The Use Of Virtual Patients In Medical School Curricula

The demonstration of patient-based cases using automated technology [virtual patients (VPs)] has been available to health science educators for a number of decades. Despite the promise of VPs as an easily accessible and moldable platform, their widespread acceptance and integration into medical curricula have been slow. Here, the authors review the technological underpinnings of VPs, summarize the literature regarding the use and limitations of VPs in the healthcare curriculum, describe novel possible applications of the technology, and propose possible directions for future work. © 2012 The American Physiological Society

Enhancing Learning Through Optimal Sequencing Of Web-Based And Manikin Simulators To Teach Shock Physiology In The Medical Curriculum

The Association of American Medical Colleges has encouraged educators to investigate proper linkage of simulation experiences with medical curricula. The authors aimed to determine if student knowledge and satisfaction differ between participation in web-based and manikin simulations for learning shock physiology and treatment and to determine if a specific training sequencing had a differential effect on learning. All 40 second-year medical students participated in a randomized, counterbalanced study with two interventions: group 1 (n = 20) participated in a web-based simulation followed by a manikin simulation and group 2 (n = 20) participated in reverse order. Knowledge and attitudes were documented. Mixed-model ANOVA indicated a significant main effect of time (F1,38 = 18.6, P \u3c 0.001, ηp2 = 0.33). Group 1 scored significantly higher on quiz 2 (81.5%) than on quiz 1 (74.3%, t19 = 3.9, P = 0.001), for an observed difference of 7.2% (95% confidence interval: 3.3, 11.0). Mean quiz scores of group 2 did not differ significantly (quiz 1: 77.0% and quiz 2: 79.7%). There was no significant main effect of group or a group by time interaction effect. Students rated the simulations as equally effective in teaching shock physiology (P = 0.88); however, the manikin simulation was regarded as more effective in teaching shock treatment (P \u3c 0.001). Most students (73.7%) preferred the manikin simulation. The two simulations may be of similar efficacy for educating students on the physiology of shock; however, the data suggest improved learning when web-based simulation precedes manikin use. This finding warrants further study. © 2011 The American Physiological Society

Enhancing learning through optimal sequencing of web-based and manikin simulators to teach shock physiology in the medical curriculum

The Association of American Medical Colleges has encouraged educators to investigate proper linkage of simulation experiences with medical curricula. The authors aimed to determine if student knowledge and satisfaction differ between participation in web-based and manikin simulations for learning shock physiology and treatment and to determine if a specific training sequencing had a differential effect on learning. All 40 second-year medical students participated in a randomized, counterbalanced study with two interventions: group 1 (n = 20) participated in a web-based simulation followed by a manikin simulation and group 2 (n = 20) participated in reverse order. Knowledge and attitudes were documented. Mixed-model ANOVA indicated a significant main effect of time (F1,38 = 18.6, P \u3c 0.001, ηp2 = 0.33). Group 1 scored significantly higher on quiz 2 (81.5%) than on quiz 1 (74.3%, t19 = 3.9, P = 0.001), for an observed difference of 7.2% (95% confidence interval: 3.3, 11.0). Mean quiz scores of group 2 did not differ significantly (quiz 1: 77.0% and quiz 2: 79.7%). There was no significant main effect of group or a group by time interaction effect. Students rated the simulations as equally effective in teaching shock physiology (P = 0.88); however, the manikin simulation was regarded as more effective in teaching shock treatment (P \u3c 0.001). Most students (73.7%) preferred the manikin simulation. The two simulations may be of similar efficacy for educating students on the physiology of shock; however, the data suggest improved learning when web-based simulation precedes manikin use. This finding warrants further study. © 2011 The American Physiological Society

Optimal Learning In A Virtual Patient Simulation Of Cranial Nerve Palsies: The Interaction Between Social Learning Context And Student Aptitude

Background: Simulation in medical education provides students with opportunities to practice interviews, examinations, and diagnosis formulation related to complex conditions without risks to patients. Aim: To examine differences between individual and team participation on learning outcomes and student perspectives through use of virtual patients (VPs) for teaching cranial nerve (CN) evaluation. Methods: Fifty-seven medical students were randomly assigned to complete simulation exercises either as individuals or as members of three-person teams. Students interviewed, examined, and diagnosed VPs with possible CN damage in the Neurological Exam Rehearsal Virtual Environment (NERVE). Knowledge of CN abnormalities was assessed pre-and post-simulation. Student perspectives of system usability were evaluated post-simulation. Results: An aptitude-treatment interaction (ATI) effect was detected; at pre-test scores ≤ 50%, students in teams scored higher (83%) at post-test than did students as individuals (62%, p = 0.02). Post-simulation, students in teams reported greater confidence in their ability to diagnose CN abnormalities than did students as individuals (p = 0.02; mean rating = 4.0/5.0 and 3.4/5.0, respectively). Conclusion: The ATI effect allows us to begin defining best practices for the integration of VP simulators into the medical curriculum. We are persuaded to implement future NERVE exercises with small teams of medical students. © 2013 Informa UK. Ltd All rights reserved

Virtual Patient Simulations And Optimal Social Learning Context: A Replication Of An Aptitude-Treatment Interaction Effect

Background: Virtual patients (VPs) offer valuable alternative encounters when live patients with rare conditions, such as cranial nerve (CN) palsies, are unavailable; however, little is known regarding simulation and optimal social learning context. Aim: Compare learning outcomes and perspectives between students interacting with VPs in individual and team contexts. Methods: Seventy-eight medical students were randomly assigned to interview and examine four VPs with possible CN damage either as individuals or in three-person teams, using Neurological Examination Rehearsal Virtual Environment (NERVE). Learning was measured through diagnosis accuracy and pre-/post-simulation knowledge scores. Perspectives of learning context were collected post-simulation. Results: Students in teams submitted correct diagnoses significantly more often than students as individuals for CN-IV (p = 0.04; team = 86.1%; individual = 65.9%) and CN-VI (p = 0.03; team = 97.2%; individual = 80.5%). Knowledge scores increased significantly in both contexts (p \u3c 0.001); however, a significant aptitude-treatment interaction effect was observed (p = 0.04). At pre-test scores ≤25.8%, students in teams scored significantly higher (66.7%) than students as individuals (43.1%) at post-test (p = 0.03). Students recommended implementing future NERVE exercises in teams over five other modality-timing combinations. Conclusion: Results allow us to define best practices for integrating VP simulators into medical education. Implementing NERVE experiences in team environments with medical students in the future may be preferable. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted

Obese Patients Show A Depressed Cytokine Profile Following Severe Blunt Injury

Computational grids have been emerging as a new paradigm for solving large complex problems over the recent years. The problem space and data set are divided into smaller pieces that are processed in parallel over the grid network and reassembled upon completion. Typically, resources are logged into a resource broker that is somewhat aware of all of the participants available on the grid. The resource broker scheme can be a bottleneck because of the amount of computational power and network bandwidth needed to maintain a fresh view of the grid. In this paper, we propose to place the load of managing the network resource discovery on to the network itself: inside of the routers. In the proposed protocol, the routers contain tables for resources similar to routing tables. These resource tables map IP addresses to the available computing resource values, which are provided through a scoring mechanism. Each resource provider is scored based on the attributes they provide such as the number of processors, processor frequency, amount of memory, hard drive space, and the network bandwidth. The resources are discovered on the grid by the protocol\u27s discovery packets, which are encapsulated within the TCP/IP packets. The discovery packet visits the routers and look up in the resource tables until a satisfactory resource is found. The protocol is validated by simulations with five different deployment environments. © 2010 Springer Science+Business Media, LLC