REViP An Anglo-German Virtual Patient case study exploring ‘repurposing and enriching’ as an effective way to share Soeren Huwendiek, Chara Balasubramaniam, Jonathan Round

‘Repurposing and Enriching’ as an effective way to share High cost of development of new VP’s ? Can effective VP’s be moved into another setting –Institution –Healthcare setting –Culture –Language

Project outline JISC funded project to look at practicalities and problems Partnership between- St. George’s, University of London Heidelberg University, Germany

Different VP systems: CAMPUS Linear Multiple options Enrichment possible Needs installed player LABYRINTH Branching Several different routes in VP Enrichment possible Runs on most browsers

Project Outline Case selection in CAMPUS German - English Transfer to Word Cultural adaption Transfer to VUE Creation of branching Transfer to Labyrinth Case review Updating of case in CAMPUS Case review REVIEWREVIEW

Mission Impossible (~3 mins)

Results: Challenges Cultural differences –Protocols (e.g. Convulsions) –Language and medical terminology (drug names) –Different cultural contexts (US army patient to Asian family) –Lab value units (mg/dL to mmol/L for glucose) Multimedia (technical) –editing in different formats Structure –from linear to branched

Time taken Case selection in CAMPUS German - English Transfer to Word Cultural adaption Transfer to VUE Creation of branching Transfer to Labyrinth Case review Updating of case in CAMPUS Case review REVIEWREVIEW 10 hours

Time taken Case selection in CAMPUS German - English Transfer to Word Cultural adaption Transfer to VUE Creation of branching Transfer to Labyrinth Case review Updating of case in CAMPUS Case review REVIEWREVIEW 18 hours

Time taken Case selection in CAMPUS German - English Transfer to Word Cultural adaption Transfer to VUE Creation of branching Transfer to Labyrinth Case review Updating of case in CAMPUS Case review REVIEWREVIEW hours hours

What we learnt A case is not hard to repurpose across systems and into a different course Beware transfer between systems - you might lose features Repurposing doesn’t necessarily save time Collaboration brings other benefits

Future developments Using automated repurposing (eViP) RCT - 4th year paediatric students 50% see labyrinth, 50% Campus cases integrated into module comparison study

Thanks to: Tejal Patel Sheetal Kavia Emily Conradi Sophie Vaughan-Davies Benjamin Hanebeck

Results: time taken per case Language translation5 hours Cultural differences 2 hours –Protocols (e.g. Convulsions) –Language and medical terminology (drug names) –Different cultural contexts (US army patient to Asian family) –Lab value units (mg/dL to mmol/L for glucose) Multimedia (technical) 3 hours –editing in different formats Structure 8 hours –from linear to branched

Repurposing VP’s is worthwhile if systems similar Danger of losing best features during repurposing across systems

Comparisons (estimates) CAMPUS case from scratch10-80 hours Revip-ed case without branching10 hours Labyrinth case from scratch 8-15 hours Revip-ed case with branching18 hours