Use Of Virtual Patients Research Articles

The chance and challenge of creating virtual patients in prosthodontics.

In the field of prosthodontics, the use of virtual patients for biomimetic restoration holds great promise for various applications. Virtual patients consist of digitized data that encompasses details on the morphology, structure, and spatial relationships within the maxillofacial and intraoral regions. Nonetheless, there are several challenges associated with acquiring digital data, achieving accurate alignment, and recording and transferring dynamic jaw movements. This paper aims to concentrate on the process of constructing virtual patients, highlight the key and challenging aspects of virtual patient construction, and advocate for the extensive adoption and utilization of virtual patient technology.

HEALTH CARE CHATBOT

Chatbots mimic human speech to make the software more user-friendly or just for amusement purposes. NLP (Natural language Processing) and AI (Artificial intelligence) are new emerging technologies that can be utilized to improve the capacity of chatbots to stimulate a more natural and free-flowing conversation. Chatbots can be used to offer customers support and services as more and more mobile device users switch to more frequent use of texts and messaging Healthcare chatbots provide a customized experience to each user in ways that may be more practical and effective than humans are capable of. By communicating with consumers in a human like manner, a medical chatbot enhances the work of a healthcare professional and aids in enhancing their performance. Medical chatbots are conversational AI-powered tools that facilitate communication between patients, insurance providers, and health care professionals. These bots can be quite useful in providing timely access to pertinent healthcare information to the appropriate parties. We discuss current chatbot research and uses in the fields of medical and health care education, our main areas if concentration includes the use of virtual patients in medical education patient education regarding healthcare issues, and the use of chatbots as course assistants to improve the curriculum for healthcare professionals. Because of their mobility and affordances, chatbots are increasingly being used into the teaching and learning processes in the field of healthcare education. Clients of this application have discussions with the wellbeing chatbot likewise to how they would have discussions with different clients. Through a series of questions, the health chatbot helps people identify their symptoms in order to assist them decide whether or not to see a doctor. People who are unsure of whether their symptoms are temporary or call for further testing from a doctor may find this.

Use of virtual patients in orthopedic teaching as an adjuvant tool to clinical training for medical students

Use of virtual patients in orthopedic teaching as an adjuvant tool to clinical training for medical students

Nursing Students' Perceptions of Using Virtual Patients to Prepare for Clinical Practice.

Educators are called on to provide opportunities for students to practice and integrate skills and knowledge to ensure preparation for the complexities of today's health care environment. This study explored nursing students' perceptions of using virtual patients to prepare for clinical practice. This study used an exploratory qualitative design. Four focus group interviews were conducted with 25 third-year nursing students. Data were collected and analyzed using thematic content analysis. Four main themes and eight subthemes emerged. Main themes included personal engagement, learning environment, organizational factors, and improvement needed. Subthemes included being a computer game player, becoming confident in clinical practice, convenient to practice, an authentic stressful learning environment, organization, better to be combined with mannequin-based simulation, technology difficulties, and aural factors. Although some perceived disadvantages were identified, the use of virtual patients could be an effective strategy to improve nursing students' preparation for clinical preparation. [J Nurs Educ. 2022;61(7):398-402.].

COVID-19 and Virtual Medical Student Education.

COVID-19 and Virtual Medical Student Education.

Integration of multimedia components into the models of treatment and diagnostic process in patients and clinical diagnostic tasks in cardiology

Introduction. Integration of multimedia results of diagnostic examinations into the information model of diagnostic and treatment process makes it possible to teach medical decision-making taking into account all available information about the patient.Aim. The purpose of this work was to use multimedia results of instrumental examination methods to form and verify the level of effective diagnostic decision-making.Material and Methods. A significant array of multimedia information arising in the course of treatment and diagnostic process was derived from databases of diagnostic units and was important for medical decision-making. The model was supplemented with clinically and demographically relevant studies of other patients when necessary. The multimedia components were integrated into the virtual simulations with two different trajectories of information presentation to the trainees depending on the purpose of further use.Results. At the first stage of the project, the multimedia components were integrated into linear models of completed cases to demonstrate medical decisions to the trainees. The multimedia components were presented as the fragments of magnetic resonance imaging (MRI) data, echocardiography and vascular ultrasound recordings, scanned electrocardiograms (ECG), angiography results, X-ray images, tomograms, and results of other visualization methods of patient examination. Each multimedia file was accompanied by a textual conclusion made by a relevant specialist. At the second stage, the multimedia components were integrated into the models with a branched trajectory of information presentation. The course of disease and the patient’s condition could change depending on the decisions made, which means that there are alternative scenarios of the therapeutic and diagnostic process unlike the real invariant treatment of the patient. This possibility is especially important for the formation of medical decision-making competencies in safe conditions of simulation. To elaborate clinical diagnostic tasks, the authors developed a rating system quantifying the effectiveness of the decisions.Discussion. Building physician competencies in the educational process through repeated decision-making under changing conditions is crucially important for the health and lives of patients and can be effectively implemented using simulation technologies. Web access to this content is strategically important for the use of virtual patients with multimedia diagnostic results to practice decision-making skills in clinical disciplines.

