The impact of repurposing to different educational levels in the attitudes of medical students towards virtual patients Zofia Mazurek, Jagiellonian University, Faculty of Medicine Andrzej A. Kononowicz Jagiellonian University, Faculty of Medicine, Department of Bioinformatics and Telemedicine

The aim of the study to present the workflow for repurposing a case to different educational levels to evaluate attitudes of medical students towards 2 versions of the same VP case destined for different target groups

Methods The original case was obtained from the eVIP project repository, translated and addapted The simplified version of the case was created The students were randomly allocated to receive the original or the simplified version of the case All the students were asked to complete an electronic questionnaire about VIP

Repurposing The original case:  developed at the Ludwig Maximilian University in Munich  System:  Linear structure

Enrichment with hints, explanations and images Repurposing to different educational level Simplification Removal of advanced, „too difficult” & less significant content Comparison of the curricula (3rd & 5th year) ≈ 30 hours Revising by subject matter expert

Original German case Case suitable for 5th year MS Case suitable for 3th year MS Cards Words Characters (without spaces) Images930 Questions81116

Randomization Data base 145: „advanced” ViP150: „simplified” ViP Activity: 18 Activity: 22 12,4 % 14,7 % Number of students Time (min)Correct answersCompletenessTime/card (min) VP for 5th year MS 1819,9 *44,8 % *55,1 % *0,74 * Simplified VP: for 3th year MS ,4 %85,6 %1,42 * Mann–Whitney U test: p<0,05

eViP student questionnaire assessing their experience with virtual patients for learning & clinical reasoning Source:  de Leng B., Donkers J., Brasch. C., Huwendiek S., Kononowicz A., „Evaluation instruments to support educators in making deliberate choices when they use virtual patients to teach clinical reasoning", Bio-Algorithms and Med-Systems, 5(9),2009 pp. 45 6,8 % of answers: Only 19 questionnaires completed The response rate comparable with different studies: 8,8 % of acceptance  Hege I., Ropp V., Adler M., Radon K., Maesch G., Lyon H, Fischer M. R. ” Experiences with different integration strategies of case-based e- learning”, Medical teacher 29, 2007 pp

Student’s opinion Due to small number of answers statistical analysis showed no significant differences „Remarks and commentaries made the [simplified] case workable at almost every level of medical education” Strongly disagree Strongly agree

Conclusions Voluntary course - unsatisfactory reponse rate The more difficult the content the smaller the interest Better acceptance of curriculum-matching VP: The importance of educational repurposing