Writing virtual patients; table d’hôte or à la carte?
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Writing virtual patients; table d’hôte
or à la carte?
David Davies & Rachel EllawayWarwick Medical School, UK
Northern Ontario School of Medicine, Canada
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Reasons for this presentation
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Case based learning smörgåsbord
Mezze of diverse designs and applications
Simulated patients, PBL triggers, paper cases, simulation scripts/scenarios, virtual patients etc
Where to start?Same difference?
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Chalk and cheese?
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Warwick Medical School
UK’s only graduate-only school, rural & urban, affluence & deprivation
group-learning, professionalism and IPE themes
case-based template: HEIDR - history, examination, investigation, diagnosis & therapy (management)
… biological, clinical & social science dimension
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Northern Ontario School of Medicine
Northern, rural, remote and aboriginal focus
strong family practice, cultural and IPE themes
Narrative template: characters, person and POV, plot, pace and density, frame of action, regional issues
… socio-cultural and inter-professional dimension
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Ingredients of our cases
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Case Case templatetemplate
Case Case templatetemplate
TherapyTherapyTherapyTherapy
DiagnosisDiagnosisDiagnosisDiagnosis
InvestigatiInvestigationon
InvestigatiInvestigationon
ExaminatioExaminationn
ExaminatioExaminationn
HistoryHistoryHistoryHistory
Case Case templatetemplate
Case Case templatetemplate
POVPOVPOVPOV
PacePacePacePace
FrameFrameFrameFrame
CharactersCharacters& culture& culture
CharactersCharacters& culture& culture
PlotPlotPlotPlot
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Maybe we have the wrong perspective?
Maybe we are too focused on VPs as artifact rather than on the
context in which they are used
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Case Case templatetemplate
Case Case templatetemplate
SchematicSchematicSchematicSchematic NarrativeNarrativeNarrativeNarrative GameGameGameGame SimulationSimulationSimulationSimulation
‘Object oriented’ parent case
child VPs activity/context focused
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SchematicSchematicSchematicSchematic NarrativeNarrativeNarrativeNarrative GameGameGameGame SimulationSimulationSimulationSimulationtype
PresentatiPresentation-basedon-basedPresentatiPresentation-basedon-based
Character-Character-basedbased
Character-Character-basedbased Rule-basedRule-basedRule-basedRule-based PerformanPerforman
ce-basedce-basedPerformanPerformance-basedce-basedbasis
Assessing Assessing patternspatterns
Assessing Assessing patternspatterns
DevelopinDeveloping g
strategiesstrategies
DevelopinDeveloping g
strategiesstrategiesRehearsalRehearsalRehearsalRehearsal
Dealing Dealing with with
complexitycomplexity
Dealing Dealing with with
complexitycomplexityskills
HEIDRHEIDRHEIDRHEIDR Socio-Socio-culturalculturalSocio-Socio-
culturalcultural
Win/loseWin/losecompetitiocompetitio
nn
Win/loseWin/losecompetitiocompetitio
nn
MannequinMannequinss
MannequinMannequinssactivity
Ingredients & flavours
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Compositional constructs
SchematicSchematicSchematicSchematic NarrativeNarrativeNarrativeNarrative GameGameGameGame SimulationSimulationSimulationSimulationSchematicSchematicSchematicSchematic NarrativeNarrativeNarrativeNarrative GameGameGameGame SimulationSimulationSimulationSimulation
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Biological Biological sciencessciencesBiological Biological sciencessciences
BehaviourBehavioural sciencesal sciencesBehaviourBehavioural sciencesal sciences
Ethics and Ethics and valuesvalues
Ethics and Ethics and valuesvalues
Medical Medical practicepracticeMedical Medical practicepractice
Form and Form and functionfunction
Form and Form and functionfunction
Social Social interactioninteraction
ss
Social Social interactioninteraction
ss
Dealing Dealing with with
dilemmasdilemmas
Dealing Dealing with with
dilemmasdilemmas
Managing Managing patientspatients
Managing Managing patientspatients
Contextual constructs
Case Case templatetemplate
Case Case templatetemplate
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Form and Form and functionfunction
Form and Form and functionfunction
Social Social interactioninteraction
ss
Social Social interactioninteraction
ss
Dealing Dealing with with
dilemmasdilemmas
Dealing Dealing with with
dilemmasdilemmas
Managing Managing patientspatients
Managing Managing patientspatients
In practice
Case Case templatetemplate
Case Case templatetemplate
SchematicSchematicSchematicSchematic NarrativeNarrativeNarrativeNarrative GameGameGameGame SimulationSimulationSimulationSimulation
Contextual use
Compositional construct
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For us all to think about
(not quite recommendations)
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Don’t try and swallow too much in a ‘super’ VP
Better to have more small VPs than few big ones
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Activities should be no more complex than
the assigned learning outcomes
VPs as simple as possible, but no simpler
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…it’s the context, stupid!
The same case/VP acquires different meaning (and utility) depending upon
where and how it’s used
No wonder it’s difficult comparing VPs…
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There is a difference between…
activity encoded within a VPvs
activity constructed around a VP
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Therefore…
seek alignment between encoded andconstructed activity
framed by the context of the integrated curriculum
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Bon Appétit!