Home About us Contact
|
Home About us Contact | ||
|
|
||
Virtual Patients (virtual + patient)
Selected AbstractsSimulation of patient encounters using a virtual patient in periodontology instruction of dental students: design, usability, and learning effect in history-taking skillsEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2004M. Schittek Janda Simulations are important educational tools in the development of health care competence. This study describes a virtual learning environment (VLE) for diagnosis and treatment planning in oral health care. The VLE is a web-based, database application where the learner uses free text communication on the screen to interact with patient data. The VLE contains forms for history taking, clinical images, clinical data and X-rays. After reviewing the patient information, the student proposes therapy and makes prognostic evaluations of the case in free text. A usability test of the application was performed with seven dental students. The usability test showed that the software responded with correct answers to the majority of the free text questions. The application is generic in its basic functions and can be adapted to other dental or medical subject areas. A randomised controlled trial was carried out with 39 students who attended instruction in history taking with problem-based learning cases, lectures and seminars. In addition, 16 of the 39 students were randomly chosen to practise history taking using the virtual patient prior to their first patient encounter. The performance of each student was recorded on video during the patient sessions. The type and order of the questions asked by the student and the degree of empathy displayed towards the patient were analysed systematically on the videos. The data indicate that students who also undertook history taking with a virtual patient asked more relevant questions, spent more time on patient issues, and performed a more complete history interview compared with students who had only undergone standard teaching. The students who had worked with the virtual patient also seemed to have more empathy for the patients than the students who had not. The practising of history taking with a virtual patient appears to improve the capability of dental students to take a relevant oral health history. [source] Design principles for virtual patients: a focus group study among studentsMEDICAL EDUCATION, Issue 6 2009Sören Huwendiek Objectives, This study aimed to examine what students perceive as the ideal features of virtual patient (VP) design in order to foster learning with a special focus on clinical reasoning. Methods, A total of 104 Year 5 medical students worked through at least eight VPs representing four different designs during their paediatric clerkship. The VPs were presented in two modes and differed in terms of the authenticity of the user interface (with or without graphics support), predominant question type (long- versus short-menu questions) and freedom of navigation (relatively free versus predetermined). Each mode was presented in a rich and a poor version with regard to the use of different media and questions and explanations explicitly directed at clinical reasoning. Five groups of between four and nine randomly selected students (n = 27) participated in focus group interviews facilitated by a moderator using a questioning route. The interviews were videotaped, transcribed and analysed. Summary reports were approved by the students. Results, Ten principles of VP design emerged from the analysis. A VP should be relevant, of an appropriate level of difficulty, highly interactive, offer specific feedback, make optimal use of media, help students focus on relevant learning points, offer recapitulation of key learning points, provide an authentic web-based interface and student tasks, and contain questions and explanations tailored to the clinical reasoning process. Conclusions, Students perceived the design principles identified as being conducive to their learning. Many of these principles are supported by the results of other published studies. Future studies should address the effects of these principles using quantitative controlled designs. [source] Web-based virtual patients in dentistry: factors influencing the use of cases in the Web-SP systemEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 1 2009N. Zary Abstract We studied the students' acceptance and utilization of virtual patients (VPs) authored by faculty using the Web-SP system over two consecutive years. We also studied factors of importance for the utilization of VPs for self-assessment. Both year-groups studied found the Web-SP system easy to use and their overall opinion of Web-SP was positive (Median: 5, p25-p75: 4-5). They found the VPs engaging, realistic, fun to use, instructive and relevant to their course. Students used, on average, 9.68 VPs per course, which constitutes 43 percent of the available VPs. The number of VPs available seemed to be sufficient for the target course, even if some of the students preferred a higher number of VPs. Of the VPs encountered, 71% (CI: 68-75%) were VPs with feedback, and correspondingly 29% of the VPs chosen were without feedback. The difference in utilization between both types of VPs was significant, at p < 0.001. Thus, the students clearly favoured VPs with feedback compared to VPs without feedback. There were three modes of engagement in which the VP was utilized. Mode 1 was the preferred mode for VPs without feedback, while mode 3 was dominant for VPs with feedback.. Whether or not a VP was