Beyond xMOOCs in healthcare education : study of the feasibility in integrating virtual patient systems and MOOC platforms

Background. Massive Open Online Courses (MOOCs) are an emerging trend in online learning. However, their technology is not yet completely adjusted to the needs of healthcare education. Integration of Virtual Patients within MOOCs to increase interactivity and foster clinical reasoning skills training, has been discussed in the past, but not verified by a practical implementation.Objective. To investigate the technical feasibility of integrating MOOCs with Virtual Patients for the purpose of enabling further research into the potential pedagogical benefits of this approach.Methods. We selected OpenEdx and Open Labyrinth as representative constituents of a MOOC platform and Virtual Patient system integration. Based upon our prior experience we selected the most fundamental technical requirement to address. Grounded in the available literature we identified an e-learning standard to guide the integration. We attempted to demonstrate the feasibility of the integration by designing a “proof-of-concept” prototype. The resulting pilot implementation was subject of verification by two test cases.Results. A Single Sign-On mechanism connecting Open Labyrinth with OpenEdx and based on the IMS LTI standard was successfully implemented and verified.Conclusion. We investigated the technical perspective of integrating Virtual Patients with MOOCs. By addressing this crucial technical requirement we set a base for future research on the educational benefits of using virtual patients in MOOCs. This provides new opportunities for integrating specialized software in healthcare education at massive scale

Actions to empower digital competences in healthcare workforce: a qualitative approach

While healthcare systems are taking advantage of the ICT to improve healthcare services, healthcare workforce needs additional competencies in order to continue the provision of the best achievable care. In this paper emphasis is given to an active research effort taken during the MEI2015 Conference. Based on hands-on group-work, participants identified the actions needed to boost the acquisition of IT competences by healthcare workforce and collaboratively indicated the most important actions. The leading priority actions were integration of IT into Curriculum, continuous IT/eHealth training at the work place, raising awareness of IT competences, participatory decisions for actions, match healthcare applications to users’ own context, inclusion of professionals in the development of eHealth projects. Interestingly, the proposed actions coupling the outcomes of another study following a different methodology, but also support the cooperation opportunities on IT skills for healthcare workforce. The latter formed a set of recommendations which were proposed within the CAMEI coordination and support action of EC-FP7

MOOC learners' engagement with two variants of virtual patients : a randomised trial

Introduction: Massive Open Online Courses (MOOCs) are an increasingly popular form of education in health professional education. VPs have been introduced in MOOCs to increase interactivity. There is a lack of research in understanding the reasons behind high dropout rates in MOOCs. We explored how learners interact with VPs and compared the significance of different VP designs on dropout rates. Methods: RCT of 378 participants split into two groups to interact with two VPs using different design: branching and linear. Data on node progression and VP attempts was analysed using descriptive and quantitative analysis. Results: Eight groups of learner interaction patterns were identified. The majority of learners completed the VP in a linear path in one attempt. A significant number either completed the case in a loop path in one attempt, completed in a linear path in multiple attempts or dropped out without attempting the case. VP design has a significant effect on dropout rates of learners. There is a higher dropout rate from a branched VP compared to linear VP. Discussion: Prior research showed that branched VPs are more engaging and promote greater learning compared to linear VPs. However, our results indicate that branched VPs had greater dropout compared to VPs that require less time to be solved. Conclusions: We conclude that branching had a negative effect on completion of the VP activity in the MOOC. Moreover, we believe that more complex VPs require more effort on task and this might not be a design that facilitates the interaction in a MOOC audience, where the participants might wish to acquire the basic medical knowledge offered by the course

A Formal Approach to Distinguish Games, Toys, Serious Games & Toys, Serious Re-purposing & Modding and Simulators

While the concept of serious game has considerably evolved in the last two decades, it still needs to be clearly differentiated from other types of artifacts. Thus, for most outside the domain, there is a degree of confusion about the relationship between serious games and other related applications such as simulators or the re-purposing of entertainment games within educational practices. This article proposes a formal approach towards classifying Games, Toys, Serious Games, Serious Toys, Serious Re-purposing & Modding and Simulators. The aim of this theoretical work is twofold. Firstly, on a practical level, this approach aims at helping actors from different ecosystems, such as health, for instance, to differentiate between these various devices and use them to their best advantage. Secondly, from a research perspective, based on a formal approach, our work aims to contribute to the development of a taxonomy for gamified intervention with serious purposes. This formal approach allows us to demonstrate that unique combinations can be proposed to distinguish each kind of application. In this context, Serious Games can be seen as a specific purpose and not as a synonym for other existing applications

Virtual Reality for Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

Background: Virtual reality (VR) is a technology that allows the user to explore and manipulate computer-generated real or artificial three-dimensional multimedia sensory environments in real time to gain practical knowledge that can be used in clinical practice. Objective: The aim of this systematic review was to evaluate the effectiveness of VR for educating health professionals and improving their knowledge, cognitive skills, attitudes, and satisfaction. Methods: We performed a systematic review of the effectiveness of VR in pre- and postregistration health professions education following the gold standard Cochrane methodology. We searched 7 databases from the year 1990 to August 2017. No language restrictions were applied. We included randomized controlled trials and cluster-randomized trials. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to rate the quality of the body of evidence. Results: A total of 31 studies (2407 participants) were included. Meta-analysis of 8 studies found that VR slightly improves postintervention knowledge scores when compared with traditional learning (standardized mean difference [SMD]=0.44; 95% CI 0.18-0.69; I2=49%; 603 participants; moderate certainty evidence) or other types of digital education such as online or offline digital education (SMD=0.43; 95% CI 0.07-0.79; I2=78%; 608 participants [8 studies]; low certainty evidence). Another meta-analysis of 4 studies found that VR improves health professionals’ cognitive skills when compared with traditional learning (SMD=1.12; 95% CI 0.81-1.43; I2=0%; 235 participants; large effect size; moderate certainty evidence). Two studies compared the effect of VR with other forms of digital education on skills, favoring the VR group (SMD=0.5; 95% CI 0.32-0.69; I2=0%; 467 participants; moderate effect size; low certainty evidence). The findings for attitudes and satisfaction were mixed and inconclusive. None of the studies reported any patient-related outcomes, behavior change, as well as unintended or adverse effects of VR. Overall, the certainty of evidence according to the GRADE criteria ranged from low to moderate. We downgraded our certainty of evidence primarily because of the risk of bias and/or inconsistency. Conclusions: We found evidence suggesting that VR improves postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education. The findings on other outcomes are limited. Future research should evaluate the effectiveness of immersive and interactive forms of VR and evaluate other outcomes such as attitude, satisfaction, cost-effectiveness, and clinical practice or behavior change.</br