Project name

Pharmacological Patient Cases (Pharmapac)-a web based seminar course (previously called ”Pharmacology and clinical pharmacology-Janus learning site”)

Date: 2001-07-31

Principal investigator:

· Lars L Gustafsson, Karolinska Institutet (KI)

Collaborative partners:

· Janus Telepharmacology

· KI-LL

· Umeå University, LITU

· SUMMIT at Stanford University

· School of Medicine at Stanford University

· Karolinska Institutet

Aims and goals of the project:

To strengthen and simplify the learning process of pharmacological and clinical principles by illustrating such principles in drug related patient cases presented using web-based interactive techniques as an integrated part of group based teaching.

The patient cases should help the student to argue about best choices of drug therapy and drug treatment schedules but also help them to learn principles of individualised dosage and to be trained in critical methods of evaluating results from clinical trials.

Current Content State Compared to Project Plan:

As planned we have produced the planned learning website (www.pharmapac.org) and carried out a transatlantic 2-week interactive course at Karolinska Institutet and at School of Medicine at Stanford University in April 2001. Moreover, we have as planned performed an evaluation of this course and of the contents of the website www.pharmapac.org among the students. In contrast to the plans we have already presented and discussed achieved results including the preliminary pilot results of the evaluation at a joint meeting attended by our collaborators from School of Medicine at Stanford and from LITU at Umea University. This meeting was also attended by governing bodies from Swe-LL, from the Wallenberg Learning Network and by teachers at Medical Faculties at Uppsala and Umea Universities. In contrast to our original plans we have a detailed schedule for continued activities for the rest of the year and for activities extending beyond the project period 2000-2001. The economic situation for continued activities for the rest of 2001 and for plans after the project period is tough.

Results:

1. A multimedia system of websites (www.pharmapac.org) for patient cases was designed, implemented and used as part of the transatlantic course in clinical pharmacology. The website is to be considered as a prototype but contains several parts- one part for answering the pharmacological patient cases; one part for chat activities between students; one part summarizing answers from all students and a critical part for teacher controlled construction of multimedia patient cases. The LITU team in Umea had the technical responsibility for system design and programming.

2. A 2 week course using the Pharmapac website was carried out with 6 students from Karolinska Institute and 6 students from School of medicine at Stanford University. Course directors were Carl-Olav Stiller from KI and Lars Osterberg from Stanford. The Swedish students spent the initial week at Stanford School of Medicine together with the Stanford students. The students solved the patient cases but an important part was seminars for joint discussions of answers.

3. A detailed assessment of the reactions to the course, to the concept and to the specific cases were carried out. The students were interviewed individually before and after the course using an oral structured interview technique. For each case the student had to fill in a questionnaire about the value of the case and about technical issues. The assessment team has included Jenn Stringer Stanford, Ernst Brodin KI, Hans Hindbeck KI and Pia Bastholm Janus Telepharmacology.

4. The collaborating team from Karolinska Institute, LITU and Stanford met in June this year together with the ISP-VL group (simulated patient project) and summarized development work, experience of the course and presented preliminary results of the assessment of the course. It was clear that the students were very positive to the concept of using multimedia patient cases integrated into seminars for learning pharmacological and clinical pharmacological principles. Plans for continued work this year and preliminary plans for 2002 and onwards were discussed. The development group has agreed on a publication plan.

5. Presentations of both development work and the course have been in internal and external publications from Stanford University and Karolinska Institute but also in national Swedish publications.

6. Already there are plans to use the Pharmapac concept of patient cases at several undergraduate medical courses at Stanford School of Medicine. At Karolinska Institute we plan to present the concept the forthcoming autumn. The Faculty of Medicine at Umea University has shown interest to study our concept.

7. The collaboration between School of Medicine at Stanford, the technical team at LITU at Umea University and the team at Karolinska Institute has been excellent. The teams in Sweden have collaborated closely in the technical development. It is our experience that the design of the patient cases are time consuming. On the Swedish side too many physicians and teachers have been involved. The final phase when Carl-Olav Stiller had the responsibility in close collaboration with Elisabeth Tornqvist and Lars L Gustafsson things moved more effectively. On the Stanford side Lars Osterberg had the full responsibility of case development during the whole development process.

8. A total of 25 persons, except 12 students, have been involved in the project so far. The time schedule has been followed strictly. It is my experience that the working relations have been excellent. All persons involved have been trained in multidisciplinary team work. A prerequisite has been a number of travels and meetings. A critical part in the development has been good and close collaboration between the overall project leader Elisabeth Tornqvist and the American, Mary Ayers.