KE9 Curriculum Integration Design: Virtual Patient Year 2 Learning in context Dr Nicola Englyst, Dr...
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Transcript of KE9 Curriculum Integration Design: Virtual Patient Year 2 Learning in context Dr Nicola Englyst, Dr...
![Page 1: KE9 Curriculum Integration Design: Virtual Patient Year 2 Learning in context Dr Nicola Englyst, Dr Kirsten Poore, Dr Claire Smith 24 th March 2011.](https://reader035.fdocuments.us/reader035/viewer/2022070406/56649e005503460f94ae89e6/html5/thumbnails/1.jpg)
KE9 Curriculum Integration Design: Virtual Patient Year 2Learning in context
Dr Nicola Englyst, Dr Kirsten Poore, Dr Claire Smith24th March 2011
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Project overview: Year 2: 'Preclinical' Medical EducationSpiralling CurriculumSemester 3
Gastrointestinal
Nervous and Locomotor 2
Semester 4
Respiratory, Cardiovascular and Renal 2
Endocrinology and the Life Cycle
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Our challenges when teaching medicine…
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How do we make learning facts interesting?!!
Lecture
Lecture
Lecture
Lecture
Lecture
Practical
Lecture Practical
Practical
Symposium
Symposium
Feedback
– Basic sciences + basic clinical information
– Lectures, tutorials, practicals and symposia1 case per
week throughout semester
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• Different learning styles and preferences.
• “Tell me, and I will forget. Show me, and I may remember. Involve me, and I will understand"
– Confucius
• Kolb: Experiential Learning Cycle
Our students are all individuals!
feeling
watchingdoing
thinking
tactilevisual
auditory
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Feedback• Students want more feedback!
• Can we provide instant individualised feedback for 250 students?
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Continuity in teaching and learning
• Our educators come from a variety of backgrounds.
• Can we find a way to provide continuity of
teaching?
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KE9 Curriculum Integration DesignOur challenge:
• To present basic scientific facts necessary to build a medical career on, in a way that is relevant, interesting and educational.
Integration of eLearning, either materials or technology, need to be designed as part of the curriculum, just like other curriculum activities.
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The aim of this project:
• To develop a series of interactive Virtual Patients to reinforce the links between science and students' future medical careers.
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VP Year 2: Curriculum Integration Design• needs and requirements of the various stakeholder
groups were initially assessed:
– liaison with curriculum management groups and students
– consulting the GMC guidelines published in Tomorrow’s Doctors
– review of available literature concerning interactive multimedia, learning theories, Human Computer Interaction (HCI) and medical education
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VP Year 2: Curriculum Integration Design
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• Virtual Patients must be integrated into existing teaching
– redevelopment of Endocrinology and Life Cycle Course (2008) specifically included incorporation of Virtual Patients
• Virtual Patients must be aligned with Learning Outcomes
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VP Year 2: Curriculum Integration Design
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Lecture
Lecture
Lecture
Lecture
Lecture
Practical
Lecture Practical
Practical
Symposium
Symposium
Feedback
Direct access
VP Year 2: Curriculum Integration Design
08:00Virtual Patient
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Year 2: Six Virtual Patients developed• In Semester 3, Gastrointestinal Course:
– Mr Andrew King with reflux disease
– Mikey Botley with infectious diarrhoea
– Mikey Botley with Hemolytic-Uremic Syndrome (HUS)https://www.som.soton.ac.uk/learn/bm/bmgastro/patient/
• In Semester 4, Endocrinology and the Life Cycle Course:
– Mr and Mrs Andrews with infertility problems
– Rachel Denver with type 1 diabetes
– Mrs Jane Rice with type 2 diabeteshttps://www.som.soton.ac.uk/learn/bm/bmendocrinologylifecycle/patient/
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Year 2: Virtual Patient content
Clinical scenario laid out:
• 3D animations or videos
• interactive tasks
• basic science-related quizzes
• embedded learning materials
– links to lectures
– patient information sheets
– external websites
Helps students to:
• test basic science understanding in a clinical context
• develop clinical skills by taking the role of a doctor interacting with a patient
• think from a patient’s perspective
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Year 2: expected level
