Using Virtual Patients in PBL

School
Bas de Leng of Health Professions Education
Prof.The
Maastricht University, dr. Netherlands
Albert Scherpbier
Summer course Monday June 22, 2009

Faculty of Health, Medicine and Life Sciences

What is a virtual patient?

 A virtual patient is a computerized problem solving case,

allowing users to virtually explore and intervene in the case.
 Two components:
1. Patient case: patient data, where valuable in a
multimedia format
2. Educational case: select content, interactivity, prompts
and feedback for a specific educational goal (clinical
reasoning, basic science knowledge)
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An example of a VP

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How to apply a VP in education?

Virtual patient 1) Implement 2) Integrate

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Example 1: use in specialist training
 All residents simultaneously
worked out the same virtual
patient.
 Three times during the work-
out a ‘time out’ was
scheduled in which the
residents discussed their
diagnostic reasoning.
 The logged actions of the
residents and their notes
were point of departure.

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Feedback tool
 Feedback tool compiled and fed back the logged actions of
the individual residents.

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Example 2: in clerkship
 Wrap-up week after a work placement.
 VP presentation by a clinician complementing students’
presentations of real patient encounters.

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Small group discussion
 Audience response system: response to anonymous
polling as a trigger for the discussion.

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 How to use VPs in preclinical years?
 VP used as a vehicle to present factual knowledge.
 Embedding interactive images:
 Adaptable scaffolding.
 Drag & drop quizzes.

ADAPTABLE SCAFFOLDING

Full scaffolding (legend, hotspots, labels) Minimal scaffolding (hotspots only)

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Other active learning with ICT…
 Microscopy practical.
 Virtual slides.

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Other active learning with ICT……
 Microscopy practical.
 Virtual slides.
 Collaborative learning:
 shared white board
 computer mediated
communication

Faculty of Health, Medicine and Life Sciences

Are you using VPs?
Often stated barriers for VP use:
 Costly and time consuming to develop.
 Content and teaching method are not peer reviewed.
 Developed for specific context on isolated topics, no
comprehensive coverage of curriculum.
 No structural funding for maintenance and update of VP
collection.
 Teacher and student concerns: replacement of teachers
and real patients, added to overloaded programme.
 No support for teachers in dealing with technical,
pedagogical or strategic problems related to VPs.
 No empirical data on design and integration of VPs.

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 How to cope with these barriers?
 Collaborative and distributed development of VPs.
 Sharing VP collections: complementing, exchanging and re-
using materials.

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Questions?

Suggestions for further reading

– Homepage e-ViP project: www.virtualpatients.eu
– Cook, D., & Triola, M. (2009). Virtual patients: a critical literature review and proposed
next steps. Medical Education, 43(4), 303-311.
– Ellaway, R., Poulton, T., Fors, U., McGee, J. B., & Albright, S. (2008). Building a virtual
patient commons. Medical Teacher, 30(2), 170-174.
– Huang, G. M. D., Reynolds, R. M. P. A., & Candler, C. M. D. (2007). Virtual Patient
Simulation at U.S. and Canadian Medical Schools. Academic Medicine, 82(5), 446-451.
– Huwendiek, S., Reichert, F., Bosse, H., de Leng, B., van der Vleuten, C., Haag, M., et al.
(2009). Design principles for virtual patients: a focus group study among students.
Medical Education, 43(6), 580-588.

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