Scenarios For The Implementation Of Vps Into The Medical Curriculum By The Example Of Jumc's Participation In The Evip-programme

Scenarios for the implementation of VPs into the medical curriculum by the example of JUMC's participation A.J. Stachoń, A.A. Kononowicz, I. Roterman-Konieczna in the eViP-Programme Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland

I. Hege, M. Holzer, M.R. Fischer Medical Education Unit, Medizinische Klinik-Innenstadt, Ludwig-Maximilians-University, München, Germany

M. Adler Instruct AG, München, Germany

September 2006 www.virtualpatients

The eViP Project 

3-years project co-funded by the European Union



Aims ■ ■ ■

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

Creating large international repository of virtual patients Sharing/exchanging of virtual patients Repurposing of virtual patients (adaptation of VPs to national health care standards and conditions) Implementation of virtual patients into the local medical curricula

Project Partners ■ St George’s, University of London

eViP

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Karolinska Institutet

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Ludwig-Maximilians University Munich

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University of Warwick

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Maastricht University

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University of Heidelberg

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University "Iuliu Hatieganu" Cluj-Napoca

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Jagiellonian University Medical College

http://www.virtualpatients.eu September 2006

First year of eViP 

Goal: close collaboration between pairs of project partners

Ludwig-Maximilians-University Munich, Germany

Jagiellonian University Medical College, Kraków, Poland

eViP September 2006

LMU & UJ repurposing workflow content

Virtual Patient (VP) content is obtained from Munich (including text, figures, images, videos) Translation of the text from German or English into Polish

translation

Content matter experts repurpose the case to national standards and conditions

adaptation Adaptation of multimedia materials (e.g. movie subtitles, localized images&forms)

media

eViP VP waiting to be introduced into medical curriculum

ready

e.g. • interdisciplinary repurposing: medicine → nursery • structure repurposing linear → branched

further repurposing

September 2006

Examples of media adaptation activities

Adding subtitles

eViP

Localization (medical documentation)

September 2006

UJ VP Inventory after first year of eViP Id

VP’s Name

VP’s Age and Gender

Specialization

1

Eberle / Terlecka

78, F

Haematology Acquired Haemophilia A

2

Angermeier / Andrzejewski

48, M

Cardiology Myocardial Infarction

3

Vogt / Wolski

54, M

Cardiology Renal Arteriostenosis

4

Maller/ Malarz

35, M

Cardiology Acute Muocarditis

5

Seidel / Szymura

35, F

Endocrinology Hodgkin’s Disease

6

Gross / Grochocka

57, F

Endocrinology Sjögren’s Syndrom

7

Mayer / Majewska

62, F

Gastroenterology Helicobacter pylori

8

Meissner / Myszkowski

77, M

Gastroenterology Gastric ulcer

9

Stolarska

25, F

Surgery Appendicitis

10

Schulte / Schulte

19, F

Infectious diseases Infectious mononucleosis

11

Kowalska

20, F

Allergology Hereditary Angioedema

12

Goetz / Bożko

71, F

Neurology Subarachnoid haemorrhage

13

Rolf / Banachowski

17, M

Traumatology Shank injury

READY 

11 cases repurposed from CASUS®

eViP 

2 cases repurposed from Polish paper cases

September 2006

E( 10 .2 00 7#P 12 _A .2 00 NG 7) (1 1. 20 07 -0 #P 3. _S 20 CH 08 ) (1 1. 20 07 #P -0 2. _V 20 O 08 G (1 ) 1. 20 07 #P -0 4. _G 20 R 08 O ) (0 1. 20 08 #P -0 1. _S 20 AE 08 (0 ) 3. 20 08 #P -0 7. _G 20 O 08 E( ) 04 .2 00 8#P 05 _M .2 00 AL 8) (0 5. 20 08 -0 7. 20 08 )

#P _E B

Hours

Repurposing time effort Repurposing time effort

90

80

70

60

50

40

30

20

10

0

Repurposed virtual patients (ordered by repurposing start date)

eViP September 2006

UJ’s VP scenarios realized in the first year of the eViP project Group of Students