• integrative learning: anatomy, histology, physiology, pharmacology
• more diagnostic
• more discussion of treatment options
gateway into clinical Years 3 onwards
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VP Year 2: Examples
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The scene is set: eg. video of an initial consultation
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links to other relevant teaching and learning resources
Interactive quizzes based on information presented
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student's completed
work
• student inputs, answers to questions and summary medical notes are stored
– enables students to resume a Virtual Patient at a later date
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• recorded data are used to analyse students’ performance
– offers individualised feedback for poorly understood topics
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Year 2: Teacher access
• teaching staff can also monitor Virtual Patient usage and students’ performance for each learning outcome associated to the case
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Year 2: EvaluationStudent evaluation ratings at end of Semester: Overall
Virtual Patient ratings for Year 2 were 3.6 (2010) and 3.9 (2009) out of 5
User tracking data: usage numbers
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Academic year
ELC Infertility
ELC Diabetes 1
ELC Diabetes 2
GI
Reflux
GI
Diarrhoea
GI
HUS
2008 N/A N/A N/A 116 N/A N/A
2009 200 153 216 109 90 22
2010 178 262 230 81 44 24
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VP Year 2: EvaluationFocus groups:
• Students rated Virtual Patients highly, particularly liking the formative feedback they provided
Informal discussions:
• Semester coordinators reported that students who failed the semester were also frequently failing to use the Virtual Patients
– engaged student understand that full use of course material enables an ability to understand the subject
• especially since the Virtual Patients are linked to assessments!
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VP Year 2: EvaluationOnline questionnaires:
• Pre-questionnaires (80 completed): >50% cited importance of clinically relevant and realistic case scenarios, 23% wanted VPs to be constructive and integrated
• Post-questionnaires (35 completed): generally very positive. Eg. meeting expectations was rated above 4 (5 = very much); features most liked were clinically relevant and realistic clinical scenarios, and instant and individualised feedback
– most wanted more Virtual Patients in their curriculum!
– would use the Virtual Patients for assessment revision
– recommend them to their fellow students25
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• Spread the word! (to students and teaching staff)
• Incorporate the VPs into your timetable
• Course coordinators provide a demonstration to students
– Where to find the VPs
– How to use the VPs
– Benefits of using VPs
– Outlining link with learning outcomes and assessments
KE9 Curriculum Integration Design:our handy tips for getting your VP
noticed!
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KE9 Curriculum Integration Design:our handy tips for getting your VP
noticed!• Key staff were reminded about VPs
Case history 3 years on:
• Rachel is now 25 years old
• Diagnosed with type 1 diabetes 3 years ago
• Relatively well controlled
• Studying for her finals
Hormones in diabetic ketoacidosis•Increased catabolic hormones
•Glucagon•Catecholamines•Cortisol•Growth hormone
•Absolute or relative insulin deficiency
What are the physiological changes causing Rachel’s initial symptoms?
• Thirst
– Excess peeing- reduce glucose and KBs
– Vomiting & dehydration
• Nausea & vomiting
– Toxic ketoacid elimination, hyperglycemia
• Breathlessness
– Kussmaul’s respiration- deep breaths to decrease CO2 to raise pH
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VP Year 2: Future work• For the remaining weeks of each course, ‘Paper-based Virtual
Patients' enable weekly case-based learning to continue throughout Year 2
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• discussed in Friday feedback sessions as for online Virtual Patients
• will form framework for future Virtual Patients
• will require further funding
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VP Year 2: Conclusion• a successful model of curriculum integration
• ongoing refinement to ensure students make full use of Virtual Patients' potential
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VP Year 2: Acknowledgements• Project leader: Dr Sunhea Choi
• Content authors: Dr Myron Christodoulides, Dr Claire Smith, Dr Nicola Englyst, Dr Ying Cheong, Dr Kirsten Poore
• Learning designer: Dr Sunhea Choi
• eLearning Developer: Matt Hammerton
• Multimedia Developer: Mimi Lee
• Funding: Faculty of Medicine with match funding from NHS Education South Central.
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