Andrzej A. Kononowicz, Aleksandra J. Stachoń Monika Guratowska, Paweł Krawczyk To start from scratch or to repurpose: That is the Question London, ICVP 2010, Wednesday April 28, 2010, 10:00–11:30 Virtual Patients: Repurposing and Collaborative Development

Jagiellonian University Founded in students / 2000 medical students Very limited experience in VP construction Joint eViP in hosted first ICVP conference in Kraków 2 ICVP 2010

UJ virtual patient database VP system in use: CASUS® (LMU Munich, Linear „string-of- pearls” data model) Text-intensive (average characters), selfstudy scenarios Cases database: 30+ repurposed cases, 30 new cases Topics: Internal Medicine, Cardiology, Neurology, Haematology, Anaesthesiology, Allergology, Gynaecology, Nephrology, Radiology, Obstetrics, Nursing Sciences, Gastroenterology, Infectious Diseases, Ophthalmology and Oncology 3 ICVP 2010

Survey Goal: Survey into opinions on repurposing among personel involved into eViP at UJ Inclusion criteria: working at least on two VP cases (creating from scratch/repurposing) Sample (22): – Translators (3) – Subject matter experts (15) – Learning technologists (2) – Technical developers (2) Question items: 28 (19 Likert, 5 MCQ, 4 free-text) Time: October 2009 – January ICVP 2010

Survey results 1/4 Preferred content of VP database Strongly Disagree NeutralAgree Strongly Agree No Answer Average Fewer disciplines with more VP cases in each discipline better than more disciplines with fewer VP cases in it 1 (5%)7 (32%)5 (23%) 3 (14%)6 (27%)0 (0%)3,3 VP should present rare rather than common diseases 4 (18%) 11 (50%) 7 (32%) 0 (0%) 2,1 VPs should be created by people involved in teaching 0 (0%) 7 (32%) 8 (36%)6 (27%)1 (5%)4,0 5 ICVP 2010

Survey results 2/4 Opinions on which VP elements can be transferred between different countries (ordered by the average score) Strongly Disagree NeutralAgree Strongly Agree No Answer Average Patient’s background0 (0%) 2 (9%)7 (32%)13 (59%) 0 (0%)4,5 Examination results0 (0%) 1 (5%)12 (55%)9 (41%)0 (0%)4,4 History of the patient0 (0%) 2 (9%)13 (59%)7 (32%)0 (0%)4,2 Expert comments0 (0%) 3 (14%)12 (55%)7 (32%)0 (0%)4,2 Questions with feedback0 (0%) 4 (18%)10 (45%)7 (32%)1 (5%)4,1 Description of diagnostic actions and therapeutic effects 0 (0%)1 (5%)4 (18%)13 (59%)4 (18%)0 (0%)3,9 Multimedia1 (5%) 5 (23%)8 (36%)7 (32%)0 (0%)3,9 Selection of diagnostic methods 0 (0%)2 (9%)4 (18%)12 (55%)4 (18%)0 (0%)3,8 Literature references1 (5%)10 (45%)5 (23%)4 (18%)2 (9%)0 (0%)2,8 6 ICVP 2010

Survey results 3/4 Repurposing vs new VP authoring Strongly Disagree NeutralAgree Strongly Agree No Answer Average VP repurposing makes sense 0 (0%)2 (9%)5 (23%)8 (36%)7 (32%)0 (0%)3,9 I prefer to repurpose than to create from scratch 1 (5%)6 (27%) 5 (23%)1 (5%)3 (14%)2,9 Repurposing taught me how to create VPs 1 (5%)0 (0%)3 (14%)10 (45%)5 (23%)3 (14%)3,9 Repurposing was for me an interesting experience 0 (0%)1 (5%)4 (18%)0 (0%)13 (59%) 4 (18%)4,4 Creating cases from scratch was for me an interesting experience 0 (0%) 1 (5%)4 (18%)12 (55%) 5 (23%)4,6 Repurposing leaves enough room for self- initiative 0 (0%)5 (23%) 1 (9%)3,5 7 ICVP 2010

Survey results 4/4 Attitude towards repurposing depends strongly on the particular case Difficulty with finding cases in the pool of VPs that meet the expectations of teachers and fitting them into an existing medical curriculum with defined learning objectives Problems with access to source/raw multimedia material for repurposing ICVP Free-text comments

Summary Repurposing is very interesting at the beginning to learn the possibilities of a new tool Limitations of repurposing – Some author prefers to implement their own educational ideas – Strong dependencies on national guidelines – Difficulties in transferring multimedia between different cultures Development of an evaluation tool that could assess the repurposing potential of a case 9 ICVP 2010