Collaborative Techniques to Design and Market 3D Virtual Healthcare Simulations

1. Collaborative Techniques to Design and Market 3D Virtual Healthcare Simulations George Mason University Wednesday July 11, 2018 DENNIS GLENN, MFA Adjunct Professor, DePaul University Graduate School for New Learning https://www.seriousplay-ny.com/

2. Prescribing clinicians find managing chronic pain challenging. Opioid use is associated with serious risks, including opioid use disorder and overdose. The NYT Reported on January 17, 2017: ‘Public health officials have called the current opioid epidemic the worst drug crisis in American history, killing more than 33,000 people in 2015. Overdose deaths were nearly equal to the number of deaths from car crashes. In 2015, for the first time, deaths from heroin alone surpassed gun homicides. https://www.nytimes.com/2017/01/06/us/opioid-crisis-epidemic.html Dennis Glenn LLC has partnered with SimTabs Inc. to design, create and market an 3D Virtual Opioid training and assessment simulation with a virtual patient intended to improve treatment of opioids for chronic pain, improve safety and effectiveness of pain treatment, and reduce risks associated with long-term opioid therapy. The CDC posits a list of 12 recommendations that need to be transferred to training and assessment simulations. Our program will create interactive modules that address these recommendations. Our interactive simulation with a virtual patient is intended for primary care clinicians (eg, nurse anesthetists, family physicians, internists, nurse practitioners, and physician assistants) who are prescribing opioids and/or treating patients with chronic pain (ie, pain conditions that typically last >3 months or past the time of normal tissue healing) in outpatient settings. This learning and assessment simulation is intended to apply to patients 18 years and older with chronic pain outside of active cancer treatment, palliative care, and end-of-life care. Our Opioid Simulation training has been released to over 50,000 members of the American Association of Nurse Anesthetists beginning March 1, 2018. Copyright Dennis Glenn 2018 2

3. What is the question on everyone’s mind? Copyright Dennis Glenn 2018 3

4. Title of session: Collaborative Techniques to Design and Market 3D Virtual Healthcare Simulations Virtual 3D simulations are difficult enough to design and create by a single vendor. The advent of virtual and augmented reality now requires the expertise of advanced skills that most institutions find expensive and extremely difficult to implement. This session will address the integration of Virtual Skills outside vendors to successfully and profitably provide the latest tools and techniques to your project. Learning Objectives 1. Finding project-based virtual skills partners 2. Creating a business model that compliments each partner 3. Management techniques to ensure project cohesiveness Copyright Dennis Glenn 2018 4

5. Organizations do what they were built to do. An organization is fundamentally comprised of a value proposition, resources, processes, and priorities (dictated by its revenue formula) that defines its capabilities, but also its disabilities—what it cannot do and prioritize. https://www.christenseninstitute.org/blog/stealing-a-page-from-disruption-to-transform-accreditation/?utm_source=Ed%20Digest&utm_medium=email&utm_campaign=6%2F15%2F18 https://hbr.org/2015/12/what-is-disruptive-innovation Copyright Dennis Glenn 2018 5

6. Most every innovation—disruptive or not—begins life as a small-scale experiment. Disrupters tend to focus on getting the business model, rather than merely the product, just right. Another intriguing anomaly was the identification of industries that have resisted the forces of disruption, at least until very recently. Higher education in the United States is one of these. Over the years—indeed, over more than 100 years—new kinds of institutions with different initial charters have been created to address the needs of various population segments, including non-consumers. Land-grant universities, teachers’ colleges, two-year colleges, and so on were initially launched to serve those for whom a traditional four-year liberal arts education was out of reach or unnecessary. Many of these new entrants strived to improve over time, compelled by analogues of the pursuit of profitability: a desire for growth, prestige, and the capacity to do greater good. Thus they made costly investments in research, dormitories, athletic facilities, faculty, and so on, seeking to emulate more-elite institutions. Doing so has increased their level of performance in some ways—they can provide richer learning and living environments for students, for example. Yet the relative standing of higher-education institutions remains largely unchanged: With few exceptions, the top 20 are still the top 20, and the next 50 are still in that second tier, decade after decade. Because both incumbents and newcomers are seemingly following the same game plan, it is perhaps no surprise that incumbents are able to maintain their positions. What has been missing—until recently—is experimentation with new models that successfully appeal to today’s non-consumers of higher education. The question now is whether there is a novel technology or business model that allows new entrants to move upmarket without emulating the incumbents’ high costs—that is, to follow a disruptive path. The answer seems to be yes, and the enabling innovation is online learning, which is becoming broadly available. Real tuition for online courses is falling, and accessibility and quality are improving. Innovators are making inroads into the mainstream market at a stunning pace. Will online education disrupt the incumbents’ model? And if so, when? In other words, will online education’s trajectory of improvement intersect with the needs of the mainstream market? We’ve come to realize that the steepness of any disruptive trajectory is a function of how quickly the enabling technology improves. https://hbr.org/2015/12/what-is-disruptive-innovation Copyright Dennis Glenn 2018 6

