the role of virtual patients in the competence continuum

8/14/2019 The Role of Virtual Patients in the Competence Continuum

1/26

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)


2/26

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

10 oktober 2012Nabil Zary - The Role of VPs in the Competence Continuun 2


3/26

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.



4/26

Examples

Simulates a certain part of a process or a case



5/26

Examples

Simulates the whole encounter



6/26

Examples



7/26

Implementation Top 4

CASUS

Campus

Web-SP

Open

Labyrinth


8/26

Part 2

Creating the foundation forhigh quality research



9/26

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.



10/26

The quadrant


Pasteur's Quadrant: Basic Science and Technological Innovation, Stokes 1997


11/26

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)



12/26

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)



13/26

The same VP in different systems


14/26

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



15/26

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.

10 oktober 2012Nabil Zary 15


16/26

The quadrant impact of the foundation

efforts



17/26

Part 3

Research Agenda



18/26

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?



19/26

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



20/26

Importing a branched VP to linear VP system

Node

Node Node

Node NodeNode

Node

Node

Node

Node

Node

Node

Branched VP Linear VP

Node


21/26

PhysicalExam

InterviewItem

Diagnosis

Therapy

"Structured" system

Text Element

"Non-Structured" system

Text Element

Text Element

Text Element

???

Importing and exporting from "structured" to "unstructured"


22/26

Part 4

Dissemination



23/26


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)


24/26

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"



25/26

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?



26/26

Thank you for listening!

Dont hesitate to contact us if you have questions, ideas for

research projects, etc

[email protected]

http://ki.se/vp-lab

mailto:[email protected]://ki.se/vp-labhttp://ki.se/vp-labhttp://ki.se/vp-labhttp://ki.se/vp-labmailto:[email protected]:[email protected]

the role of virtual patients in the competence continuum

Documents