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Creating and validating e-cases as educational tools in general practitioners’ continuing medical education context

Hadadgar A., Changiz T., Kononowicz A. A., Safaeian L., Mirshahzadeh N., Najimi A., Ahmadi F., Mostafavizadeh K., Zary N., Masiello I.

Bio-Algorithms and Med-Systems

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2018

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Vol. 14, no. 1

art. no. 20170027

EN

Objective: This study aimed at creating electronic cases (e-cases) and analyzing their validity as a diagnostic assessment tool within the context of continuing medical education (CME) to measure general practitioners’ (GPs) knowledge of common infectious disease. Methods: We designed assessment e-cases in an electronic CME platform. The e-cases were designed to measure GPs’ knowledge about diagnosis and treatment of common infectious disease in outpatient settings. The data collected were analyzed for five forms of evidence: content, response process, internal structure, relations with other variables and consequences. Results: A total of 46 GPs participated in the study. Among them, 87% perceived the e-cases as resembling the patients whom they visit in their everyday practice. Although attendance in this activity made 85% of the participants more cautious about prescription of antibiotics, we could not detect any statistically significant association between the assessment scores and the physicians’ previous antibiotic prescription. The diagnostic assessment with e-cases was supported by most of the elements of validity evidence, including content, response process, internal structure and consequences. Conclusions: Overall, evidence suggests that using e-cases might be a valid diagnostic assessment CME activity to measure GPs’ knowledge of common infectious disease, but more research is necessary.

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Evaluation of three educational use cases for using Virtual Patients in Massive Open Online Courses (MOOCs): a Delphi study

Stathakarou N., Zary N., Kononowicz A. A.

Bio-Algorithms and Med-Systems

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2015

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Vol. 11, no. 2

113--119

EN

Massive Open Online Courses (MOOCs) extended with Virtual Patients (VPs) may foster specific medical skills. In particular, three educational use cases have been proposed to enable interactivity and foster clinical reasoning skills training: collective evaluation of decision making in the context of uncertainty, collective repurposing of cases with division of discussion into subgroups, and computational models in short cases for flexible selection and adaptive learning with VPs. The aim of this study was to evaluate the educational strengths and weaknesses of the proposed use cases. Methods: We went through a two-round modified Delphi process. A panel of experts was formed and asked with open-ended questions to identify the strengths and weaknesses of each use case. The obtained responses were categorized thematically; four specific aspects of the use cases were isolated. In the second phase, the panel was asked to read the collected, categorized responses and prioritize the use cases focusing on each of the four identified aspects. Results: Six experts participated in the process. According to their opinion, decision making in uncertain context was the most feasible in implementation and in fostering clinical reasoning skills training; cultural repurposing was judged to leverage the MOOC potential the most; and computational models in short cases were considered the most interesting use case for the learners. Conclusions: The use cases were validated and prioritized; the Delphi approach brought insights into the use cases’ potential benefits, threats, and challenges.

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Use and usability of health related e-services among the senior citizens

Alfredsson J, Zary N

Bio-Algorithms and Med-Systems

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2012

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Vol. 8, no. 1

133--144

EN

Services provided by governmental and the health sectors in Sweden are increasingly being digitalized. This includes use of information technology (IT) to search healthcare information, electronic booking for consultation and other health-related services. The use of health services is growing among the senior citizens and it is therefore important to investigate how electronic (e-health services) are used and how they are suited to the senior citizens. The objective of the study was to review the health related e-services and identify those that are for the elderly population. The study was divided into three phases. First a literature review was undertaken followed by a questionnaire in the second phase. Finally qualitative observations with focus on usability were carried out in the third phase. An overview of the available health related e-services is reported and those that are used by the senior citizens were identified. The result showed a large and growing use of health related e-services by internet savvy senior citizens. An increased and more varied use of the available services could be achieved with a targeted marketing. The investigated health related e-services were perceived as relatively user-friendly, nevertheless senior citizens and the patients in general would benefit from an enhancement and continuous review of the usability of the provided e-services.

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Impact of the virtual patient introduction on the clinical reasoning process in dental education

Zary N, Johnson G., Fors U. G. H.

Bio-Algorithms and Med-Systems

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2012

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Vol. 8, no. 2

173--184

EN

In the Virtual patient (VP) system Web-SP, the case authoring is entirely delegated to faculty. An analysis of the virtual patients (VPs)VPs authored by faculty showed that the most common practice chosen by the case authors was to provide an introductory clinical vignette including rich anamnestic data. To evaluate the influence of the vignette, a controlled trial was conducted to determine if the absence of vignette would influence the students’ therapeutic decisions and their clinical reasoning. This double blind controlled trial randomized 57 fourth year dentistry students into two groups. Two virtual patient cases were created with the same content in both groups, but the VPs encountered by the intervention group lacked the introductory vignette. The therapy decisions and the history taking activity were scored and analysed by the course director. A stratified analysis was undertaken, stratifying by day. There were no statistically significant differences between the two groups with respect to their therapeutic decision scores (p=.16). Participants in both groups were equivalent with respect to the number of relevant medical history questions asked (p=.33) and the number of irrelevant questions asked (p=.20). This study indicates that vignettes did not have an impact on students' problem solvingclinical reasoning process. The use of detailed vignettes or case introductions might not be needed. A possible reason includes students’ prior exposure for a full semester to other VPs for course work and problem solvingclinical reasoning. Perhaps the intervention was too subtle to impact on learners at this stage of development. Clinical vignettes might have more impact at earlier stages of student learning such as early in the semester but not as preparation for final exam. The limited number of participants may have concealed differences between the groups. We also need to investigate if the one-hour limit given the students might influence the therapeutic decisions.

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Towards the development of a gold standard for authoring, introducing and sustaining virtual patients in multi-campus clinical education environments

Vassiliou D., Arnrup K., Broström O., Evans M., Ruiz M., Hagwall K., Henriksson P., Sköld M., Sejersen R., Zary N

Bio-Algorithms and Med-Systems

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2010

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Vol. 6, no. 11

35--38

EN

The use of Virtual Patients (VPs) in medical education is increasing but they tend to become author-dependent. Research about the usual context of clinical courses distributed over several hospitals and with several teachers has not been addressed. The purpose of the study was therefore to develop a model for authoring, implementing and sustaining the use of VPs in a multi-campus clinical educational environment.