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vp Sim. Simulation Software for Education and Assessment. 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
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vpSim Simulation Software for Education and Assessment
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
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
Technology Adoption Curve “Chasm” You are here Innovators Early Adopters Early Majority Late Majority Laggards ✖ Adapted from Geoffrey Moore, Crossing the Chasm, 1991
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
vpSim DEMONSTRATION
vpSim Approach • The Macintosh of Simulation • Hides the complexity • Author-driven design • Author-tested • Stimulates creativity, “actually fun to use”
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
Traditional VP Authoring Technician Custom VP Software Authors Virtual Patient
vpSim Authoring Authors vpSim vpSim Player Any VP Player MedBiq VP Standard
“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
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
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
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
vpSim simulation for the rest of us For further information and demonstration, mcgee@medschool.pitt.edu vpSim.pitt.edu
Goal: Adoption of Virtual Patients at 75% of Schools
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
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
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
Technology Adoption Curve vpSim Innovators Early Adopters Early Majority Late Majority Laggards Adapted from Geoffrey Moore, Crossing the Chasm, 1991
Comparables • Labyrinth, OpenLabyrinth + VUE – Cumbersome two application process • WebSP, UConn – Exploratory only • DiagnosisX – Complicated, not MedBiq compatible • DxR – Complicated, not MedBiq