Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment--Web-SP

Abstract

Background: The Web-based Simulation of Patients (Web-SP) project was initiated in order to facilitate the use of realistic and interactive virtual patients (VP) in medicine and healthcare education. Web-SP focuses on moving beyond the technology savvy teachers, when integrating simulation-based education into health sciences curricula, by making the creation and use of virtual patients easier. The project strives to provide a common generic platform for design/creation, management, evaluation and sharing of web-based virtual patients. The aim of this study was to evaluate if it was possible to develop a web-based virtual patient case simulation environment where the entire case authoring process might be handled by teachers and which would be flexible enough to be used in different healthcare disciplines.

Results: The Web-SP system was constructed to support easy authoring, management and presentation of virtual patient cases. The case authoring environment was found to facilitate for teachers to create full-fledged patient cases without the assistance of computer specialists. Web-SP was successfully implemented at several universities by taking into account key factors such as cost, access, security, scalability and flexibility. Pilot evaluations in medical, dentistry and pharmacy courses shows that students regarded Web-SP as easy to use, engaging and to be of educational value. Cases adapted for all three disciplines were judged to be of significant educational value by the course leaders.

Conclusion: The Web-SP system seems to fulfil the aim of providing a common generic platform for creation, management and evaluation of web-based virtual patient cases. The responses regarding the authoring environment indicated that the system might be user-friendly enough to appeal to a majority of the academic staff. In terms of implementation strengths, Web-SP seems to fulfil most needs from course directors and teachers from various educational institutions and disciplines. The system is currently in use or under implementation in several healthcare disciplines at more than ten universities worldwide. Future aims include structuring the exchange of cases between teachers and academic institutions by building a VP library function. We intend to follow up the positive results presented in this paper with other studies looking at the learning outcomes, critical thinking and patient management. Studying the potential of Web-SP as an assessment tool will also be performed. More information about Web-SP: http://websp.lime.ki.se.

Figure 1

The main components of Web-SP. The user may follow any path in the "explorative phase" (case encounter). It is also possible to "jump back" from the diagnosis, therapy and feedback sections to the explorative phase.

Figure 2

The waiting room where all the available cases are displayed.

Figure 3

The patient introduction screen.

Figure 4

The Patient Interview section.

Figure 5

Physical examination screen showing the Inspection of the shoulder.

Figure 6

Laboratory tests screen showing an ordered CT of the L-spine.

Figure 7

Diagnosis and differential diagnosis.

Figure 8

Feedback on asked questions, physical examinations and ordered lab tests.

Figure 9

Editing of the Patient introduction screen.

Figure 10

Authoring of the medical history screen.

Figure 11

Steps recommended to author a patient case required that the teacher have prepared a manuscript and relevant media documents. The first step is to develop a manuscript of the case, then to start up the Web-SP case creation interface to author the patient case.

Figure 12

Shows the overall opinion of the students (in percent) regarding Web-SP.

Figure 13

A dentistry module that shows an overview of the available intra-oral photos.

Figure 14

A dentistry module viewing all the available dental x-rays as normally presented in the patient medical record.