Second-Phase Virtual Patient Literature Review

We are returning focus to case-based online content and how 'virtual patient' encounters may be developed and integrated into curriculum. A comprehensive review was undertaken a few years ago and revealed how a number of national and international medical schools were making use of various virtual patient authoring tools available at the time. The study brought a number of pedagogic principals to light and suggested a basis on which to develop a system. The full review can be accessed here.

However, the perceivable changes in the development of software and devices since then have given cause to re-evaluate how case-based online resources are being developed and delivered. For example, the advent of HTML5 and increasing use of smartphones may have dictated some degree of change in approach to development and deployment of content.

A new review will firstly conduct a review of widely used authoring systems and the gathering of information relating to the success of their use within various settings across different medical education institutions. If you have any thoughts or experience of the implementation of current clinical scenario-based study resources, then please do comment and share.

School of Medicine E-Learning Team

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Blogging has become an extremely popular electronic means to share knowledge and ideas in the form of a chronological journal. Read more about what blogs are in the previous article.

For those interested in setting up a blog for any subject specific purpose, here is a short list of what can be considered as a few of the top free blogging platforms available on the web;

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Virtual Patients at Cardiff; Literature Review Abstract

Purpose
After developing a small number of experimental Virtual Patients as optional components in the undergraduate curriculum and having received very favourable feedback from students about them the School now needs to undertake a more comprehensive review of virtual patients. The review intends to uncover the pedagogic underpinnings for effective virtual patient delivery and help CU staff identify areas of the medical curriculum where they would be best suited.

Method
A literature review of how both national and international medical teaching institutions have reported the effectiveness of their VP implementation, with particular focus on elements of the educational theories which have best enhanced the intended transferable learning aspects. The results were then used with the intention of helping staff identify areas of the undergraduate curriculum where VP’s would be best suited, and to what degree they can be integrated into core teaching.

Results
Results indicated a wide variance of the ways in which VPs were integrated into core medical teaching but with common theme of pedagogic design prinicpals which were key to the effectiveness of preparing the student for ‘real’ patient encounters; authenticity was seen as a key enabling factor for this.

Conclusion
It was found that the development of competence in clinical reasoning was a key target for any VP; authenticity of clinical events and patient dialogue facilitated by appropriate media being a dominant factor in preparing the student for real patient interaction, particularly in exercising social and communication skills. VP’s can be integrated as a focal subject for use within lectures or seminars, or used as a self-directed study aid, accessed externally to core teaching; the degree of its integration should be left to the discretion of the curriculum leads.

Virtual Patients at Cardiff; A Review

Virtual Patients are computer-based simulations of fictitious patients presenting with a complaint. The complaint is analysed by the learner and encourages thinking processes surrounding history taking, examination, diagnosis, treatment and discharge, without the obvious risks associated with a student treating a real patient case. The cases can focus on important common condition but can also be used to cover important conditions that it may be difficult for students to gain experience of, such as domestic abuse.

Main Points...

• Allows self-directed learning opportunities
• Narrative/didactic style of delivery for earlier years students
• Branched/exploratory style of learning for later years where knowledge can be applied
• Focus is on applying clinical knowledge to diagnostic thinking and management
• Cognitive realism - that is that the challenge posed to the learner seems real - is more important than visual realism - that is that real photos or video clips are used
• Communication/social skills for patient dialogue can be exercised Opportunity to familiarise with patient dialogue
• Continual focus on learning objectives is key for maintaining relevance
• Regular self-assessment opportunities allows the learner to evaluate their own progress
• Promotion of clinical reasoning is arguably the most important distinguishing feature of VP delivery and purpose

Read more about the comprehensive literature review conducted at Cardiff University School of Medicine...

Access the full literature review here.