Implementing an Online Interactive Curriculum using Virtual Patients

1. Implementing an Online Interactive Curriculum using Virtual Patients Trupti Jivram, Terry Poulton St George’s University of London

2. Problem-Based Learning …and its limitations

3. Linear PBL

4. Branched PBL

5. To change the existing PBL curriculum, to create a more interactive, personalised model of course delivery with virtual patients at its core To be delivered in the Transitional year between campus-based learning and clinical attachments, as Clinical PBL Based on18 adaptive and enriched interactive cases, with 36 formative assessments, integrated with social software/wikis for notes/reflections

6. Why G(eneration) 4? G1 – Subject- or discipline-based G2 - System-based G3 - Case based, but linear G4 – Interactive with options, consequences

7. Case creation Existing paper cases rewritten to fit the VP model by subject Matter Experts (SMEs) Cases are authored using Decision Simulation (DSim developed by the University of Pittsburgh) Cases reviewed by PBL VP experts Resources added Tutor notes created Student notes created

8. Case delivery Student access cases via Moodle Cases delivered in DSim Groups discuss the options and consequences as they progress through the case Outcome is dependant of the option chosen Students can use the wiki ‘notepad’ to share resources during and after the session

9. Problem-based Learning

10. Example of a case

12. Wiki – ‘Notepad’ Links to websites Learning objectives

13. Assessment cases Optional formative VPs Related to the topic of the week, delivered at the end of each week Different styles MCQ Branching Testing day with students Each case has a mixture of both styles

14. Evaluation • Pre and post questionnaires with students • Focus groups with case writers, tutors and students • Interviews

15. Students • Questionnaires (using 5-point Likert-scale statements) were distributed to approximately 200 students • Obtain indicators of their experience and perceptions before and after use of the virtual patient cases.

16. Quotes from Students “...took the wrong path, and they end up in a disaster ...,” “…but in a branched one, they have the choices to take it back and learn something new. I think that’s good.” “…it is quite memorable, whereas in the paper case, you don’t have that. So, they just go to learn something in a very tedious way” “It’s getting you to think more, because you’re making choices”...

17. Staff perspectives “The feedback from the students seems to be incredibly positive” “…it really does seem to take the PBL to another level that really mimics what they’re seeing when they go out into the clinical world.” “So it really is a big educational step, and the students have said that they found that they’re on the wards, and then they go and do PBL, and the two are cementing each other”

18. Impact of change “At this early stage the impact would seem to be completely positive, the cases were produced and delivered on time and were well received by students as shown above.” “Students report that alternating placements with the G4 PBL helped them to draw information between placements. Enthusiasm extended throughout the year.”

19. Virtual worlds First tutorial was delivered in Second Life Contained a GP surgery and a renal unit with objects that student can use to assess the patient

20. GP Surgery

22. Please rank the following forms of PBL • Paper • Online • Virtual world

24. Key messages and recommendations • G4 demonstrated that branched virtual patients enhance the quality of the student learning experience in Problem-based Learning. • Virtual Patients change the dynamics of facilitation • Case Authors require specialised preparation / training and support • Second Life was not considered a suitable environment for PBL VPs at present

25. Curriculum TransformationWorkshop5-6 December 2011at St George’s, University of London http://www.elu.sgul.ac.uk/elu_wordpress/workshops/curriculum-transformation-workshop/