Virtual patient

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The term virtual patient is used to describe interactive computer simulations used in health care education [1] to train students on clinical processes such as making diagnoses and therapeutic decisions. [2] Virtual patients attempt to combine modern technologies and game-based learning to facilitate education, and complement real clinical training. [3] The use of virtual patients is increasing in healthcare due to increased demand for healthcare professionals and education of healthcare trainees, and provides learners with a safe practice environment. [2] There are many formats from which a virtual patient may be chosen, but the overarching principle is that of interactivity. Virtual patients typically have mechanisms where information is parsed out in response to the learners, simulating how patients respond to different treatments. Interactivity can be created with questions, specific decision-making tasks, text composition, etc., and is non-sequential. Most systems provide quantitative and qualitative feedback.[ citation needed ] In some cases, virtual patients are not full simulations themselves, but are mainly based on paper-based cases; as they do not allow for physical examination or an in-depth medical history of an actual patient. [4] There are certain drawbacks as crucial clinical findings may be missed due to the lack of examining patients in person.

Contents

Forms

Virtual patients may take several different forms: [5]

Types of interactions

Several different modes of virtual patient delivery have been defined: [6]

Possible benefits

Research has shown that utilizing virtual patients is time-efficient and cost-effective for developing clinical reasoning skills in students through independent and repeated practice of physician tasks in a safe environment without the risk of harm to the patient or learner, which can significantly increase the mental pool of learned cases in students. [7] [8] Unlike simulated or real patients, virtual patients can be accessed on demand, and the user may monitor a case over several months while spending less than an hour in real time. [9] Furthermore, virtual patients can be endlessly replayed and easily modified to allow the user to explore different clinical scenarios and patient outcomes. [8] [10]  Compared to simulated patients, virtual patients make observation and assessment more robust and easier to control, and they can be used as a standardized assessment method. [11] Simulated patients can be viewed as educational tools that enhance existing methods of clinical teaching, making them more efficient and increasing the fairness of skill evaluation.

Over-reliance on hypothetical "average" models has been criticized for not teaching medical students to identify the significant amount of normal variation seen in the real world. [12]

Data standards

The MedBiquitous consortium established a working group in 2005 to create a free and open data standard for expressing and exchanging virtual patients between different authoring and delivery systems. [13] This was in part to address the problem of exchanging and reusing virtual patients and in part to encourage and support easier and wider use of virtual patients in general.

This standard has been very successful and is now widely adopted, e.g. in major projects like eViP. In 2010, this standard attained status as an ANSI standard.

Related Research Articles

<span class="mw-page-title-main">Simulation</span> Imitation of the operation of a real-world process or system over time

A simulation is an imitative representation of a process or system that could exist in the real world. In this broad sense, simulation can often be used interchangeably with model. Sometimes a clear distinction between the two terms is made, in which simulations require the use of models; the model represents the key characteristics or behaviors of the selected system or process, whereas the simulation represents the evolution of the model over time. Another way to distinguish between the terms is to define simulation as experimentation with the help of a model. This definition includes time-independent simulations. Often, computers are used to execute the simulation.

<span class="mw-page-title-main">Mixed reality</span> Merging of real and virtual worlds to produce new environments

Mixed reality (MR) is a term used to describe the merging of a real-world environment and a computer-generated one. Physical and virtual objects may co-exist in mixed reality environments and interact in real time.

<span class="mw-page-title-main">Medical education</span> Education related to the practice of being a medical practitioner

Medical education is education related to the practice of being a medical practitioner, including the initial training to become a physician and additional training thereafter.

Roleplay simulation is an experiential learning method in which either amateur or professional roleplayers improvise with learners as part of a simulated scenario. Roleplay is designed primarily to build first-person experience in a safe and supportive environment. Roleplay is widely acknowledged as a powerful technique across multiple avenues of training and education.

An objective structured clinical examination (OSCE) is an approach to the assessment of clinical competence in which the components are assessed in a planned or structured way with attention being paid to the objectivity of the examination which is basically an organization framework consisting of multiple stations around which students rotate and at which students perform and are assessed on specific tasks. OSCE is a modern type of examination often used for assessment in health care disciplines.

In health care, a simulated patient (SP), also known as a standardized patient, sample patient, or patient instructor, is an individual trained to act as a real patient in order to simulate a set of symptoms or problems. Simulated patients have been successfully utilized for education, evaluation of health care professionals, as well as basic, applied, and translational medical research.

Hertfordshire Intensive Care & Emergency Simulation Centre (HICESC) is an advanced teaching facility based at the University of Hertfordshire. At its creation in 1998, it was an inter-Faculty practical laboratory hosted by the Department of Electronic, Communication and Electrical Engineering (ECEE) for access by medical engineering students and jointly established by the Department of Nursing and Paramedic Sciences, Faculty of Health and Human Sciences for use by their students.

A serious game or applied game is a game designed for a primary purpose other than pure entertainment. The "serious" adjective is generally prepended to refer to video games used by industries like defense, education, scientific exploration, health care, emergency management, city planning, engineering, politics and art. Serious games are a subgenre of serious storytelling, where storytelling is applied "outside the context of entertainment, where the narration progresses as a sequence of patterns impressive in quality ... and is part of a thoughtful progress". The idea shares aspects with simulation generally, including flight simulation and medical simulation, but explicitly emphasizes the added pedagogical value of fun and competition.