selected for review during a teacher led seminar or not, did not affect student behaviour, at least on the surface. Teacher led seminars may still be of importance to provide credibility to the VPs by integrating them into the curriculum. [source] An adaptive clinical Type 1 diabetes control protocol to optimize conventional self-monitoring blood glucose and multiple daily-injection therapyINTERNATIONAL JOURNAL OF ADAPTIVE CONTROL AND SIGNAL PROCESSING, Issue 5 2009Xing-Wei Wong Abstract The objective of this study was to develop a safe, robust and effective protocol for the clinical control of Type 1 diabetes using conventional self-monitoring blood glucose (SMBG) measurements, and multiple daily injection (MDI) with insulin analogues. A virtual patient method is used to develop an in silico simulation tool for Type 1 diabetes using data from a Type 1 diabetes patient cohort (n=40) . The tool is used to test two prandial insulin protocols, an adaptive protocol (AC) and a conventional intensive insulin therapy (IIT) protocol (CC) against results from a representative control cohort as a function of SMBG frequency. With the prandial protocols, optimal and suboptimal basal insulin replacement using a clinically validated, forced-titration regimen is also evaluated. A Monte Carlo (MC) analysis using variability and error distributions derived from the clinical and physiological literature is used to test efficacy and robustness. MC analysis is performed for over 1 400 000 simulated patient hours. All results are compared with control data from which the virtual patients were derived. In conditions of suboptimal basal insulin replacement, the AC protocol significantly decreases HbA1c for SMBG frequencies ,6/day compared with controls and the CC protocol. With optimal basal insulin, mild and severe hypoglycaemia is reduced by 86,100% over controls for all SMBG frequencies. Control with the CC protocol and suboptimal basal insulin replacement saturates at an SMBG frequency of 6/day. The forced-titration regimen requires a minimum SMBG frequency of 6/day to prevent increased hypoglycaemia. Overaggressive basal dose titration with the CC protocol at lower SMBG frequencies is likely caused by uncorrected postprandial hyperglycaemia from the previous night. From the MC analysis, a defined peak in control is achieved at an SMBG frequency of 8/day. However, 90% of the cohort meets American Diabetes Association recommended HbA1c with just 2 measurements a day. A further 7.5% requires 4 measurements a day and only 2.5% (1 patient) required 6 measurements a day. In safety, the AC protocol is the most robust to applied MC error. Over all SMBG frequencies, the median for severe hypoglycaemia increases from 0 to 0.12% and for mild hypoglycaemia by 0,5.19% compared with the unrealistic no error simulation. While statistically significant, these figures are still very low and the distributions are well below those of the controls group. An adaptive control protocol for Type 1 diabetes is tested in silico under conditions of realistic variability and error. The adaptive (AC) protocol is effective and safe compared with conventional IIT (CC) and controls. As the fear of hypoglycaemia is a large psychological barrier to appropriate glycaemic control, adaptive model-based protocols may represent the next evolution of IIT to deliver increased glycaemic control with increased safety over conventional methods, while still utilizing the most commonly used forms of intervention (SMBG and MDI). The use of MC methods to evaluate them provides a relevant robustness test that is not considered in the no error analyses of most other studies. Copyright © 2008 John Wiley & Sons, Ltd. [source] Design principles for virtual patients: a focus group study among studentsMEDICAL EDUCATION, Issue 6 2009Sören Huwendiek Objectives, This study aimed to examine what students perceive as the ideal features of virtual patient (VP) design in order to foster learning with a special focus on clinical reasoning. Methods, A total of 104 Year 5 medical students worked through at least eight VPs representing four different designs during their paediatric clerkship. The VPs were presented in two modes and differed in terms of the authenticity of the user interface (with or without graphics support), predominant question type (long- versus short-menu questions) and freedom of navigation (relatively free versus predetermined). Each mode was presented in a rich and a poor version with regard to the use of different media and questions and explanations explicitly directed at clinical reasoning. Five groups of between four and nine randomly selected students (n = 27) participated in focus group interviews facilitated by a moderator using a questioning route. The interviews were videotaped, transcribed and analysed. Summary reports were approved by the students. Results, Ten principles of VP design emerged from the analysis. A VP should be relevant, of an appropriate level of difficulty, highly interactive, offer specific feedback, make optimal use of media, help students focus on relevant learning points, offer recapitulation of key learning points, provide an authentic web-based interface and student tasks, and contain questions and explanations tailored to the clinical reasoning process. Conclusions, Students perceived the design principles identified as being conducive to their learning. Many of these principles are supported by the results of other published studies. Future studies should address the effects of these principles using quantitative controlled