The eViP Consortiumwww.virtualpatients.eu

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)

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How are they used?Problem-based learning

Teaching

Learning

Exams

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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”

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Is repurposing and enriching existing VPsan effective way to share?

eViP Partners1. St George’s, University of London, UK2. Karolinska Institutet, Sweden3. Ludwig-Maximilians-University, Munich, Germany4. University of Warwick, UK5. Universiteit Maastricht, Netherlands6. Heidelberg University, Germany7. University of Medicine Cluj-Napoca, Romania8. Uniwersytet Jagiellonski, Poland9. University of Witten Herdecke, Germany

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eViP Collaborators• MedBiquitous www.medbiq.org • DecisionSimulation, JB McGee, University of

Pittsburgh www.decisionsimulation.com • mEducator www.meducator.net • AAMC and MedEdPORTAL • Creative Commons www.creativecommons.org • AMEE www.amee.org • MedEdWorld www.mededworld.org • Chinese University of Hong Kong • Northern Territory General Practice, Australia• University of West Indies, Trinidad and Tobago

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eViP Work DoneWP1: Pilot Case Study

WP2: Standard implementationWP3: VP Repurposing and Enrichment

WP4: Awareness & DisseminationWP5: Assessment & Evaluation

WP6: Exit & SustainabilityWP7: Project management

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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 repurposing3. Conduct repurposing exercises4. Tested feasibility of definitions5. Analysed the efficiency of repurposing6. Obtained feedback from staff involved in repurposing7. Obtained feedback from staff and students using VPs8. 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

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UMWorkflow

Identify ‘paediatric VPs’ delivered in HDSTART

Lars

FINISH

Select VPs from HD not yet

available in UM

Review selected HD VPs by

experts at UM

Discuss suitability of German VPs for Dutch curriculum and identify

missing content to enrich

Adapt Virtual Learning

Environment to fit the VP

Customise VP player user-

interface (e.g. from HD to UM)

Select VP and translate (German to Dutch culture)

Check language with native speaker

Repurpose and enrich VP for local

culture and educational scenario

Test and GO-LIVE

WP2: Standards Implementation

What did we do? 1. Established a Technical Reference Group (TRG)2. Developed the eViP application profile3. Created eViP metadata profile4. Developed eViP conformance testing suites5. Implemented the eViP application profile6. 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 VPs2. Select VPs for repurposing and enrichment3. Repurpose VPs across different cultures4. Repurpose across different health care disciplines5. Adapt VPs to the eViP application profile6. Develop a peer-review process for quality assurance7. 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 www.virtualpatients.eu 2. Publish all eViP outputs and documentation3. Develop an online following using a social networking

strategy4. Publishing up-to-date articles, interviews, podcasts and

videos about eViP and related VP topics5. Present eViP activity and documentation at conferences6. 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 scenarios2. Developed evaluation instruments for VP design and curricula

integration3. Evaluated a set of repurposed and enriched VPs4. Established an Assessment and Evaluation Group (AEG)5. Present eViP activity and documentation at conferences6. 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 models2. Agreed copyright and IPR model3. Agreed awareness & dissemination model

WP6: Highlights

• Overcoming IPR barriers in sharing digital content across Europe

• Agreed a sustainability model for eViP

IPR ManagementSteps involved1.Evaluate IPRs relating to VPs in partner jurisdictions2.Agree and adopt common consent form and patient

information sheethttp://www.virtualpatients.eu/resources/evip-common-consent-form/

3.License resources using Creative Commons4.Create a best practice workflow

Campbell et al., 2009

5.Work towards a clinical commons

www.virtualpatients.eu Led by St George’s University of London involving all partners

WP7: Project Management

What did we do? 1. Established a robust project management structure2. Created effective communication mechanisms 3. Monitor the project development4. 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

-1st 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 2nd 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

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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 www.jorum.ac.uk

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