Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment – Web-SP

BACKGROUND: The Web-based Simulation of Patients (Web-SP) project was initiated in order to facilitate the use of realistic and interactive virtual patients (VP) in medicine and healthcare education. Web-SP focuses on moving beyond the technology savvy teachers, when integrating simulation-based education into health sciences curricula, by making the creation and use of virtual patients easier. The project strives to provide a common generic platform for design/creation, management, evaluation and sharing of web-based virtual patients. The aim of this study was to evaluate if it was possible to develop a web-based virtual patient case simulation environment where the entire case authoring process might be handled by teachers and which would be flexible enough to be used in different healthcare disciplines. RESULTS: The Web-SP system was constructed to support easy authoring, management and presentation of virtual patient cases. The case authoring environment was found to facilitate for teachers to create full-fledged patient cases without the assistance of computer specialists. Web-SP was successfully implemented at several universities by taking into account key factors such as cost, access, security, scalability and flexibility. Pilot evaluations in medical, dentistry and pharmacy courses shows that students regarded Web-SP as easy to use, engaging and to be of educational value. Cases adapted for all three disciplines were judged to be of significant educational value by the course leaders. CONCLUSION: The Web-SP system seems to fulfil the aim of providing a common generic platform for creation, management and evaluation of web-based virtual patient cases. The responses regarding the authoring environment indicated that the system might be user-friendly enough to appeal to a majority of the academic staff. In terms of implementation strengths, Web-SP seems to fulfil most needs from course directors and teachers from various educational institutions and disciplines. The system is currently in use or under implementation in several healthcare disciplines at more than ten universities worldwide. Future aims include structuring the exchange of cases between teachers and academic institutions by building a VP library function. We intend to follow up the positive results presented in this paper with other studies looking at the learning outcomes, critical thinking and patient management. Studying the potential of Web-SP as an assessment tool will also be performed. More information about Web-SP

Virtual Reality Simulation: An Innovative Teaching Tool for Dietetics Experiential Education

This paper investigates the role of virtual reality and web technologies in the field of dietetics education. Within this frame, special emphasis is given on the building of web-based virtual learning environments so as to successfully fulfill their educational objectives. In particular, basic pedagogical methods are studied, focusing mainly on the efficient preparation, approach and presentation of learning content, and specific designing rules are presented considering the hypermedia, virtual and educational nature of this kind of applications. The paper also aims to highlight the educational benefits arising from the use of virtual reality technology in dietetics and study the emerging area of web-based dietetic simulations. Virtual reality simulation allows the visualization of data in three dimensions and provides interactive functionalities that reinforce the feeling of immersion into a computer-generated virtual world. Finally, the innovative virtual reality environment for dietetics education pedagogy and development is demonstrated

Design and Development of Virtual Patients for Healthcare Education: State of the Art and Research

The digital transformation of healthcare and the COVID-19 pandemic have accelerated research and deployment of virtual patients (VP), that is, interactive computer simulations used in healthcare education to train students on clinical processes. To help researchers and practitioners understand the state of the art in VP development, we conducted a systematic literature review of 48 papers. Our analysis focused on educational level, medical specialty, competencies, technologies, technical format, and operating systems and tools. We found that VPs are primarily used in the medical field and student education as interactive patient scenarios based on multimedia system technology. VP authoring systems were identified as the primary tool for developing primary clinical reasoning skills. Based on our findings, we suggest implications for medical education research and practice

Virtual patients design and its effect on clinical reasoning and student experience : a protocol for a randomised factorial multi-centre study

Background Virtual Patients (VPs) are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent) and structured clinical reasoning feedback (present or absent). Methods/Design This is a multi-centre randomised 2x2 factorial design study evaluating two independent variables of VP design, branching (present or absent), and structured clinical reasoning feedback (present or absent).The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded. In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for both primary outcomes

Evaluation of Evidence-Based Practices in Online Learning: A Meta-Analysis and Review of Online Learning Studies

A systematic search of the research literature from 1996 through July 2008 identified more than a thousand empirical studies of online learning. Analysts screened these studies to find those that (a) contrasted an online to a face-to-face condition, (b) measured student learning outcomes, (c) used a rigorous research design, and (d) provided adequate information to calculate an effect size. As a result of this screening, 51 independent effects were identified that could be subjected to meta-analysis. The meta-analysis found that, on average, students in online learning conditions performed better than those receiving face-to-face instruction. The difference between student outcomes for online and face-to-face classes—measured as the difference between treatment and control means, divided by the pooled standard deviation—was larger in those studies contrasting conditions that blended elements of online and face-to-face instruction with conditions taught entirely face-to-face. Analysts noted that these blended conditions often included additional learning time and instructional elements not received by students in control conditions. This finding suggests that the positive effects associated with blended learning should not be attributed to the media, per se. An unexpected finding was the small number of rigorous published studies contrasting online and face-to-face learning conditions for K–12 students. In light of this small corpus, caution is required in generalizing to the K–12 population because the results are derived for the most part from studies in other settings (e.g., medical training, higher education)

Design and Development of Simulation-based Instruction on Meaningful Use and Interprofessionalism Core Competencies in a Healthcare Team-based Learning Environment

Policymakers and electronic health records (EHR) experts agree that healthcare professionals lack proficiency in meaningful use of EHRs. This competency gap can result in increased medical errors. It is essential for health professions graduates to acquire skill sets that are adaptable to any electronic health information technologies including the EHRs to facilitate work process and information access. Simulation as an instructional method to create transformative learning experiences has shown promise in the medical profession. In simulations, learners are able to engage in real-life scenarios and practice their cognitive, affective, and psychomotor skills in a safe environment. The goal was to design and develop a simulation-based instructional module on meaningful use of EHR and interprofessional collaborative practice core competencies and evaluate students’ performance and satisfaction under an inter professional teambased setting. Using a design and development research approach, a simulation-based instructional module on meaningful use of EHR and interprofessional core competencies was designed. An internal validation of the module was conducted with an expert panel of medical professionals and instructional designers. Following validation, the instructional module was developed and pilot tested with a group of 21 second- and third year health professions students in medicine, pharmacy, and nursing in an interprofessional team-based learning environment. Students’ performance on meaningful use and interprofessionalism core competencies and their satisfaction during the simulation-based training were evaluated. The results confirmed that the students properly implemented the core competencies based on their performances during the immersive virtual patient encounter in the 3D virtual world. The analysis also showed how the students’ satisfaction was met as a reaction to the guided experiential learning’s (GEL) simulation-based instructional intervention, and in some instances were not sufficiently met. The analysis of the students’ testimonials further confirmed their overall satisfaction with the immersive simulation experience.The findings, based on the feedback from the students and faculty in this pilot implementation, highlighted simulation-based interactive gaming instruction and the hands-on experience in a 3D virtual world guided by GEL as an effective and engaging way to train healthcare professionals in the preparation to deliver care in a safe and effective manner under interprofessional team-based settings for better patient safety and outcome