Project name

Report for the Interactive Simulation of Patients - a Virtual Learning Space (ISP-VL) project

Report for the third project half-year (2001-01-01 – 2001-06-30)

Principal Investigators

· Rolf Bergin, Karolinska Institutet (KI) HIS

· Co-PI: Uno Fors, Karolinska Institutet (KI) HIS

Collaborative Partners

· KI-LL

· Uppsala LL

· SUMMIT (Stanford University)

· Stanford University Medical School

Curriculum aims and goals

This project aims to build a virtual global learning-space for learning and training collaborative problem solving within the area of medicine. The project will also build a national as well as an international experimental environment and assessment tool, based on student activating learning methodology. The project will use clinical learning situations of health care professionals as a model to explore the possibilities of virtual meeting and collaboration spaces and deal with real time simulated patients. The basic pedagogical idea is to put the student “in charge” of defining and finding adequate knowledge. There is furthermore an ambition to get students emotionally involved since an emotionally based learning has a high degree of retention.

Educational evaluation aims and goals

The assessment process will be ongoing simultaneously with the development and deployment activities. Focus will mainly be on learning outcomes such as understanding of clinical problems and problem solving, cross cultural collaborative learning environment regarding educational procedures and routes in clinical problem solving, impact on students self confidence in clinical problem solving and their emotional involvement, impact on teachers to cooperate on the advancement of simulation tools and different pedagogical methods and cost-effectiveness. In addition, the technical base of the system will be monitored and evaluated.

Current Project Status Compared to Project Plan

All parts of the ISP-VL project are on the time schedule. There are at present no known constraints on the timeframe.

Current Content State Compared to Project Plan

The current content state is according to the project plan and there are no known constraints. The content development of the project can be divided in several parts, shortly described in the following.

Translation and test of the prototype patient Britt. The “standard patient case” (Britt Larsson), which was fully translated into US English during the last project period, has been used as a base for developing the first ISP-VL specific case, Elisabeth. See further details below.

Construction of a new Swedish patient case for use in ISP-VL project. The ISP-VL specific Swedish patient case, Elisabeth, was completed during the first months of the current project period. Two different Elisabeth cases (HIV/PCP and Endocarditis) were fully developed. These cases were based on collaboration between faculty persons at Karolinska Institutet, Uppsala University and Stanford School of Medicine, with the physician Anders Thalme from KI taking the lead. These two cases were written in English, but also a Swedish version is nearly finished.

Important medical and educational contribution in the case development was also given by the Stanford faculty Julie Parsonnet and Lisa Gerwin.

Construction of a special Stanford patient for use in ISP-VL. The construction of a Stanford patient case for use in ISP-VL has been going on and the manuscript developed by the Stanford specialists in infectious diseases served as a base when filming of the Tom case took place in Sweden early this year, using a professional US Actor. The first cases of the six planned will be ready for use during the next project period coming up.

Test implementation during the European Union meeting at Älvsjö. The global collaboration technique and two of the Elisabeth cases were tested during a live demo at the European Union top political meeting at Älvsjö, Sweden using four students and top-of-the-line videoconference technique from Ericsson. The event was inaugurated by the Swedish minister for trade and commerce, Leif Pagrotsky and served the project both as a “rehearsal” for the global sessions and as an effective PR event for ISP-VL.

Communicative aspects. There has been a frequent exchange – in the order of some days to a week - between the staff at KI and at Stanford. This has mostly been done via e-mail, and file-transfers, but there have also been a number of Videoconferences during the period. When the dedicated videoconference tool Polycom was installed at KI and Stanford, the video conferencing was greatly enhanced.

The KI-LLab director and Co-PI of ISP-VL visited Stanford for project meetings in January, and two other trips for the KI faculty person Anders Thalme and UU faculty person Jonas Boberg contributed greatly to the successful spring.

Stanford persons have been in Sweden during the filming of the Tom case in March and also at the ISP-VL/PharmaPac workshop in June (see below).

Course details. The details of the pilot course, where the ISP-VL system, the global collaboration technique, the educational setting and the assessment framework was tested in April (see below) were worked out in cooperation with teachers and course directors at KI, Uppsala and at Stanford school of Medicine. The assessment framework has been discussed and designed in close contact with the KI LearningLab Assessment team as well as with Stanford School of Medicine evaluation experts. Other SweLL and SLL Assessment team members have also been briefed about the assessment issues of the project.

ISP-VL/PharmaPac workshop. A dedicated workshop for the two projects ISP-VL and PharmaPac was held in June, where project team members from Stanford, Uppsala and KI participated. During this workshop, both project specific details for the ISP-VL projects were discussed as well as possible collaboration and information dissemination between the two projects elaborated upon. More than 30 persons participated in very successful three-day workshop.

Results from pilot courses

The first ISP-VL courses were performed during April and May this year. Two different set-ups were used for this pilot course test:

1. A 3-day global course with students from KI, Uppsala and Stanford

2. Local distributed courses at Stanford and KI.

The global course was performed as a simultaneous course with students at all three universities connected though a video conferencing unit (Polycom) enabling all students to talk to and see each other at the same time as the simulated patient cases was run. All three student groups could interact with the system and even though there were faculty available at all three sites, the students were the active group.

Even though the global course was mainly aimed for fine-tuning the global collaboration set-up and testing the Elisabeth cases, resulting in some minor technical glitches, all students were very positive to global collaboration in general and especially for working with ISP-VL as a tool for case based learning.

The two different local distributed courses performed, were used both for further testing of the Elisabeth cases, and as a set-up for testing the implementation of learning tools as ISP-VL into different curricula. These pilot courses were one-day events.

Further Information Related to the Project

http://isp.his.ki.se/

Assessment team comments

The assessment team closely monitored the two pilot courses, and interviews with students, faculty and questionnaires were used to gather data. Initial results indicated very positive reactions from the students in both course types, and a more full evaluation report will be included in next project report.

An important strength with this project is the way in which the underlying pedagogical philosophy – and primarily not technical factors - has been allowed to guide the overall design and the development of individual patient-cases. This philosophy is very closely related to those pedagogical ideas, which underlie for instance problem-based learning. The project will definitely provide rich opportunities for assessment of learning outcomes of student collaboration in virtual classrooms and the use of advanced ICT-applications. The outcome of the project is likely to be of great interest to faculties around the world both within and outside the medical field.