Teachers’ Expectations And Concerns About Introducing Virtual Patients In A Clinical Course

Teachers’ expectations and concerns about introducing Virtual Patients in a clinical course

Samuel Edelbring, Nabil Zary VP-lab, CME KI Sweden

Organisation culture plays a role in diffusion of new technology (Rogers 2003) • A part of our culture is course directors and teachers. • Their expectations are important to bring out in an implementation process.

research question for this investigation  What possibilities do teachers see with virtual patients and what concerns do they have about introducing VPs in their course?

Setting of the investigation  Course planning group with Web-SP implementation at 4 hospitals sharing the same cases in similar course.  Expectations and concerns were investigated before the actual use of VPs.  Open ended questions in written form.

Questions in the form  In what way do you believe that the VP-activity will contribute to student learning in your course?  What general expectations do you have on the VP activity?  Do you have any concerns regarding the use of VPs?

Result  12 forms handed out, 8 returned (67% response rate) containing free text expectations and concerns.

Expectations regarding contributions to student learning Content of the VPs as such and functionality, “opening up” the diagnostic reasoning process and the relation to real patient contact.  It will provide an overview of different reasoning paths.  Support and activate students’ own clinical reasoning.  Give an understanding of how patient interview and investigations work together like tools on the way to finding a diagnosis.  Expose students to the variety of lab tests and different investigation methods that are available.  This will be more process oriented than previous paper cases in seminars.  It will prepare students well before meeting actual patients.

General expectations on VP course activity How students will use the software and its role in the course.  I hope that students will sit at home in piece and quiet to reflect over potential differential diagnoses.  This will complement the actual clinical experience.  It is better to instead use the valuable course time for actual patient encounters.  This is a fun variation to the traditional seminar.  The reusability and scalability aspect is valuable.

Concerns Worries about upcoming technical problems, creation of cases, levels of cases and that VPs would replace real patient contact.  It must not replace patient-doctor encounter.  That there will be technical problems of accessability or slow functionality.  That the level of difficulty will be to low/high.  That students don’t work through the cases properly at home.  That teachers will find case creation too time consuming and difficult.  That students will use the VPs at the expense of reading course literature.

Two views of learning reflected in the material  Learning as acquiring new factual knowledge and remembering: ”active students learn more/remembers easier the important stuff”, ”there is a risk that students read to little in the textbook and thus not really gain new knowledge”  Learning as processing and integrating existing knowledge, applying/trying out/training of investigation techniques: ”To learn to gather data in order to reach a diagnosis” ”This can give an increased understanding of how the patient interview and physical examinations should be structured”, ”a tool for integrating students’ knowledge of the different parts of the course”

In what learning aspect can VPs contribute their full potential? Results overlayed on Miller’s Model for assessment of clinical competence (Miller 1990) processing and performing

acquiring new knowledge and remembering

Summary  We believe that teachers and course directors have a key position in defining the role of VPs in health science education.  Expectations and concerns with teachers can brought forward by using open ended questions in a written form.  Expectations on student learning with VPs vary between acquisition of factual knowledge and higher order clinical reasoning.  Interesting to follow up teachers conceptions after more experience with VPs.