Virtual Communities in Medicine International collaboration in Medical Education

1. Virtual Communities in Medicine International collaboration in Medical Education Shlomi Codish, MD Head, Computer Assisted Learning Unit Ben Gurion University of the Negev codish@bgu.ac.il

2. Stating the problem • Medical information is exponentially increasing and constantly changing • One person can never “know everything” • Medical schools must shift from teaching information to teaching learning skills • Teaching takes place in hospital while a lot of medicine takes place in the community

3. Teaching Clinical Medicine • Takes place in many different locations • Done by many people with differing • attitudes • motivation • teaching skills • Patient population not • Similar across wards • No consistent exposure

4. Patient simulations • Computerized, and later on, Web-Based patient simulations are applied to address these problems. • Various approaches: • Cognitive approach • Specific skills, i.e. • physical examination • history taking • differential diagnosis lists • Simulate specific problems to cover a “core curriculum”

5. Problems again (and solutions?) • Quality of medical information • Peer review? • Complexity of computerized systems • Front ends (SRDC?) • “not invented here syndrome” • a-priori consortia • Volume of simulations

6. Specific initiatives • Stanford Short Rounds Consortium • User based • Diagnostic Reasoning • commercial • CLIPP cases • Academia and professional organization cooperation • ACP online • Professional organization • IVIMEDS • Virtual medical campus – academia and commercial interests

7. Case study - CLIPP • Initiated by COMSEP – Council on Medical Students Education in Pediatrics • Cases created by COMSEP members • Extensive Peer Review process • Case selection academic and well planned • Financed by COMSEP http://www.clippcases.org

14. Case Study: SRDC • Project initiated at Stanford SUMMIT • Easy front end text based application for creating simple simulations • Financed by research funds • No significant participation • No peer-review • Project fizzled out http://summit.stanford.edu/ourwork/DEVELOPTOOLS/SHORTROUNDS/srdc.html

15. Case Study: DxR • Initiated at SIU as academic endeavor • Went commercial – various vendors • Cases developed at developer’s discretion • Minimal peer-review • Funded commercially • Widely used, in very varied situations http://www.dxronline.com

20. IVIMEDSThe International Virtual Medical School • Joint effort of 37 medical schools in 14 countries • An attempt to benefit from each member’s expertise to create a full medical school combining e-learning and face to face teaching • Use of >200 simulated patients! http://www.ivimeds.org

21. Hardware simulators • While not the topic of this talk… • Hardware simulations are available in Israel on a national level: • Advantages include • Enables hands-on approach • Nearest real life situation • Particularly useful for emergency medicine and procedures • Disadvantages include • Costly – to maintain and to use • Requires travel • Obviously, a correct mixture is best http://www.msr.org.il

22. Other collaborative efforts • Health Education Assets Library H.E.A.L (www.healcentral.org) • Dermatology Atlas (www.dermis.net) • Pathology question bank • ACP Clinical Problem Solving Cases (cpsc.acponline.org )

26. Summary • The problems facing medical education dictate the use of simulated patients • This is costly, time consuming and frustrating • Most previous efforts have failed • Poor planning • Poor funding • Poor implementation • Software design • Educational design and content • Actual student use • Poor evaluation

27. More summary • The only way to go is to combine efforts • Development consortia more successful than individual efforts