Scenarios for the implementation of

VPs into the medical curriculum

by the example of JUMC's
participation
in the
A.J. Stachoń, eViP-Programme
A.A. Kononowicz, I. Roterman-Konieczna
Department of Bioinformatics and Telemedicine,
Jagiellonian University Medical College, Kraków, Poland

I. Hege, M. Holzer, M.R. Fischer

Medical Education Unit, Medizinische Klinik-Innenstadt,
Ludwig-Maximilians-University, München, Germany

M. Adler
Instruct AG, München, Germany

www.virtualpatients
September 2006
 The eViP Project
 3-years project co-funded by the European Union
 Aims
■ Creating large international repository of virtual patients
■ Sharing/exchanging of virtual patients
■ Repurposing of virtual patients (adaptation of VPs to national
health care standards and conditions)
■ Implementation of virtual patients into the local medical curricula
 Project Partners
■ St George’s, University of London

eViP
■ Karolinska Institutet
■ Ludwig-Maximilians University Munich
■ University of Warwick
■ Maastricht University
■ University of Heidelberg
■ University "Iuliu Hatieganu" Cluj-Napoca
■ Jagiellonian University Medical College http://www.virtualpatients.eu

September 2006
 First year of eViP
 Goal: close collaboration between pairs of project partners

Ludwig-Maximilians-University Jagiellonian University

Munich, Germany Medical College, Kraków, Poland

eViP September 2006

 LMU & UJ repurposing workflow
Virtual Patient (VP) content is obtained from Munich
content (including text, figures, images, videos)

Translation of the text from

translation German or English into Polish

Content matter experts

adaptation repurpose the case to national
standards and conditions

Adaptation of multimedia materials media

eViP
(e.g. movie subtitles,
localized images&forms)

ready
VP waiting to be introduced into
medical curriculum
further
repurposing
e.g.
• interdisciplinary repurposing:
medicine → nursery
• structure repurposing
linear → branched

September 2006
Examples of media adaptation activities

Adding subtitles

eViP
Localization (medical documentation)

September 2006
 UJ VP Inventory after first year of eViP
Id VP’s Name VP’s Age and Gender Specialization

Haematology
1 Eberle / Terlecka 78, F
Acquired Haemophilia A
Cardiology
2 Angermeier / Andrzejewski 48, M
Myocardial Infarction
Cardiology
3 Vogt / Wolski 54, M
Renal Arteriostenosis

4 Maller/ Malarz 35, M

Cardiology READY
Acute Muocarditis
Endocrinology
5 Seidel / Szymura 35, F
Hodgkin’s Disease
 11 cases repurposed
Endocrinology
6 Gross / Grochocka 57, F
Sjögren’s Syndrom from CASUS®
Gastroenterology
7 Mayer / Majewska 62, F
Helicobacter pylori

eViP
8 Meissner / Myszkowski 77, M
Gastroenterology  2 cases repurposed
Gastric ulcer
from Polish paper cases
Surgery
9 Stolarska 25, F
Appendicitis
Infectious diseases
10 Schulte / Schulte 19, F
Infectious mononucleosis
Allergology
11 Kowalska 20, F
Hereditary Angioedema

Neurology
12 Goetz / Bożko 71, F
Subarachnoid haemorrhage

Traumatology
13 Rolf / Banachowski 17, M
Shank injury

September 2006
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September 2006
eViP
 UJ’s VP scenarios realized in the first year
of the eViP project
Numer of Scenario of Material/
Group of Students Year of Study Class
Students implementation Virtual Patients

Medical Polish Students 2 eViP cases

231 3rd Telemedicine 2 self-study
(Pilot Study) in Polish

Medical
2 eViP cases
Dentistry Polish Students 76 3rd informatics and self-study
in Polish
statistics 2

eViP
Medical Foreign Basis of Computer 2 eViP cases
68 1st self-study
Students Science in English

learning-by- creation of
Medical PhD 48 post-graduate Computer Science
teaching 14 new VPs

Applied Computer creation of

Science Students VP content
27 4th E-learning Flash
(supervised by medical experts) Enrichment
animation

September 2006
 Surveys in the project’s first year - results
Scenario of
Q3 Q4 VP’s mark
Group of Students N Students preferences
implementation
Likert Scale 1 - 5 Scale 1 - 10

75% self study

Medical Polish
52% classes 7,4
Students 134 self-study 4,2 -
(Pilot Study) 65% revision 7,8
29% assessment

81% self study

Dentistry Polish 60% classes 8,0
Students
56 self-study 4,4 4,4
72% revision 8,2

eViP
48% assessment

60% self study

Medical Foreign 56% classes 7,4
Students
25 self-study 3,9 3,8
16% revision 7,3
48% assessment

Q3 – Was the presented clinical case interesting for you?

Q4 – Would you like to have VPs implemented to your medical study?

September 2006
 Key factors for supporting the
integration
 Support from experienced eViP partners
 Support from students
 Translations
 Content enrichment (Students of Comp. Science)
 VP authoring (PhD Candidates)

eViP
 Willingness to participate in VPs classes
 Incentives for authors guaranteed by eViP
 Mixed bottom-up & top-down approach

September 2006
 Future goals and perspectives

• Continue/Broaden integration with clinical

courses
• Share experiences with other partners

eViP
• Joint research studies with other institutes

September 2006
1st International Conference on Virtual Patients

Kraków, Poland
5 J une to 6 J une 2009
www.icvp.eu

eViP September 2006

 Surveys in the project’s first year - results
Group of Scenario of Q3 Q4 Q6 Q7 Q8 Q9 Q11 Q12 Students VP’s mark
N
Students implementation preferences
Likert Scale 1 - 5 Scale 1 - 10
75% self study
Medical Polish
52% classes 7,4
Students 134 self-study 4,2 - 4,2 4,2 4,1 3,9 4,3 4,6
65% revision 7,8
(Pilot Study)
29% assessment

81% self study

Dentistry Polish 60% classes 8,0
56 self-study 4,4 4,4 4,3 4,6 4,4 3,9 4,3 4,6
Students 72% revision 8,2
48% assessment

60% self study

Medical Foreign 56% classes 7,4
25 self-study 3,9 3,8 - 3,8 3,9 3,6 - 3,9

eViP
Students 16% revision 7,3
48% assessment

Q3 – Was the presented clinical case interesting for you?

Q4 – Would you like to have VPs implemented to your medical study?
Q6 – Was the content of the VP understandable?
Q7 – Was the content of the VP logically structured?
Q8 – Did the presented case contain useful knowledge?
Q9 – Do you believe that learning using virtual patients is more efficient than conventional methods?
Q11 – Was the language of the VP appropriate?
Q12 – Was the VP system (CASUS) easy to operate?

September 2006
 Virtual Patients at JUMC before eViP
 Non-coordinated bottom-up initiatives of individual
faculty members


eViP MicroSIM ®

Little experience with case-based learning

http://www.laerdal.com

September 2006
 Key factors to remember
 Legal issues
 Patient’s consent
 VP’s copyright cleared
 Incentives for content authors and educators
 Financial
 Organizational
 Changes in curriculum
 Where to use VPs?

eViP
 How to motivate student to use VPs?
 Technical Issues
 VP System (own development, existing system)
 VP Model (linear, branched)
 VP repository profile
 Specialized (few discipilnes with many cases) ?
 Broad Scoped (VPs should cover as many disciplines as possible with
potentially few cases) ?

September 2006
 VP Content Enrichment
Student’s projects

eViP September 2006