowing how their training would be resolved. The practical seminars, which are essential in this subject, allowed for synchronous contact with their teachers, maintaining the scheduled calendar and providing a situation of linkage and continuity with the academic activity. The seminars with guest professors and the competitive game have provided complementary training options. The evaluation, which was usually done orally, has allowed Second Life® to be offered as a synchronous examination platform.

#### *4.1. Benefits of Using Second Life to Teach during the Confination*

x Ease of adaptation for current medical students (Generation Z) to interactive 3D platforms [6] facilitates the willingness to use Second Life®.

#### *Proceedings* **2020**, *54*, 9


#### *4.2. Drawbacks*


Although there have been some technical limitations, both students and teachers involved have rated the use of Second Life® during the confinement very highly.

**Author Contributions:** Conceptualization, S.R.; J.M.A.-M.; A.J.-Z. and F.S.-P.; methodology, S.R. and F.S.-P.; software, A.J.-Z. and F.S.-P.; validation, S.R.; J.M.A.-M.; A.J.-Z. and F.S.-P.; formal analysis, S.R. and F.S.-P.; investigation, S.R.; J.M.A.-M.; A.J.-Z. and F.S.-P.; resources, F.S.-P.; data curation, S.R.; J.M.A.-M.; A.J.-Z. and F.S.-P.; writing—original draft preparation, S.R. and F.S.-P.; writing—review and editing, S.R.; J.M.A.-M.; A.J.- Z. and F.S.-P.; visualization, S.R.; J.M.A.-M.; A.J.-Z. and F.S.-P.; supervision, F.S.-P.; project administration, F.S.- P.; funding acquisition, F.S.-P. All authors have read and agreed to the published version of the manuscript.

**Funding:** The Innovative Education Project #PIE19-217 of the University of Málaga partially supported this study. The maintenance cost of the Medical Master Island during this project was supported by the Andalusian Society of Radiology (Asociación de Radiólogos del Sur), a subsidiary of the Spanish Society of Medical Radiology (SERAM).

**Acknowledgments:** We want to express our appreciation to all the students and teachers who, due to the special circumstances of the pandemic, have agreed to participate in this teaching experience.

**Conflicts of Interest:** The authors declare no conflict of interest.

#### **References**


© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

*Proceedings*
