Jonathan Round, Alex Higton , Terry Poulton

1. Reaching parts medical education doesn’t reachInnovative Approaches in Clinical Education using Virtual Patients Jonathan Round, Alex Higton, Terry Poulton

3. What do Virtual Patients do well? Take you to places you can’t or shouldn’t go Risk free practice Deliver standardised experience in a (virtually) real way

4. 3 models extending VPs The virtual ward round The virtual clinic The multi-professional virtual patient Error patient

5. Virtual Ward Round What’s missing Rationale Design Resources Feedback

6. Virtual Ward Round What’s missing…ward savvy, ward nouse, the clinical process Rationale…online delivery of a week’s ward action Design…html, frames driven, multiple linear, control over information Resources…internet connection, projector, facilitator Feedback

7. Virtual Ward Round Context Course structure

8. VWR Aims… REAL PROBLEMS EXPOSURE WARD WISDOM UNMASKING THE CLINICAL PROCESS ENGAGING FEASIBLE www.jround.co.uk/virtual_ward_round/d1_bedview.html

9. Challenges… CONCEPT LAYOUT PROGRAMMING CASE WRITING DELIVERY www.jround.co.uk/virtual_ward_round/d1_bedview.html

10. Tools used… www.jround.co.uk/virtual_ward_round/d1_bedview.html

15. www.jround.co.uk/virtual_ward_round/d1_bedview.html

16. Bed 1 Bed 1 Bed 1 Bed 1 Bed 1 Bed 2 Bed 2 Bed 2 Bed 2 Bed 2 Bed 3 Bed 3 Bed 3 Bed 3 Bed 3 Bed 4 Bed 4 Bed 4 Bed 4 Bed 4 Site Architecture… Monday Tuesday Wednesday Thursday Friday www.jround.co.uk/virtual_ward_round/d1_bedview.html

17. Site Architecture… Monday Tuesday Wednesday Thursday Friday Developments History Examination Investigations Fluids Treatment Bed 1 Developments History Examination Investigations Fluids Treatment Bed 2 Developments History Examination Investigations Fluids Treatment Bed 3 Bed 4 Developments History Examination Investigations Fluids Treatment www.jround.co.uk/virtual_ward_round/d1_bedview.html

18. VWR ratings 221 students, 6 rotations Likert scale Most valuable session

19. Feedback www.jround.co.uk/virtual_ward_round/d1_bedview.html

20. Comments…Strengths Virtual ward round gave us an insight into the management of different conditions. The Virtual WR were good at bringing all topics together and making you think. Virtual ER - management of common problems and what happens in real life. The virtual ward round may be less cases, but to go through them in more detail. Virtual Ward Round is a great idea, but feels a bit much and 30 mins is not enough time. I loved the Virtual WR.

21. Comments…Weaknesses Virtual Ward Rounds at the start of the day. I was exhausted and brain dead by the time the Virtual Ward Round came around. Maybe do it in the morning! Less (maybe 3) Virtual WR patients or longer time. Virtual WR is helpful but too many patients.

22. Virtual Clinic What’s missing…multiple sequential clinical related challenges Rationale…prepare students, expose students to a “morning’s” work. consolidation of learning Design…decision simulation, linear/branched Resources…individual or small group learning, internet connection Feedback…

26. Comments - Strengths Really good Please provide more to medical schools very useful excersize Excellent resource - promote Allowed numerous cases to be explored at once in quick succession Good to be given numerous clinical scenarios Complements PBL You get to think like a doctor Choices within vignettes allow clinical reasoning Brought it to life – nice to do PBL process on my own.

27. Comments - weaknesses Guidance needed on … CXR intrepretation…UEC values Where’s the back button? I’d like to review CXRs later in the case I’d like to explore different outcomes Doesn’t tell you the idea path, can’t be bothered to do it again Too long to complete.

28. Multiprofessional Virtual Patient What’s missing...seeing patients from another angle, integrated care, teamwork Rationale…expose students to same VP, but from different angles, allow to switch Design…multitrack VP, with crossover points and joint meetings. Decisionsimulation/labyrinth Resources…individual/small group, internet enabled computer Feedback

32. Error Virtual Patient What’s missing…learning from past mistakes Rationale…professionals make the same mistakes over and over and over again Design…branched VP Resources…decision sim, for asynchronous or group work Feedback

33. Timeline Nov 2009

36. Error feedback

37. Adjectives What will I take away Standing up to someone who is more “specialised” than you is difficult and scary but sometimes it needs doing and is an important thing to learn how to do

38. Conclusions Many situations where ‘typical’ VP may not be mimic clinical reality Adaptions to VP model stretch reach of the virtual patient Students challenged and appreciative of new designs www.jround.co.uk/virtual_ward_round/d1_bedview.html app.decisionsimulation.com Chest Clinic Lauren Brook Errol Rouch