Table 3

‘Top ten’ themes - positive (coloured) and negative - generated, voted, ranked and ordered by the nominal group

RankThemes generatedDomainaTotal scoreParticipants rating
theme in ‘top ten’ n
1Lack of avatar realism, especially limited/stereotyped body language,
impeded psychiatric assessment and group interaction, both of which
depend on non-verbal communication
Sim577
2Conducting the role play in Second Life reduced stress/worry, which eased
engagement
Affect355
3Second Life could facilitate distance learning - students and (expert)
teachers can access it from different geographical locations
Utility324
4Audio delay on Second Life resulted in participants talking over each otherOp234
4Second Life increases potential to act disinhibited (e.g. changing avatar’s
appearance, walking around), which distracts from learning
Sim234
6Role-playing on Second Life does not add value compared with existing
learning opportunities
Limitation192
7Second Life provided a useful conceptual barrier between teacher and
student, which facilitated role play but still allowed teacher to effectively
highlight clinical aspects
Sim246
8Second Life would allow teaching to be flexible in terms of space (allows for
a private/convenient location; does not require booking rooms) and time
(can be done at any hour)
Utility215
9Role-playing in Second Life was interactive and more fun than role-playing
in real life
Affect214
10Compared with interacting in real life, it was harder to maintain
concentration throughout the session on Second Life (e.g. as less varied
non-verbal communication)
Sim163
10Conducting the session in the same physical room meant you could hear
people in both real life and in Second Life; the audio delay was distracting
Sim162
  • Op, operational issues; Sim, aspects of simulation.

  • a. Domains were defined retrospectively by the subsequent thematic analysis.