designs. [source] Virtual Reality Triage Training Provides a Viable Solution for Disaster-preparednessACADEMIC EMERGENCY MEDICINE, Issue 8 2010Pamela B. Andreatta EdD ACADEMIC EMERGENCY MEDICINE 2010; 17:870,876 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, The objective of this study was to compare the relative impact of two simulation-based methods for training emergency medicine (EM) residents in disaster triage using the Simple Triage and Rapid Treatment (START) algorithm, full-immersion virtual reality (VR), and standardized patient (SP) drill. Specifically, are there differences between the triage performances and posttest results of the two groups, and do both methods differentiate between learners of variable experience levels? Methods:, Fifteen Postgraduate Year 1 (PGY1) to PGY4 EM residents were randomly assigned to two groups: VR or SP. In the VR group, the learners were effectively surrounded by a virtual mass disaster environment projected on four walls, ceiling, and floor and performed triage by interacting with virtual patients in avatar form. The second group performed likewise in a live disaster drill using SP victims. Setting and patient presentations were identical between the two modalities. Resident performance of triage during the drills and knowledge of the START triage algorithm pre/post drill completion were assessed. Analyses included descriptive statistics and measures of association (effect size). Results:, The mean pretest scores were similar between the SP and VR groups. There were no significant differences between the triage performances of the VR and SP groups, but the data showed an effect in favor of the SP group performance on the posttest. Conclusions:, Virtual reality can provide a feasible alternative for training EM personnel in mass disaster triage, comparing favorably to SP drills. Virtual reality provides flexible, consistent, on-demand training options, using a stable, repeatable platform essential for the development of assessment protocols and performance standards. [source] Revalidation and virtual patients: a vision of the future?AUSTRALIAN VETERINARY JOURNAL, Issue 1-2 2003Article first published online: 10 MAR 200 No abstract is available for this article. [source] Using Immersive Simulation for Training First Responders for Mass Casualty IncidentsACADEMIC EMERGENCY MEDICINE, Issue 11 2008William Wilkerson MD Abstract Objectives:, A descriptive study was performed to better understand the possible utility of immersive virtual reality simulation for training first responders in a mass casualty event. Methods:, Utilizing a virtual reality cave automatic virtual environment (CAVE) and high-fidelity human patient simulator (HPS), a group of experts modeled a football stadium that experienced a terrorist explosion during a football game. Avatars (virtual patients) were developed by expert consensus that demonstrated a spectrum of injuries ranging from death to minor lacerations. A group of paramedics was assessed by observation for decisions made and action taken. A critical action checklist was created and used for direct observation and viewing videotaped recordings. Results:, Of the 12 participants, only 35.7% identified the type of incident they encountered. None identified a secondary device that was easily visible. All participants were enthusiastic about the simulation and provided valuable comments and insights. Conclusions:, Learner feedback and expert performance review suggests that immersive training in a virtual environment has the potential to be a powerful tool to train first responders for high-acuity, low-frequency events, such as a terrorist attack. [source] Development and evaluation of a cd-rom to support student learning in dentist,patient communicationEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2003J. T. Newton The interaction between dentist and patient is central to the provision of effective healthcare. A multidisciplinary team containing expertise in the social and behavioural sciences, medicine, dentistry, education and information technology was formed to design a CD-ROM to support more traditional teaching and learning in this area. The final version of the program consists of a ,virtual' patient from whom students are asked to take a medical history. The ,patient' interacts with the student and responds to the style of their questioning by changes in anxiety, or degree of annoyance. To date, the CD-ROM has been evaluated in two stages. The first stage was a predictive formative evaluation by the research/development team, and the second stage was a formative evaluation by 144 dental students of the first full prototype. A third stage, to be conducted next year, will involve measuring the longer term impact of the CD-ROM through the assessment of students' abilities to communicate with patients. The evaluation had two components: students made rates of how useful and easy to use they found the program, and students' attitudes towards interacting with patients were evaluated adopting constructs from the theory of Planned Behaviour. Students were positive about the use of the CD-ROM, though they requested some changes in the functionality of the program. Compared to a sample of students who had not used the CD-ROM, the students who used the CD-ROM felt more positive about communicating with their patients, at the end of the course, and expressed stronger intentions to communicate well with patients. We conclude that the CD-ROM we have developed in a useful adjunct to learning in dentist,patient communication. [source] | ||||||||||