<span class="mw-page-title-main">Medical simulation</span> Medical training and evaluation technique

Medical simulation, or more broadly, healthcare simulation, is a branch of simulation related to education and training in medical fields of various industries. Simulations can be held in the classroom, in situational environments, or in spaces built specifically for simulation practice. It can involve simulated human patients, educational documents with detailed simulated animations, casualty assessment in homeland security and military situations, emergency response, and support for virtual health functions with holographic simulation. In the past, its main purpose was to train medical professionals to reduce errors during surgery, prescription, crisis interventions, and general practice. Combined with methods in debriefing, it is now also used to train students in anatomy, physiology, and communication during their schooling.

An instructional simulation, also called an educational simulation, is a simulation of some type of reality but which also includes instructional elements that help a learner explore, navigate or obtain more information about that system or environment that cannot generally be acquired from mere experimentation. Instructional simulations are typically goal oriented and focus learners on specific facts, concepts, or applications of the system or environment. Today, most universities make lifelong learning possible by offering a virtual learning environment (VLE). Not only can users access learning at different times in their lives, but they can also immerse themselves in learning without physically moving to a learning facility, or interact face to face with an instructor in real time. Such VLEs vary widely in interactivity and scope. For example, there are virtual classes, virtual labs, virtual programs, virtual library, virtual training, etc. Researchers have classified VLE in 4 types:

<span class="mw-page-title-main">Harvey mannequin</span> Medical simulator

Harvey was one of the earliest medical simulators available for training of health care professionals. Harvey was created in 1968 by Dr. Michael S. Gordon at the University of Miami. Harvey is currently sold by the Laerdal Corporation.

<span class="mw-page-title-main">Gene Hobbs</span> American technical diver and co-founder of the Rubicon Foundation

Eugene Weston Hobbs II, known as Gene Hobbs is an American technical diver and founding board member of the non-profit Rubicon Foundation. Hobbs has served as medical officer for the Woodville Karst Plain Project since 2004 and was named the 2010 Divers Alert Network/ Rolex Diver of the year. Hobbs was a hyperbaric technologist and simulation coordinator at Duke Medical Center before taking a position as the Director of Simulation for the University of North Carolina School of Medicine and Clinical Instructor in the Department of Pediatrics. As of 2018, Hobbs is the business manager for the UNC Health Care Department of Neurosurgery.

The Dextroscope is a medical equipment system that creates a virtual reality (VR) environment in which surgeons can plan neurosurgical and other surgical procedures.

An in silico clinical trial, also known as a virtual clinical trial, is an individualized computer simulation used in the development or regulatory evaluation of a medicinal product, device, or intervention. While completely simulated clinical trials are not feasible with current technology and understanding of biology, its development would be expected to have major benefits over current in vivo clinical trials, and research on it is being pursued.

<span class="mw-page-title-main">Treatment decision support</span>

Treatment decision support consists of the tools and processes used to enhance medical patients’ healthcare decision-making. The term differs from clinicaldecision support, in that clinical decision support tools are aimed at medical professionals, while treatment decision support tools empower the people who will receive the treatments. This service may be delivered at the site of healthcare services, or as an employee benefit through third-party providers.

<span class="mw-page-title-main">MSR – The Israel Center for Medical Simulation</span>

MSR – The Israel Center for Medical Simulation is Israel's national institute for simulation-based medical education (SBME) and patient safety training. It is located at the Chaim Sheba Medical Center in the Tel HaShomer neighborhood of Ramat Gan, in the Tel Aviv District. MSR is internationally recognized as leader in patient safety simulation-based training.

Virtual reality (VR) is a computer application which allows users to experience immersive, three dimensional visual and audio simulations. According to Pinho (2004), virtual reality is characterized by immersion in the 3D world, interaction with virtual objects, and involvement in exploring the virtual environment. The feasibility of the virtual reality in education has been debated due to several obstacles such as affordability of VR software and hardware. The psychological effects of virtual reality are also a negative consideration. However, recent technological progress has made VR more viable and promise new learning models and styles for students. These facets of virtual reality have found applications within the primary education sphere in enhancing student learning, increasing engagement, and creating new opportunities for addressing learning preferences.

<span class="mw-page-title-main">Virtual reality applications</span> Overview of the various applications that make use of virtual reality

There are many applications of virtual reality. Applications have been developed in a variety of domains, such as education, architectural and urban design, digital marketing and activism, engineering and robotics, entertainment, virtual communities, fine arts, healthcare and clinical therapies, heritage and archaeology, occupational safety, social science and psychology.

Immersive learning is a learning method which students being immersed into a virtual dialogue, the feeling of presence is used as an evidence of getting immersed. The virtual dialogue can be created by two ways, the usage of virtual technics, and the narrative like reading a book. The motivations of using virtual reality (VR) for teaching contain: learning efficiency, time problems, physical inaccessibility, limits due to a dangerous situation and ethical problems.

Virtual reality is the creation of a three-dimensional, interactive environment. With this technology, users are able to move through this developed simulation, as if it is real.

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