Case Study: Uniwersytet Jagiellonski

Andrzej Kononowicz and Aleksandra Stachon describe how they have used VPs in their institution.

Background

We have used CASUS, a web-based VP system including a player and authoring tool for linear cases. CASUS has been developed by LMU and Instruct.A.G.

Note: Additionally, a commercial tool MicroSim InHospital (by Laedal Medical Corporation) has been used by the Anaesthesiology and Intensive Care Department at UJ. MicroSim is a multimedia-rich desktop application for emergency medicine. MicroSim InHospital is used by undergraduate students Anaesthesia and Intensive Care Medicine course (6th year students). This system is, however, a black box solution for the UJ, without the possibility of adding new cases or repurposing existing ones. For that reason we regard the MicroSim system as outside the scope of the eViP project.

VP in the CASUS system have been presented to medical, undergraduate students within the ‘Telemedicine” course and an elective course “e-Learning” (with 3rd and 4th year students).

Our VPs contain multimedia materials like images and video clips. The interactive elements used are: seven different question types with quantitative and qualitative feedback, hyperlinks and expert comments. As mentioned earlier, VP cases in CASUS are linear.
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Emotional Scenarios

UJ is still in the initial phase of VP introduction. Two virtual patients have been presented in a self-directed learning scenario as part of the eViP pilot study. Further scenarios are planned, but have not been performed yet.
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Curricula Integration

VPs have been presented in Telemedicine classes dealing with foundations of IT technologies in medicine. Introduction of VPs into clinical subjects is planned.
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Integration With Other e-Learning Opportunities

A theoretical introduction to the topic of VP, summarising their features and comparing different VP systems is presented to the students via an e-learning platform. Medical students help in translations of VPs from different languages (German and English) within the elective course ‘e-Learning’.
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Technical Integration

Students access the CASUS system using the same usernames as for the UJ e-learning platform (Blackboard Academic Suite). All relevant links and instructions for the use of VPs are copied into the courses on Blackboard in HTML format.

An electronic VP evaluation questionnaire for the pilot study has been created using Blackboard’s survey tool.

A fully automatic single sign-on option between the Blackboard and CASUS system using the SCORM or IMS interface is planned.
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VPs For Assessment

No formative or summative assessment has been undertaken yet.
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Evaluation of VPs

An evaluation of two repurposed VPs has been carried out as part of the eViP pilot study among 3rd year students. The evaluation has been continued after the pilot study was over, returning in total 139 evaluation forms.

The study showed a keen interest in VPs among the polled students (mean 4.14 in a 1-5 Likert scale). The presented knowledge was comprehensible (mean 4.20 in a 1-5 Likert scale) and the applied VP system (CASUS) was definitely easy to use (mean 4.57 in a 1-5 Likert scale).

The general mark of the presented patients was high (7.59 in a 10-point scale). Direct comparison of the two presented VPs, from which one was repurposed from a different culture and one from a different structure, revealed a slight superiority of the second one of the first (7,39:7,77) even though it is far too early to draw general conclusions from these result in the matter of VPs repurposing workflows.
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Future Plans

A learn-by-teaching project for postgraduate medical students is about to start in a few days aiming to create new patients for credit. Repurposing of medical virtual patients into nursing is planned for the near future. It is also intended to enrich the current virtual patients with animations using Flash.
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Any Advice?

  • A comprehensive and frequently updated VP referatory is needed for preserving an overview of the existing patients
  • Web-based VP systems are more practical and accessible than desktop applications
  • Medical students can be of great help in introducing VPs at a school. It is worth asking them for help while preparing new cases. For instance, translations of cases from other systems may be done with good results by medical students of final years (supervision by subject matter specilaists is of course necessary)

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