The eViP Consortium

What is a Virtual Patient? “An interactive computer simulation of real-life clinical scenarios for the purpose of medical training, education, or assessment” Ref: An architectural model for MedBiquitous virtual patients by R Ellaway, C Candler, P Greene, V Smothers (2006)

How are they used? Problem-based learning Teaching Learning Exams

Problem-based Learning Sessions

Teaching Sessions

Self-directed Learning

Formative and Summative Exams

Virtual Patients

electronic Virtual Patients 3-Year programme involving 6 separate projects 9 European partners and other collaborators Co-funded by the European Commission “To create a shared online bank of virtual patients, adapted for multicultural and multilingual use, for the improved quality and efficiency of medical and healthcare education across the world” Is repurposing and enriching existing VPs an effective way to share?

eViP Partners 1.St George’s, University of London, UK 2.Karolinska Institutet, Sweden 3.Ludwig-Maximilians-University, Munich, Germany 4.University of Warwick, UK 5.Universiteit Maastricht, Netherlands 6.Heidelberg University, Germany 7.University of Medicine Cluj-Napoca, Romania 8.Uniwersytet Jagiellonski, Poland 9.University of Witten Herdecke, Germany

eViP Collaborators MedBiquitous DecisionSimulation, JB McGee, University of Pittsburgh mEducator AAMC and MedEdPORTAL Creative Commons AMEE MedEdWorld Chinese University of Hong Kong Northern Territory General Practice, Australia University of West Indies, Trinidad and Tobago

eViP Work Done WP1: Pilot Case Study WP2: Standard implementation WP3: VP Repurposing and Enrichment WP4: Awareness & Dissemination WP5: Assessment & Evaluation WP6: Exit & Sustainability WP7: Project management What did we do? What were the highlights? What was the impact?

WP1: Pilot Case Study What did we do? 1.Define repurposing (define from a high level) 2.Define different types of VP repurposing 3.Conduct repurposing exercises 4.Tested feasibility of definitions 5.Analysed the efficiency of repurposing 6.Obtained feedback from staff involved in repurposing 7.Obtained feedback from staff and students using VPs 8.Collated feedback and finalised the report

WP1: Highlights Proving the feasibility of VP repurposing and enrichment There was a positive response from staff AND students Established workflows for repurposing and enrichment

Typical Repurposing Workflow

WP2: Standards Implementation What did we do? 1.Established a Technical Reference Group (TRG) 2.Developed the eViP application profile 3.Created eViP metadata profile 4.Developed eViP conformance testing suites 5.Implemented the eViP application profile 6.Constructed a consent and licensing workflow 7.Created Best Practice Guidelines for standards implementation

WP2: Highlights First ever international standard for VPs Successful implementation of the eViP application profile A new licensing model for academia across Europe

WP3: Repurposing & Enrichment What did we do? 1.Identify and publish an inventory of existing VPs 2.Select VPs for repurposing and enrichment 3.Repurpose VPs across different cultures 4.Repurpose across different health care disciplines 5.Adapt VPs to the eViP application profile 6.Develop a peer-review process for quality assurance 7.Contribute to the development of the eViP VP repository

WP3: Highlights 320+ Repurposed and standardised VPs Overcame cultural, linguistic and socioeconomic differences in VPs Contributed towards a systematic peer-review process Optimised metadata for the medical education community

WP3: Impact Proved the hypothesis that repurposing is more efficient than creating VPs ‘from scratch’

WP4: Awareness & Dissemination What did we do? 1.Develop the eViP website 2.Publish all eViP outputs and documentation 3.Develop an online following using a social networking strategy 4.Publishing up-to-date articles, interviews, podcasts and videos about eViP and related VP topics 5.Present eViP activity and documentation at conferences 6.Publish scholarly articles in relevant journals and newsletters

WP4: Highlights Publishing the referatory of 320+ VPs Comprehensive market research and analysis on how people use VPs 42% increase in site traffic eViP website ranks top in Google search International Conference on Virtual Patients

WP4: Impact More than just a website… –No. 1 port of call for all things VP-related –Dedicated online following (>58% new visitors) –Valuable resources for VPs and VP info (interviews, etc)

WP5: Assessment & Evaluation What did we do? 1.Developed an inventory of existing VP types and implementation scenarios 2.Developed evaluation instruments for VP design and curricula integration 3.Evaluated a set of repurposed and enriched VPs 4.Established an Assessment and Evaluation Group (AEG) 5.Present eViP activity and documentation at conferences 6.Publish scholarly articles in relevant journals and newsletters

WP5: Highlights Mini conference on VP research in Maastricht Publishing eViP evaluation instruments Publishing eViP Best Practice Guidelines First reported effort to describe VP design and curricular implementation

WP5: Highlights

WP6: Exit & Sustainability What did we do? 1.Agreed cooperative business and licensing models 2.Agreed copyright and IPR model 3.Agreed awareness & dissemination model

WP6: Highlights Overcoming IPR barriers in sharing digital content across Europe Agreed a sustainability model for eViP

IPR Management Steps involved 1.Evaluate IPRs relating to VPs in partner jurisdictions 2.Agree and adopt common consent form and patient information sheet License resources using Creative Commons 4.Create a best practice workflow Campbell et al., Work towards a clinical commons Led by St George’s University of London involving all partners

WP7: Project Management What did we do? 1.Established a robust project management structure 2.Created effective communication mechanisms 3.Monitor the project development 4.Foster relations with the wider community

WP7: Highlights Organisation of ICVP MedBiq Development of new style of project management Working as part of a successful team

Impact: Repurposing Demonstrated the value and efficiency of repurposing content from one culture to another Showed repurposing from one VP structure to another is less efficient Demonstrated that repurposing VPs must have an educational value purpose and fit Raised awareness of the steps involved in repurposing, and provided guidance for creation and repurposing.

Impact: Standards and IPR Delivered an ANSI –accredited standards for VPs which was practical and effective Proved there is an important practical role for technical standards in medical education –Making VP content more interoperable –Making VP content more accessible by adopting a unified approach for IPR clearance Produced Internationally recognised IPR clearance model for sharing digital content for use beyond VPs Demonstrated value of blended sustainability approach –Open access –Consultancy-driven

Impact: The website and its resources Over 320 virtual patients openly available The main port of call for virtual patients -1 st on Google >2,000 visitors per month 58% new visitors Full guideline on creation, repurposing etc Provides news and views on virtual patients

Impact: Partner activities Increased awareness of pedagogical aspects relating to VPs 4/5 -fold increase in VP presentations at European conferences half involving eViP partners. Special issue on VPs in Medical Teacher, 2009 Ran 1st and 2 nd international conferences on VPs Uptake of partners VP players worldwide Ran VP Workshops on VP creation, worldwide

Impact: Curriculum Implementation Collaborating with other institutions to: Implement VPs Integrate VPs by: –Replacing paper-based PBL –Supplementing lectures –Supplementing clinical bed-side teaching –Replacing paper-based assessment Evaluate process of curricular implementation Disseminate with wider community

Impact: Community of Practice Continue to engage and disseminate with other institutions using the eViP website to: Develop VP implementation strategies Discuss VP innovations and research Share best practice on all areas associated with VPs Secure further ‘international’ grant funding Eg. the FET flsgship initiative Peer-reviewed VPs to be shared via : –eViP website –MedEdPORTAL –Jorum Open

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