This presentation from Nataly Martini (University of Auckland) focussed on a small study exploring the repurposing of virtual patients used in a single health course, to be used for interprofessional learning (IPL).
Health care professionals use clinical decision-making processes and there are many models for undertaking this depending on discipline. For students with little or no experience, clinical decision-making processes are slow and deliberate, but this is crucial in terms of helping them come to a diagnosis and treatment plan. Simulations are often used with the goal being to have the student recall knowledge and apply it to the case. It also allows students to practice the variety of skills needed to be employable (e.g. communication, interprofessional practice) across a range of cases. Clinical reasoning opportunities that include IPL are often not available and placements may not be adequate to develop this skill.
High fidelity simulations (e.g. using mannequins) are very effective in engaging students especially with technical skills (e.g. intubation) and with more generic skills (e.g. communication). However, there is a high cost and it is logistically challenging for all students to undertake IPL in this situation (i.e. it may only happen once a year).
Virtual patients can be a good alternative. Virtual patients involve a computer program that uses a patient the student can interact and engage with. They can be effective at teaching clinical skills, communication skills and teamwork and without the negative consequences on real patients. Advantages include that no co-location of students is needed, nor even alteration of existing timetables. It supplements mannequin-based simulations by preparing students for the high-fidelity practice. Disadvantages can include the cost and time to develop, but they are easily scalable.
This small study indicated that use of virtual patients for IPL improved readiness to practice and engage in interprofessional practice as well as improvements in teamwork and collaboration scores. The simulation allowed students to:
- Communicate thoughts
- Appreciate roles and responsibilities
- Be more confident in decision making
- Improve teamwork
- Develop positive attitudes to simulation and IPL
This could potentially be used synchronously or asynchronously, especially if other technologies such as ‘virtual paging’ (where one student can contact another re an opinion) were incorporated. There were some design challenges:
- visuals (e.g. authentic)
- sound (necessary for authenticity)
- environment and conversation (simple in terms of how they are communicating with the patient)
Design pedagogy should include:
- relevance (for all students)
- be challenging for all (for stronger and weaker students)
- provide feedback (consider how this is incorporated in or out of the simulation)
- provide assessment opportunities (without breaking the flow of the simulation)
- ability to collect data (about student performance)
On the whole, the use of virtual patients for interprofessional learning was seen as a cost-effective and logistically more manageable way of addressing preparation for interprofessional practice.
Written by Cassandra Hood
Academic Developer – CILT