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2 2009

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Repurposing virtual patients for clinical reasoning: development of a guideline and assessment of time and effort

Hanebeck B., Tönshoff B., Huwendiek S.

Bio-Algorithms and Med-Systems

2009

Vol. 5, no. 9

69--72

Introduction: Fostering clinical reasoning is considered to be one of the major learning goals in medical education. However, there is only limited access to real patients to learn clinical reasoning. This deficiency can be overcome by providing virtual patients as an adjunct to real patient encounters. Research has been carried out on design features for virtual patients, especially to improve clinical diagnostic reasoning skills. However, developing new virtual patient cases from scratch is costly, making it reasonable to repurpose existing cases. Efforts to apply these to already existing virtual patients are, as yet, unreported, but are considered to be considerably lower than creation of new cases. Methods: We established a guideline for repurposing virtual patients for fostering clinical reasoning, which was developed from the literature and from our own experiences in repurposing 15 virtual patients. Furthermore, we documented the associated effort in terms of work hours. Results: The established guideline for repurposing virtual patients for clinical reasoning includes the following six major steps: (1) Case selection and initial check; (2) Literature review; (3) Development of a repurposing concept; (4) Enrichment for fostering clinical reasoning; (5) Reduction of cognitive load; (6) Final checks including review by expert and completion. The six steps are described in detail. The associated time and effort were calculated on average by 33 hours per case. Conclusion: We describe a guideline for repurposing virtual patients for clinical reasoning and its associated time and effort. We hope that others planning to repurpose virtual patients for clinical reasoning find this guideline helpful.

Repurposing existing virtual patients; an Anglo-German case study

Balasubramaniam C., Poulton T., Huwendiek S.

Bio-Algorithms and Med-Systems

2009

Vol. 5, no. 9

91--98

Virtual Patients (VPs) are expensive to make from scratch. An attractive solution is to take those from one institution and transfer them to another. However, is it educationally feasible to simply translate the language of a VP from one country to another? The Repurposing Existing Virtual Patients (REViP) project between St George's, University of London and the University of Heidelberg has repurposed and content-enriched existing German VPs to English language, culture and pedagogy. These VPs were then embedded, tested and evaluated as core components within the paediatrics module and then ultimately made open to the wider community for free. The project has confirmed that repurposing and enriching is an effective way to share and reuse VPs as opposed to creating from scratch. However, much care should be taken to make the VPs suitable for the educational needs of the student, in their local context. This case study explores how the project was implemented and highlights the key outputs and conclusions.