Virtual Patients (VPs) are invaluable resources as tools to develop skills in competency training, where there are decisions, actions and processes to record or mimic. They are very expensive to produce, and those institutions which can make them, are often reluctant to share. This project proposes to repurpose VPs constructed by the University of Heidelberg, embed the repurposed VPs within an appropriately accredited Paediatric module at St George’s University of London, and also make them available to the wider community.

Repurposing Existing Virtual Patients


Background Project Final Report is now available

The Virtual Patient

Electronic virtual patients (VPs) are defined as “interactive computer simulations of real-life clinical scenarios for the purpose of medical training, education, or assessment”. Medicine and healthcare face the same problems: a need for interactive scenario based learning that provides alternatives to student-patient contact, which is declining because of the healthcare budget constraints that limit clinical teaching, and the reduction in the time that patients stay in hospital. VPs are now recognised by the medical education community as the best, and maybe the only effective tools for developing clinical reasoning. Such simulations provide students with a reliable and safe environment in which to rehearse and practice physical and communication skills and develop clinical reasoning ability. Students can test their knowledge and skills safely and frequently, whilst at the same time drawing upon learning resources designed to extend their understanding.

The courses in these subjects are largely supported by workplace learning, and in the clinical years these are the ‘clinical attachments’. There are a number of initiatives to support these attachments with virtual patients. Despite persuasive evidence of their effectiveness, virtual patients are not widespread in medical and healthcare curricula. VPs are “time and resource intensive to produce”, which is completely prohibitive to institutions that lack robust e-learning programs. These challenges and others have severely restricted the impact of VP simulation on the undergraduate medical curriculum. Where VPs are produced, development tends to be confined within single institutions, with little evidence of sharing. Those institutions that do prepare VPs have little opportunity to make them for more than one subject area.

Current Virtual Patient Initiatives

In Europe, SGUL is leading a major 3-year project funded by the European Commission, called eViP, investigating the sharing of VPs between the 7 project partners with a view to creating a comprehensive multilingual, multicultural, European pool of VPs. This project is now underway and is already making excellent progress during the current ‘pilot’ phase. The project is also tackling some of the technical issues arising from sharing content between different VP players and systems in order to smooth the way for the pedagogical, language, and cultural changes needed to successfully transfer and implement a VP from one country to another.

This project is collaborating with the MedBiquitous Virtual Patient working group to ensure that all technical development work conforms to the latest MedBiquitous Virtual Patient standard. This is the first step in technologically ‘future proofing’ the VPs for easy access and transfer between different systems and players, not just in Europe but the world. To aid this process, SGUL have recently been appointed as the MedBiquitous Europe office for administering the VP standard in the UK and other European institutions.

The key difference between the eViP and this proposed REVIP project is that REVIP aims to specifically explore and evaluate the embedding of repurposed and enriched VPs within a Paediatrics component in the SGUL Medical curriculum. This is not something that is specifically covered by the eViP project.

Aims and Objectives

The overall aim of the Repurposing Existing Virtual Patients (REVIP) project is to:

  • repurpose 5 VPs from the University of Heidelberg (HD) to UK language, culture, and pedagogy and subsequently share with the wider community
  • embed the repurposed VPs within an appropriately accredited SGUL module and subsequently evaluate the impact of the resources

The main objectives of the Repurposing Existing Virtual Patients (REVIP) project are to:

  • Repurpose virtual patients (VPs) produced in the Department of Paediatrics at Heidelberg University (HD) for use in St. George’s University of London (SGUL)
  • Content enrich the VPs with high quality existing learning materials
  • Embed the VPs in the paediatrics attachment of the MBBS undergraduate medical degree (MBBS)
  • Provide easy access to these VPs for UK national use by integrating them into a national repository or local referatory, in such a way that they can be further customised to local needs
  • Evaluate the impact of the VPs on students carrying out the paediatric clinical attachments
  • Evaluate the process of repurposing VPs across different European institutions
  • Deliver a case study focussing on one of the five VPs
  • Disseminate the evaluation results and feedback to the wider community
  • Disseminate the basic principles of using and adapting virtual patients in general, particularly for competency based courses.
  • Provide guidance on best practice for the reuse of such scarce resources, and encourage higher education institutions to reuse content more frequently
  • Create a project website and update a reflective log using a project blog

Project Methodology

REVIP is divided into 15 work packages as listed below and will follow best-practice using PRINCE2 methodology:

WP1   Project Start-up
WP2   Project Web Presence
WP3   VP Resource Inventory
WP4   Overview of Module and QA
WP5   Select VPs
WP6   Transfer of VPs from HD to SGUL
WP7   VP Repurposing
WP8   VP Enrichment
WP9   VP Testing
WP10  VP Embedding
WP11  Instructions and Guides
WP12  VP Release
WP13  Evaluation and Dissemination
WP14  Exit and Sustainability
WP15  Project Management Documentation

Deliverables

The key deliverables of the project are:

  • Updated project plan
  • QA plan for VP inclusion within module and detail module syllabus evaluation plan
  • Dissemination plan
  • Exit and sustainability plan
  • 5 repurposed VPs released to the wider community via a national repository/referatory
  • Case study focussing on one of the five repurposed and enriched VPs
  • Progress report and budget at 6-months
  • Final project evaluation report and financial statement
  • Project website
  • Reflective project blog

Project Staff

  • Chara Balasubramaniam (Project Manager)
  • Terry Poulton (Project Director)
  • Jonathan Round (Subject Expert) SGUL
  • Soeren Huwendiek (Subject Experts) HD
  • Benjamin Hanebeck (Subject Experts) HD
  • Narain Ramluchumun (Technical Developer)
  • Tejal Patel (Learning Technologist)

Documents & Multimedia