vp Sim

1. vpSim Simulation Software for Education and Assessment

2. Virtual Patients • Computer-based clinical simulations for teaching and assessment • Simulation • Safe, consistent • Enables determined practice • Fills curricular gaps • Practice unusual conditions, crash landings • Range • Linear narrative with interaction • Branching narrative • Physiologic model-based

3. Boston AnesSim Center established CLIPP cases for Pediatrics Krakow Virtual Patient meeting Association of Standardized Patient Educators PLATO text-based VP BEME review of simulation 2000 1996 1993 2007 2010? 1966 1994 2001 2004 2005 2009 Barrows overview of standardized patients Huang reports 11% of schools creating VPs Society for Simulation in Healthcare’s 1st meeting Harvard virtual patients 67% schools using Anessims MedBiq VP standard specification released

4. Why is it taking so long for virtual patients to catch on?

5. Technology Adoption Curve “Chasm” You are here Innovators Early Adopters Early Majority Late Majority Laggards ✖ Adapted from Geoffrey Moore, Crossing the Chasm, 1991

6. How do we cross the Chasm? • Need a lot of cases • Wide range of diseases, variations • Validated, peer-reviewed • Standards-based – shareable, editable, extensible • Cases need a lot of authors • Not just the early adopters • Every specialty, multi-specialty • Authors need an easy-to-use authoring program • Short learning curve • Flexible, able to cover broad range of conditions • Editing of existing cases

7. vpSim DEMONSTRATION

8. vpSim Approach • The Macintosh of Simulation • Hides the complexity • Author-driven design • Author-tested • Stimulates creativity, “actually fun to use”

9. Key Features • Branched narratives based on user input; multiple potential outcomes • Game-like: variable experience, scores, money, time • Compliant with MedBiquitous VP standard • Web-based, web-services • Professional development techniques – desktop application-like feel, fully documented • Fully functional application

10. Traditional VP Authoring Technician Custom VP Software Authors Virtual Patient

11. vpSim Authoring Authors vpSim vpSim Player Any VP Player MedBiq VP Standard

12. “The exciting thing [about vpSim] is that students’ decisions have a positive or negative impact on the patient. It takes you and your patient down a particular road…Your knowledge and motivation affects [the patient’s] outcome.” Allen Humphrey, Course Director, Director case-based learning “It took 50-60 hours to create a case in PharmaCal [a proprietary system].  It took only 4-6 hours to create a case in vpSim.” Christine Schonder, Neil Benedict, School of Pharmacy “[vpSim] combines authoring and case creation all in one, where other [applications] have ‘here’s where you create the case, here’s where you enter it into the system’.” “This interface is absolutely fantastic. It’s so plastic. So flexible.” GigiDuker, Course Director

13. Next Steps for Virtual Patients • Need a sustainable model • Trust that software will be around • Faculty support • Growth strategy for new features, extensions • Communities of users • Validated, peer-reviewed cases (MedEdPortal) • Research the “how and when” • Demonstrate educational and clinical outcomes • Keep it simple

14. 75% of schools developing & using Virtual Patients Boston AnesSim Center established CLIPP cases for Pediatrics Krakow Virtual Patient meeting Association of Standardized Patient Educators PLATO text-based VP BEME review of simulation 2000 1996 1993 2007 1966 1994 2001 2004 2005 2009 2010 Barrows overview of standardized patients Huang reports 11% of schools creating VPs Society for Simulation in Healthcare’s 1st meeting Harvard virtual patients 67% schools using Anessims MedBiq VP standard specification released

15. Laboratory for Educational Technology Gary Tabas, MD – Director of Clinical Education Peter Kant, MS – Director of Production Jane Alexander DmitriyBabichenko Developers Chris Toth TeppitukKrinchai Maria Malingowski – Web support, user support Kelly Goode – Administrative Assistant, user support

16. vpSim simulation for the rest of us For further information and demonstration, mcgee@medschool.pitt.edu vpSim.pitt.edu

18. Goal: Adoption of Virtual Patients at 75% of Schools

19. Creating a Case • Identify learning objectives, outcomes • Define audience, environment, expectations • Locate reasonable case • Determine critical (expert) path • Align decision nodes with learning objectives • Assign values to decisions • Associate feedback with both positive and negative decisions

20. Creating a Case • Identify learning objectives, outcomes • Define audience, environment, expectations • Locate reasonable case • Determine critical (expert) path • Align decision nodes with learning objectives • Assign values to decisions • Associate feedback with both positive and negative decisions

21. Technical Stuff • Cross-platform, cross-browser compatible • Web-based using VB.NET, SQL, Flash • Well documented code • Flexible web services structure - integrates into existing LMS, external reporting, 3rd party apps • Fully functional application – ready for large-scale testing and refinement

22. Technology Adoption Curve vpSim Innovators Early Adopters Early Majority Late Majority Laggards Adapted from Geoffrey Moore, Crossing the Chasm, 1991

37. Comparables • Labyrinth, OpenLabyrinth + VUE – Cumbersome two application process • WebSP, UConn – Exploratory only • DiagnosisX – Complicated, not MedBiq compatible • DxR – Complicated, not MedBiq

38. Most Schools Subscribe