Centre for Virtual Patients

Evaluation of curricular integration of virtual patients:

Development of a student questionnaire and a reviewer
checklist within the electronic virtual patient (eVIP)
project
 
 

Sören Huwendiek, Helen Rani Haider, Burkhard Tönshoff, Bas de Leng

ICVP’09 conference
Krakow, Poland
 Centre for Virtual Patients

Introduction

The curricular integration of virtual patients is essential for their success

To date there are no standardized instruments available to evaluate the

curricular integration of virtual patients
 Centre for Virtual Patients

Aim of the Project

 

Development of a student questionnaire and reviewer

checklist
 
to evaluate the curricular integration of virtual patients with the
primary aim of
fostering clinical reasoning
 
which is employable in different kinds of didactic scenarios using
virtual patients
 
 offers the opportunity to compare different integration
modes and
elucidate strategies of effective curricular integration
 Centre for Virtual Patients

Literature review
 

• Systematic literature review: Medline, ERIC, Google Scholar

 
• Search terms included: Blended Learning, Flexible Learning,
Constructive
Alignment, Curricular Integration, E-Learning and Virtual Patients
 
 
 no standardized instrument to evaluate the curricular
integration of virtual
patients could be found
 
 theoretical frameworks supporting the development and
design of the
questionnaire
 Centre for Virtual Patients

  Literature informing the theoretical framework of the questionnaire (1)

 
The Community of Inquiry Model by Garrison et al. as a general
framework
for the questionnaire:
 
 learning occurs through the interaction of 3 core components:
 

- cognitive presence
- social presence
- teaching presence
 Centre for Virtual Patients

Literature informing the theoretical framework of the questionnaire (2)

 
 

• Octagonal Framework of Blended Learning by Badrul Khan

(2000)
 
• Criteria categorizing didactic scenarios by Heyer (2006)
 
• Principles of curricular integration of virtual patients, a focus
group study
among students at the University of Heidelberg (2009)
 
• Literature concerning educational strategies to promote
clinical diagnostic
reasoning (Bowen 2006)
 Centre for Virtual Patients

The questionnaire (1)

 
 
• 20 questions, clustered in 5 main categories:

(A) Teaching presence

 
(B) Cognitive presence
 
(C) Social presence
 
(D) Learning effect
 
(E) Overall judgement
 
• Additionally:
 
(F) 3 Open ended questions
 Centre for Virtual Patients

The questionnaire (2)

5-Point-Likert-Scale:

(1) strongly disagree

(2) disagree
(3) neutral
(4) agree
(5) strongly agree

(6) not applicable

After each question free text field: briefly reasons for answer (optional)
 Centre for Virtual Patients

“Corresponding teaching event”

 

• to describe teaching and learning activities which go along with

virtual patients
 
• definition of “corresponding teaching event” according to educational
scenario
 

(e.g. virtual patients used during problem-based learning, small-group-discussions after

working with virtual patients)
 

 In this manner questionnaire employable for different kinds

of
educational scenarios using virtual patients
 Centre for Virtual Patients

The reviewer checklist

 

• to characterize the curricular integration scenario of virtual patients in

detail by teacher

• 12 items describing the educational scenario in detail

• 24 items clustered in the same 5 subsets used in the student

questionnaire
 
 Centre for Virtual Patients

Process of refinement by eVIP experts

 

• first draft reviewed by eVIP-partners, refined, tested on target group

and again
refined
 
• final review through eVIP-partners
 
• Translation in local partners language and tested with students,
refined and
retranslated into English
 
• Final student instrument, translated in 6 languages , available on eVIP-
website

• Final reviewer checklist in English, available on eVIP-website

 Centre for Virtual Patients

Study among 5th year medical students

Educational scenarios:

- VPs integrated into the Paediatrics Course at Heidelberg

Medical School using small group discussion after VP-Work

- VPs as preparation for skills lab training (Paediatrics)

 
 

Results:

the questionnaire and checklist proved to be very helpful in identifying

strong areas and areas with need of improvement concerning the
curricular integration of VPs

 
 Centre for Virtual Patients

Conclusion
 
 

 
A multi-lingual student questionnaire and checklist to analyse
and compare virtual patient curricular integration scenarios is
now available

First studies evaluating virtual patient integration scenarios at the University of

Heidelberg proved the instruments to be helpful to optimize the educational
scenarios

 
 
 We hope the instruments will be widely implemented
around the globe
 Centre for Virtual Patients

Bibliography
 
•Rourke, L., Anderson, T., Garrison, D.R., Archer, W.: Assessing Social Presence In
Asynchronous Text-based Computer Conferencing, Journal of Distance Education, ISSN: 0830-
0445, 2001.
•Rourke, L., Anderson, T., Garrison, D.R., Archer, W.: Assessing Social Presence In
Asynchronous 2003.
• Khan, B.H.: A Framework for Open, Flexible and Distributed Learning, Proceedings
of the Technological Education and National Development Conference, “Crossroads
of the New Millenium” (2nd , April 8-10, 2000, Abu Dhabi, United Arab Emirates)
• Heyer, S. : Didaktische Szenarien und deren Verhältnis zu Lernmaterialien,
Forschungsberichte des Fachbereichs Elektrotechnik & Informationstechnik, ISSN
0945 0130, Fernuniversität Hagen, 2006 (www.fernunihagen.de/etit/fachbereich/
forschung/index.html)
• Huwendiek, S. et al.: Curricular integration principles of virtual patients: a focus
group study among students, 2008. Manuscript in preparation.
• Bowen, J.L.: Educational Strategies to Promote Clinical Diagnostic Reasoning, N
Engl J Med, 355: 2217-25, 2006.
• Ark, T. K., Brooks, L. R., Eva, K. W.: The benefits of flexibility: the pedagogical value
of instruction to adopt multifaceted diagnostic reasoning strategies, Medical
Education, 41:3, 281-287, 2007.
• Gruppen, L.D., Frohna, A.Z.: Clinical Reasoning. In: Norman, Geoffrey R.
International handbook of research in medical education. Kluwer Academic
Publishers, Dordrecht 2002.
Centre for Virtual Patients
 Centre for Virtual Patients

Thank you for your

attention!
 Centre for Virtual Patients

Study among 5th year medical students

Work with VPs

 Centre for Virtual Patients

Study among 5th year medical students

Work with VPs Tutor moderated small

group discussion
 Centre for Virtual Patients

Introduction

 
Campus-Lernprogramm,
Zentrum für virtuelle Patienten (ZVP),
Heidelberg
(for further information see:
www.medicase.de)
 
 

 
 
eVIP Electronic Virtual Patients,
Co-funded by the European Union
(for further information see:
www.virtualpatients.eu)