7. Where do we start: A common agenda: A common understanding of the problem, a shared vision for success, and a shared strategy for change. Shared measurement: Agreement on the ways success will be measured and reported, with a short list of common indicators identified and used for learning and improvement. Mutually reinforcing activities: A diverse set of stakeholders, typically across sectors, which coordinate a set of differentiated activities through a mutually reinforcing plan of action. Continuous communication: All players engage in frequent and structured open communication to build trust, ensure mutual objectives, and create common motivation. Backbone support: An independent, funded staff dedicated to the initiative provides ongoing support by guiding the initiative’s vision and strategy, supporting aligned activities, establishing shared measurement practices, building public will, advancing policy, and mobilizing resources. Copyright Dennis Glenn 2018 7

8. 1. A common agenda: A common understanding of the problem, a shared vision for success, and a shared strategy for change. What about the people who are going to benefit? The solution is about understanding what a community wants, not assuming what it needs. Working with communities, identifying their needs with their input, and listening to them. Of note, partnerships often involve more than two organizations, and there are often networks and multiple pathways through which contributions are made. In addition to public–private partnerships, public–public partnerships between government and academic institutions are common, as well as private–private partnerships, such as those between NGOs and corporations. From competitors as enemies to competitors as potential collaborators. Early within the partnership formation stage, emphasize the importance of clarity of expectations and manageable interest of the partnership, and underscore the need for clarity of goals and shared objectives among the partners. As the partnership is being formed, be especially committed on the importance of defining roles for the all the partners, including responsibilities. Copyright Dennis Glenn 2018 8

9. Partnerships need shared goals and objectives as well as shared risks within the partnership, and the partnership needs a structure that includes joint operations decision making and interdependent resources and approaches. In developing a partnership’s governance model, are different stakeholders’ views being held? How will goals be operationalized? How will disagreements be managed? How will decisions be made? Create mechanisms that allow partnerships to course correct during their operations. Partnerships, often struggle to garner commitments to continue and scale beyond their initial phase. The definition of a sustainable partnership can vary, and can include a successful dissolution of the partnership or an evolution into something else rather than sustaining the partnership itself. Emphasize the importance of developing evaluation and measurement questions and mechanisms at the beginning of the partnership rather than waiting until the closure or renewal stage. Copyright Dennis Glenn 2018 9

10. Principles behind the Agile Manifesto We follow these principles: Our highest priority is to satisfy the customer through early and continuous delivery of valuable software. Welcome changing requirements, even late in development. Agile processes harness change for the customer's competitive advantage. Deliver working software frequently, from a couple of weeks to a couple of months, with a preference to the shorter timescale. Business people and developers must work together daily throughout the project. Build projects around motivated individuals. Give them the environment and support they need, and trust them to get the job done. The most efficient and effective method of conveying information to and within a development team is face-to-face conversation. Working software is the primary measure of progress. Agile processes promote sustainable development. The sponsors, developers, and users should be able to maintain a constant pace indefinitely. Continuous attention to technical excellence and good design enhances agility. Simplicity--the art of maximizing the amount of work not done--is essential. The best architectures, requirements, and designs emerge from self-organizing teams. At regular intervals, the team reflects on how to become more effective, then tunes and adjusts its behavior accordingly. Copyright Dennis Glenn 2018 10