Medical Polish Students (Pilot Study)

Numer of Students

Year of Study

Class

Scenario of implementation

Material/ Virtual Patients

231

3rd

Telemedicine 2

self-study

2 eViP cases in Polish

3rd

Medical informatics and statistics 2

self-study

2 eViP cases in Polish

Dentistry Polish Students

76

Medical Foreign Students

68

1st

Basis of Computer Science

self-study

2 eViP cases in English

Medical PhD

48

post-graduate

Computer Science

learning-byteaching

creation of 14 new VPs

E-learning

VP content Enrichment

creation of Flash animation

Applied Computer Science Students (supervised by medical experts)

eViP

27

4th

September 2006

Surveys in the project’s first year - results Group of Students

Medical Polish Students (Pilot Study)

Dentistry Polish Students

Medical Foreign Students

N

134

56

25

Scenario of implementation

self-study

self-study

Q3

Q4

VP’s mark Students preferences

Likert Scale 1 - 5

4,2

4,4

Scale 1 - 10

-

75% self study 52% classes 65% revision 29% assessment

7,4 7,8

4,4

81% self study 60% classes 72% revision 48% assessment

8,0 8,2

3,8

60% self study 56% classes 16% revision 48% assessment

7,4 7,3

eViP

self-study

3,9

Q3 – Was the presented clinical case interesting for you? Q4 – Would you like to have VPs implemented to your medical study?

September 2006

Key factors for supporting the integration 

Support from experienced eViP partners



Support from students  Translations  Content enrichment (Students of Comp. Science)  VP authoring (PhD Candidates)

eViP

 Willingness to participate in VPs classes 

Incentives for authors guaranteed by eViP



Mixed bottom-up & top-down approach

September 2006

Future goals and perspectives • Continue/Broaden integration with clinical courses • Share experiences with other partners

eViP

• Joint research studies with other institutes

September 2006

1st International Conference on Virtual Patients

Kraków, Poland 5 J une to 6 J une 2009 www.icvp.eu

eViP September 2006

Surveys in the project’s first year - results Group of Students Medical Polish Students (Pilot Study)

Dentistry Polish Students

Medical Foreign Students

N

134

56

25

Scenario of implementation

self-study

self-study

self-study

Q3

Q4

Q6

Q7

Q8

Q9

Q11

Q12

Likert Scale 1 - 5 4,2

4,4

3,9

-

4,4

3,8

4,2

4,3

-

4,2

4,6

3,8

4,1

4,4

3,9

3,9

3,9

3,6

4,3

4,3

-

Students preferences

VP’s mark Scale 1 - 10

4,6

75% self study 52% classes 65% revision 29% assessment

7,4 7,8

4,6

81% self study 60% classes 72% revision 48% assessment

8,0 8,2

60% self study 56% classes 16% revision 48% assessment

7,4 7,3

3,9

eViP

Q3 – Was the presented clinical case interesting for you? Q4 – Would you like to have VPs implemented to your medical study? Q6 – Was the content of the VP understandable? Q7 – Was the content of the VP logically structured? Q8 – Did the presented case contain useful knowledge? Q9 – Do you believe that learning using virtual patients is more efficient than conventional methods? Q11 – Was the language of the VP appropriate? Q12 – Was the VP system (CASUS) easy to operate?

September 2006

Virtual Patients at JUMC before eViP 

Non-coordinated bottom-up initiatives of individual faculty members

eViP MicroSIM ®

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http://www.laerdal.com

Little experience with case-based learning

September 2006

Key factors to remember 

Legal issues  Patient’s consent  VP’s copyright cleared

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Incentives for content authors and educators  Financial  Organizational

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Changes in curriculum  Where to use VPs?  How to motivate student to use VPs?



eViP

Technical Issues

 VP System (own development, existing system)  VP Model (linear, branched) 

VP repository profile

 Specialized (few discipilnes with many cases) ?  Broad Scoped (VPs should cover as many disciplines as possible with potentially few cases) ?

September 2006

Student’s projects

VP Content Enrichment

eViP September 2006