the role of virtual patients in the competence continuum
TRANSCRIPT
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The Role of Virtual Patients in theContinuum of CompetenceNabil Zary
Assistant Professor in Medical Simulation with focus on
Virtual Patient Research
Assistant Director of the VP-Lab at LIME
Centre for Medical Education (CME)
Health Informatics Centre (HIC)
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Outline for my presentation
Introduction to Virtual Patients
Definition, Examples, The top 4
Creating the foundation for high quality research
The dilemma, Typology, BEME guide, Standards, Consolidation
efforts
Research agenda
Research questions
Dissemination Krakow conference, Special issue on VP
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Definition
Specific type of computer program that simulates real-life
clinical scenarios; learners emulate the roles of health care
providers to obtain a history, conduct a physical exam, andmake diagnostic and therapeutic decisions
Ellaway R, Poulton T, Fors U, McGee JB, Albright S. Building a virtual patient commons.
Med Teach 2008;30:1704.
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Examples
Simulates a certain part of a process or a case
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Examples
Simulates the whole encounter
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Examples
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Implementation Top 4
CASUS
Campus
Web-SP
Open
Labyrinth
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Part 2
Creating the foundation forhigh quality research
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The dilemma the justification approach
e-learning in academic curricula is constantly taking on. This trend isparticularly noticeable in medicine, where various specialized forms of computer
aided learning emerge. Among them are virtual patients - computer simulations
of real-life clinical scenarios for the purpose of education in medicine, nursing or
dentistry. Representing logically consistent clinical cases they offer effective
means of facilitating problem-based sessions on variouslearning stages (pre-clinical, clinical years, CME).
Virtual patients grow in importance due to the decreased time spend bypatients in hospitals, time constraints of clinical teachers ordifficulties inpresenting rare diseases. It is very likely that one day training on virtual patients
will become for medical students as natural as flight simulators arefor pilots.
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The quadrant
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Pasteur's Quadrant: Basic Science and Technological Innovation, Stokes 1997
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Virtual Patient Typology
19 factors were synthesized around 4 categories
General
Title, description, language, identifier, provenance, typical study
time
EducationalEducational level, educational modes, coverage, objectives
Instructional design
Path type, user modality, media use, narrative use, interactivity use,
feedback use
Technical
Originating system, format, integration and dependence
Sren Huwendiek, Bas deLeng, Nabil Zary, Martin R. Fischer, Jorge G. Ruiz, Rachel Ellaway
Towards a Typology of Virtual Patients, Medical Teacher (Accepted)
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Technical Standards
Enabling Interoperability, Accessibility and Reusability of Virtual Patients across Europe -- Design and ImplementationN Zary, I Hege, J Heid, L Woodham, J Donkers, AA Kononowicz
Stud Health Technol Inform (Accepted)
Validation of Strategies to Test for Interoperability of Virtual Patients
A Kononowicz, J Heid, J Donkers, I Hege, L Woodham, N Zary
Stud Health Technol Inform (Accepted)
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The same VP in different systems
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BEME guide evidence
1. What features of virtual patients promote effective learning in medical trainees?
How do virtual patients compare in effectiveness to other methods: lectures, genericcomputer-assisted instruction?
What outcomes have been used to measure the effectiveness of virtual patients?
What formats of virtual patients in terms of case structure and multimedia
2. What features of virtual patients promote effective assessment (or something like
that)?
To what extent are virtual patients valid, reliable and feasible methods of assessingspecific learning outcomes in medical education?
http://www.bemecollaboration.org/beme/pages/reviews/ruiz.html
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Research community focus
Cook D.A et al, Virtual patients: a critical literature review and proposed next steps.
Med Educ. 2009 Apr;43(4):303-11.
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The quadrant impact of the foundation
efforts
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Part 3
Research Agenda
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Research questions
How should VPs be designed and presented?
Feedback, repetitive practice, progressive difficulty, clinical
variation
Outcome: learning/cost effective VPs
How should VPs be integrated with other educational activities?
How can VPs be used in assessment?
Who will develop and maintain VPs?
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eViP project
eViP = Project about electronic Virtual Patients
3 year project, 9 partners and co-funded by the European Union
Main outcome
Create a bank of repurposed and enriched multilingual and
multicultural virtual patients and share them
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Importing a branched VP to linear VP system
Node
Node Node
Node NodeNode
Node
Node
Node
Node
Node
Node
Branched VP Linear VP
Node
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PhysicalExam
InterviewItem
Diagnosis
Therapy
"Structured" system
Text Element
"Non-Structured" system
Text Element
Text Element
Text Element
???
Importing and exporting from "structured" to "unstructured"
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Part 4
Dissemination
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International Conference on Virtual Patients
Krakow, Poland, June 5-6, 2009
The first conference focusing on Virtual Patients (http://icvp.eu)
12 accepted short communications (KI)
Published in the Journal of Bio-Algorithms & Med-Systems
(http://bit.ly/ICVP09)
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Hammarsten A, Edelbring S, Fors U, Zary N.
"Virtual Patient Players and Authoring tools different players, different characteristics."
Vassiliou D, Arnrup K, Derolf A, Edelbring S, Evans M, Westerlund E, Spaak J, Henriksson P,
Mindus S, Skld M, Sylvn C, Sejersen R, Fors U, Zary N, Sjblom E, Brostrm O.
"Integration of Theoretical Knowledge and Clinical Practice Using Virtual Patients"
Edelbring S, Zary N.
Teachers expectations and concerns about introducing Virtual Patients in a clinical course
Zary N, Hege I, Heid J, Kononowicz A, Woodham L, Donkers J.
"Enabling Interoperability, Accessibility and Reusability of Virtual Patients Findings from theeViP project"
Courteille O, Karlgren K.
"Effects of interface modality on a virtual patient learning experience
Muntean V, Fors U, Zary N, Calinici T.
"Students Language Proficiency and Cross-Cultural Use of Virtual Patients"
Sejersen R, Zary N.
"The role of a Learning technologist when implementing virtual patients in a health sciencecurriculum."
Georg C, Zary N.
"Virtual Patients as an Innovative Learning Activity in Distance Nursing Education"
Lennstrm I, Georg C, Zary N.
"Authoring Virtual Patients for Medicine and Nursing Curricula Similarities and Differences"
Johnson G, Zary N.
"Implementation of Virtual Patients in a Dental School A Proposed Model to Move beyond theEarly Adopters"
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Medical Teacher Special Issue on Virtual
Patients The replacement of 'paper' cases by interactive online Virtual Patients in Problem-Based
Learning (PBL)
Towards a Typology of Virtual Patients
Practica Continua: connecting and combining simulation modalities for integrated teaching,
learning and assessment Cross-Cultural Use and Development of Virtual Patients
Virtual Patients in Virtual Worlds
The Role of Intellectual Property in Virtual Patient Creation, Repurposing and Sharing
Improving Assessment with Virtual Patients
The Use of Virtual Patients to Assess the Clinical Skills and Reasoning of MedicalStudents: Initial Insights on Student Acceptance
Creation of Virtual Patients from CT Images of Cadavers to Enhance Integration of Clinical
and Basic Science Student Learning in Anatomy
Online Virtual Patients - a driver for change in Medical and Healthcare Professional
Education in developing countries?
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Thank you for listening!
Dont hesitate to contact us if you have questions, ideas for
research projects, etc
http://ki.se/vp-lab
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mailto:[email protected]://ki.se/vp-labhttp://ki.se/vp-labhttp://ki.se/vp-labhttp://ki.se/vp-labmailto:[email protected]:[email protected]