Maritime City is an innovative tool developed by Patricia Higgins (memory nurse specialist Oxleas NHS FT) and Avril Hocking, Jan Webb and Karen Cleaver from the University of Greenwich.
Maritime City draws on ‘serious’ gaming technology to provide an interactive approach to training and simulation. The tool provides a substitute for role-play, but being computer based, allows students to re-visit and reappraise their decision-making, providing a novel and safe way to visit, reflect on and revisit decision-making. To date two scenarios have been developed and fully completed, with a further three scenarios in development. The adult safeguarding tool currently comprises one scenario, involving an elderly couple who are clearly struggling to retain independence living at home due to onset of dementia. The completed child safeguarding scenario involves a home visit by a social worker following concerns raised about the welfare of the children living at the address. Subsequent scenarios involve a home visit by police, a visit to a paediatric emergency department and finally a child protection conference (scenario 4).
The child safeguarding scenarios were developed by experts in the field and drew on our post-graduate (MA) child safeguarding students’ professional practice experiences. The adult safeguarding scenario was developed with support from a number of individuals including a carer, representatives from the Alzheimer’s Society Bromley, Mind Care, and the Memory Clinic at Oxleas NHS FT. The purpose of the tools is to enable students and practitioners to reflect on their own values, as well as providing a medium for assessing and identifying risk. For example, by challenging assumptions about older people with dementia and engaging practitioners undertaking training through this medium, the tool enables a more reflective approach to engagement with older people with dementia, thereby improving the care this vulnerable group receives.
The tools have been piloted with a range of students, including those undertaking the Faculty’s Post Graduate Safeguarding Programmes, District Nursing and pre-registration Learning Disability Nursing (LDN) programmes. Feedback from students has been overwhelmingly positive. District Nurses reported that the dementia scenario:
“Identified the importance of building a good rapport with individuals and the need for good social interaction”.
“Enabled us to put ourselves in the carer’s position”, and helped us recognise the different communication styles employed by the district nurse, as the scene unfolded”
“Enabled us to reflect on the unconscious decisions that can be made during visits”.
Feedback from LDN students confirmed that the game raised their awareness about how to pose questions and how much information they could possibly obtain during a home visit. It also raised cultural awareness, the importance of building a good rapport with individuals, and the impact of dementia as they felt the scene was ‘real’. A student commented that:
“The game had broadened my knowledge with regards to home visits, and the possible signs and symptoms of dementia”.
Likewise, students using the child safeguarding tool reported that the game provides realism and an accurate interpretation of the real world as it allows participants to interact dynamically within the scenario. Feedback identified that whilst the ‘avatars’ could be more human looking, the plot and how they were presented was accurate, and was in summary a useful tool to enable critical reflection on practice.