11. The fundamentals of scrum The organization forms and empowers a small team, usually three to nine people, most of whom are assigned full-time. The team is cross-functional and includes all the skills necessary to complete its tasks. It manages itself and is strictly accountable for every aspect of the work. https://hbr.org/2016/05/embracing-agile https://hbr.org/video/4846148015001/a-quick-introduction-to-agile-management Copyright Dennis Glenn 2018 11

12. The Business Model Canvas, a common template process for strategic management, can provide you with a plan to visualize new business ideas. By using the Business Model Canvas, you’ll create a starting point for all participants to visualize the project in its initial development process and allow for rapid changes and pivots. https://strategyzer.com/canvas/business-model-canvas Copyright Dennis Glenn 2018 12

13. Visualize the workflow: Limit work in progress (WIP): Manage and enhance the flow: Make process policies explicit: Continuously improve:      Scrum can be less flexible than Kanban. The timing revolves around sprints, with each sprint lasting two to four weeks. In each sprint, the team has specific roles and follows specific ceremonies. https://www.smartsheet.com/agile-vs-scrum-vs-waterfall-vs-kanban Copyright Dennis Glenn 2018 13

14. Kanban vs Scrum Differences and Similarities: Scrum vs Kanban https://www.smartsheet.com/agile-vs-scrum-vs-waterfall-vs-kanban Copyright Dennis Glenn 2018 14

15. http://www.inclusivedesigntoolkit.com/GS_overview/overview.htmlhttp://www.inclusivedesigntoolkit.com/GS_overview/overview.html Copyright Dennis Glenn 2018 15

16. What is the question on everyone’s mind? Copyright Dennis Glenn 2018 16

17.  How to introduce the Business Model Canvas to all project team members  How to define the value proposition to each customer segment  How to identify the elements of a minimum value product (MVP) to refine your ideas in the Business Model Canvas  How to define the customer relationship with your game, create the delivery channels, identify key partners and suppliers, and establish the cost structures  How to evaluate all of these elements and create a cohesive plan Copyright Dennis Glenn 2018 17

18. A common agenda: A common understanding of the problem, a shared vision for success, and a shared strategy for change. Copyright Dennis Glenn 2018 18

19. Shared measurement: Agreement on the ways success will be measured and reported, with a short list of common indicators identified and used for learning and improvement. https://tomec.lmunet.edu/files/assessment_and_feedback_for_residents_and_students.pdf In psychological terminology, performance relates to behavioral aspects of human activity. Performance has less to do the with cognitive processes and more with action, movement, speech, and gesture, though behaviors are also often used as proxy indicators of underlying attributes (personality) or abilities (cognitive reasoning). Given the strong tie to practice, performance discourse often invokes methods of simulation because it is cumbersome or unreasonable to performs the same behaviors repeatedly in clinical settings. http://www.cornellpress.cornell.edu/book/?GCOI=80140100474510 , p.25 Copyright Dennis Glenn 2018

20. Mutually reinforcing activities: A diverse set of stakeholders, typically across sectors, which coordinate a set of differentiated activities through a mutually reinforcing plan of action. Copyright Dennis Glenn 2018 20

21. Continuous communication: All players engage in frequent and structured open communication to build trust, ensure mutual objectives, and create common motivation. Copyright Dennis Glenn 2018 21

22. Backbone support: An independent, funded staff dedicated to the initiative provides ongoing support by guiding the initiative’s vision and strategy, supporting aligned activities, establishing shared measurement practices, building public will, advancing policy, and mobilizing resources. Copyright Dennis Glenn 2018 22

23. https://strategyzer.com/canvas/business-model-canvas Copyright Dennis Glenn 2018 23

24. https://www.slideshare.net/Chard99 Copyright Dennis Glenn 2018 24

25. Copyright Dennis Glenn 2018 25

26. DENNIS GLENN, MFA Adjunct Professor, DePaul University Graduate School for New Learning His instructional design and eLearning experience was honed when he joined Northwestern University as manager of the advanced media production studio, later being promoted to assistant dean for distributed education at the School of Communication. Dennis has designed interactive virtual patients for the medical industry that assess the cognitive decision-making abilities of surgeons, doctors, and nurses. He has taught at universities including Northwestern, Columbia College, Lake Forest Graduate School of Management, and DePaul’s Graduate School of New Learning, where he teaches in two domains: engaging social media, and mastery learning using serious games. Copyright Dennis Glenn 2018 26

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