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Models for Virtual Patients

Models for Virtual Patients. Presented by Jonathan Round. What is a virtual patient? - entry level. Elements Scenario Choices and consequences First person participant User interface. Example. Robert is a 6 week old boy who presents to A+E with poor feeding and no other symptoms.

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Models for Virtual Patients

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  1. Models for Virtual Patients Presented by Jonathan Round

  2. What is a virtual patient? - entry level • Elements • Scenario • Choices and consequences • First person participant • User interface Models for Virtual Patients

  3. Example • Robert is a 6 week old boy who presents to A+E with poor feeding and no other symptoms. • Examination is entirely normal apart from a temperature of 38.1° C • What should you do? Reassure and send home with paracetamol Take blood cultures and start on antibiotics Models for Virtual Patients

  4. You chose to reassure and send home with paracetamol. • Robert represents 6 hours later unresponsive with intractable convulsions. • A post mortem demonstrates bacterial meningitis. • Fevers in the very young should always be taken seriously as there are rarely any localising signs Models for Virtual Patients

  5. Example • Robert is a 6 week old boy who presents to A+E with poor feeding and no other symptoms. • Examination is entirely normal apart from a temperature of 38.1° C • What should you do? Reassure and send home with paracetamol Take blood cultures and start on antibiotics Models for Virtual Patients

  6. You chose to take blood cultures, clean catch urine, lumbar puncture and start on antibiotics • This is good, because the child had bacterial meningitis. Your interventions saved Robert’s life. • Clinical signs are often absent or subtle in the young. Models for Virtual Patients

  7. What is a virtual patient? - advanced levels • Elements • Scenario • Choices and consequences • First person participant • User interface • Allows realistic choices • Has realistic consequences • Appropriate for level of user • Links to/contains education Models for Virtual Patients

  8. Generic problems • Inflexible • Expensive to set up • Realistic choice models require clinician time • Visually appealing models require programmer time Models for Virtual Patients

  9. Clinical realism and the problem of choice - 3 option model • Patient presents 3 options • First step 9 options • Second step 27 options • Third step 81 options 120 potential clinical situations Models for Virtual Patients

  10. Hi-Fi Different models to cope with choice Algorithm based Linear Lo-Fi Models for Virtual Patients

  11. Hi-Fi Different models to cope with choice Algorithm based Linear Lo-Fi High degree of visual/aural realism Complex programming Expensive ++ $100,000 Solve problem with cash Models for Virtual Patients

  12. Hi-Fi Different models to cope with choice Algorithm based Linear Lo-Fi Participant choices input information into a calculator that outputs clinical change Complex formulae at the heart No narrative Good for physiology or biochemical scenarios Solve problem with ‘infinite’ choice Models for Virtual Patients

  13. Hi-Fi Different models to cope with choice Algorithm based Linear Lo-Fi Allows only one route through the scenario Incorrect responses lead to immediate correction Minimal real choice Good to test knowledge of protocols Poor for realism - problem not solved Easy to create Models for Virtual Patients

  14. Hi-Fi Different models to cope with choice Algorithm based Linear Lo-Fi Multiple choices at each step Emphasises decisions Minimal attention to appearance Cheap Problem solved! Models for Virtual Patients

  15. Creating a Lo-Fi nodal virtual patient Presents to GP Major nodes - describe major points in clinical course Referred to clinic Investigations Definitive treatment complete Models for Virtual Patients

  16. Creating a Lo-Fi nodal virtual patient Major nodes connected by appropriate management choices Models for Virtual Patients

  17. Creating a Lo-Fi nodal virtual patient Other boxes added and then choices inserted Models for Virtual Patients

  18. Creating a Lo-Fi nodal virtual patient Whole case completed Models for Virtual Patients

  19. Models for Virtual Patients

  20. Welcome. You have now been a paeditrician since 4 pm, when your shift started. Its day 1 of the job, and you are trying to remember all that stuff from the paed course. Anyway, it wasn't too busy and now you have discovered the mess and the takeaway menus. A Lamb Rogon Josh has arrived and you are half way through, when the crash bleep goes off "Paediatric arrest in A+E". What would you like to do? Finish curry Run to A+E Mahein Hussain Models for Virtual Patients

  21. Advantages of Lo-Fi nodal approach • Quick • Adaptable • Linkable • Uses clinicians and programmers effectively • Anyone can do it! Models for Virtual Patients

  22. Chara Balasubramaniam Arnold Somasunderam Ferhal Utku Terry Poulton www.etu.sgul.ac.uk/virtualpatients/examples.htm Thanks to… More at… Models for Virtual Patients

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