Andrzej A. Kononowicz, Aleksandra J. StachońMonika Guratowska, Paweł Krawczyk

To start from scratch or to repurpose:

That is the Question

London, ICVP 2010, Wednesday April 28, 2010, 10:00–11:30Virtual Patients: Repurposing and Collaborative Development

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Jagiellonian University• Founded in 1364• 50 000 students /

2000 medical students• Very limited experience in VP

construction• Joint eViP in 2007• 2009 hosted first ICVP conference

in Kraków

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UJ virtual patient database

• VP system in use: CASUS® (LMU Munich, Linear „string-of-pearls” data model)

• Text-intensive (average 25 000 characters), selfstudy scenarios• Cases database: 30+ repurposed cases, 30 new cases• Topics: Internal Medicine, Cardiology, Neurology, Haematology,

Anaesthesiology, Allergology, Gynaecology, Nephrology, Radiology, Obstetrics, Nursing Sciences, Gastroenterology, Infectious Diseases, Ophthalmology and Oncology

Patienthistory

Historytaking

Physicalexamination

LabvaluesDiagnosisTherapy

Linear model

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Survey

• Goal: Survey into opinions on repurposing among personel involved into eViP at UJ

• Inclusion criteria: working at least on two VP cases (creating from scratch/repurposing)

• Sample (22):– Translators (3)– Subject matter experts (15)– Learning technologists (2)– Technical developers (2)

• Question items: 28 (19 Likert, 5 MCQ, 4 free-text)• Time: October 2009 – January 2010

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Survey results 1/4Preferred content of VP database

StronglyDisagree Disagree Neutral Agree Strongly

AgreeNo

Answer Average

Fewer disciplines with more VP cases in each discipline better than more disciplines with fewer VP cases in it

1 (5%) 7 (32%) 5 (23%)

3 (14%) 6 (27%) 0 (0%) 3,3

VP should present rare rather than common diseases

4 (18%)

11 (50%)

7 (32%)

0 (0%) 0 (0%) 0 (0%) 2,1

VPs should be created by people involved in teaching

0 (0%) 0 (0%) 7 (32%)

8 (36%) 6 (27%) 1 (5%) 4,0

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Survey results 2/4Opinions on which VP elements can be transferred between different countries (ordered by the average score)

StronglyDisagree Disagree Neutral Agree Strongly

AgreeNo

Answer Average

Patient’s background 0 (0%) 0 (0%) 2 (9%) 7 (32%) 13 (59%)

0 (0%) 4,5

Examination results 0 (0%) 0 (0%) 1 (5%) 12 (55%) 9 (41%) 0 (0%) 4,4History of the patient 0 (0%) 0 (0%) 2 (9%) 13 (59%) 7 (32%) 0 (0%) 4,2

Expert comments 0 (0%) 0 (0%) 3 (14%) 12 (55%) 7 (32%) 0 (0%) 4,2

Questions with feedback 0 (0%) 0 (0%) 4 (18%) 10 (45%) 7 (32%) 1 (5%) 4,1Description of diagnostic actions and therapeutic effects

0 (0%) 1 (5%) 4 (18%) 13 (59%) 4 (18%) 0 (0%) 3,9

Multimedia 1 (5%) 1 (5%) 5 (23%) 8 (36%) 7 (32%) 0 (0%) 3,9

Selection of diagnostic methods

0 (0%) 2 (9%) 4 (18%) 12 (55%) 4 (18%) 0 (0%) 3,8

Literature references 1 (5%) 10 (45%) 5 (23%) 4 (18%) 2 (9%) 0 (0%) 2,8

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Survey results 3/4Repurposing vs new VP authoring

StronglyDisagree Disagree Neutral Agree Strongly

AgreeNo

Answer Average

VP repurposing makes sense

0 (0%) 2 (9%) 5 (23%) 8 (36%) 7 (32%) 0 (0%) 3,9

I prefer to repurpose than to create from scratch

1 (5%) 6 (27%) 6 (27%) 5 (23%) 1 (5%) 3 (14%) 2,9

Repurposing taught me how to create VPs

1 (5%) 0 (0%) 3 (14%) 10 (45%) 5 (23%) 3 (14%) 3,9

Repurposing was for me an interesting experience

0 (0%) 1 (5%) 4 (18%) 0 (0%) 13 (59%)

4 (18%) 4,4

Creating cases from scratch was for me an interesting experience

0 (0%) 0 (0%) 1 (5%) 4 (18%) 12 (55%)

5 (23%) 4,6

Repurposing leaves enough room for self-initiative

0 (0%) 5 (23%) 5 (23%) 5 (23%) 5 (23%) 1 (9%) 3,5

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Survey results 4/4

• Attitude towards repurposing depends strongly on the particular case

• Difficulty with finding cases in the pool of VPs that meet the expectations of teachers and fitting them into an existing medical curriculum with defined learning objectives

• Problems with access to source/raw multimedia material for repurposing

Free-text comments

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Summary• Repurposing is very interesting at the beginning

to learn the possibilities of a new tool• Limitations of repurposing– Some author prefers to implement their own

educational ideas– Strong dependencies on national guidelines– Difficulties in transferring multimedia between

different cultures• Development of an evaluation tool that could

assess the repurposing potential of a case