Digital and virtual support in the hermeneutic case-based learning in health professional education: A systematic review

Digital and virtual support in the hermeneutic case-based learning in health professional education: A systematic review Abstract. Background: Nowadays, the digitization dominates almost all aspects of our lives, especially in the nursing field. The medial-supported teaching design program helps learners to be prepared for the digital challenges of their professional field. In addition, the concept of hermeneutic casework provides nurses with an expertise that can be applied individually and case-related. Virtual simulations can represent a realistic case scenario and extend the conventional concept of casework with modern technology. Aim: The aim of the review is, to identify national and international used types of virtual and digital medias in connection with the method of hermeneutic casework and describe its usefulness in health education. Methods: A literature review according to the design of a systematic review in the databases CINAHL, MEDLINE via PubMed, Cochrane and Springer Link has been conducted and complemented by the snowball principle. Results: Eleven publications were analysed. The results show predominantly positive effects, which can be divide into eleven areas. Conclusion: The use of virtual patients is considered in both empirical and media-didactic research as an effective and an efficient learning arrangement. In a positive and a negative sense, the results depend from the didactic and methodological preparation, the design of the learning modules and the quality of the medium as well as the teaching.

Impact of COVID-19 pandemic on oncologists’ professional and personal lives: A pre-vaccine study.

45 Background: The COVID-19 pandemic has adversely impacted healthcare workers globally, leading to high rates of burnout, especially among frontline workers. We conducted a study to assess the pandemic’s impact on community-based medical oncologists and hematologists (mO/H) in the U.S. before the widespread distribution of vaccines. Methods: Between October and December 2020, mO/H participated in a compensated, online survey addressing the impact of COVID-19 on oncologists’ professional and personal lives and other issues in oncology; demographic, clinical, and practice-based questions were also asked. Results are presented using descriptive statistics. Results: A total of 259 geographically diverse mO/H, with a median of 18 (1-42) years in practice, completed the survey. At the time of the study, local trends in COVID-19 cases were reported as increasing, stable, or decreasing by 29%, 51%, and 20%, respectively. The summative view of the pandemic was “proud of my work as a physician in the frontlines” (37%), “a challenge to get through” (35%), and “no significant impact” (23%). Over half reported a moderate to severe impact on their professional (60%) and personal lives (65). The top 3 factors adversely impacting professional life were: concern of transmitting COVID-19 to patients or staff (52%), difficulty providing patient care (45%), and loss of income (41%). The top 4 factors adversely impacting personal life were: concerns of safety for self and family (84%), a sense of anxiety (50%), loss of family income (24%), and a sense of depression/doom (22%). Fifty percent agreed or strongly agreed that they had increased burnout at work since the beginning of the pandemic. However, workload was assessed as stable (51%) or reduced (33%) during the pandemic. The top 3 factors contributing to burnout were: loss of face-to-face patient interaction (46%), financial loss by practice (42%), and reduced patient volume (35%). The factors thought to impact income were: use of virtual patients visits (38%), pay cuts from the employer (33%), and cancellation of elective procedures (31%). Overall, 41% reported receiving funds from government-based programs (e.g., CARES act) during the pandemic. While about half (52%) did not believe that the pandemic would impact their retirement, some felt that the pandemic would likely hasten (17%) or delay (17%) their plans to retire. Conclusions: This study confirms greater feelings of burnout among U.S. community-based mO/H in the wake of the pandemic and offers insight into drivers of professional and personal dissatisfaction. While mO/H have concerns about loss of income, notably, loss of in-person patient interaction is also a key factor impacting their professional satisfaction. Given the high baseline rate of burnout among mO/H, it is critical to prevent, mitigate and control additional risks imposed by pandemic-related factors.

Design and evaluation of mobile scenario based learning in the self-management of chronic pain.

Chronic pain is a lifelong issue, being one of the main causes of disability, affecting a great number of people worldwide, many of which often avoid seeking medical advice from pain experts and/or demonstrate poor adherence to their therapeutic plan. One of the most important steps in achieving a manageable course of disease, is the ability of self-management. We aimed at applying a method of systematic patient education and self-management through the use of Virtual Patients (VPs), a well-established method for educating medical doctors and students but never before targeting patients. Two VPs scenarios were designed, tested and evaluated by patients with rheumatic disorders, achieving a SUS score of 88/100 "Best Imaginable", alongside with positive reviews from the participants. The positive feedback from the patients supports the potential of VP educational paradigm to educate these patients and equip them with disease coping skills and strategies.

Communication skills training using virtual reality: A descriptive qualitative study

BackgroundModern medical pedagogical strategies are shifting toward the use of virtual patient simulations. ObjectiveThis study aims to examine students' users' attitudes and experiences and clinical facilitators' perspectives on student performances in the clinical setting post-virtual patient training. DesignA descriptive qualitative study design was used. SettingNursing faculty at a local university in Singapore. Participants24 nursing undergraduates and six clinical facilitators. MethodsThis study is a follow-up of an experimental study on the Virtual Counseling Application Using Artificial Intelligence (VCAAI). The study took place from the academic year 2017/2018 ended in November 2019. Focus group discussions and individual interviews were conducted. All interviews and focus group discussions were audiotaped, transcribed verbatim, and analyzed using thematic analysis. ResultsTwo overarching themes (students' virtual patient user experience and clinical facilitators' evaluations of students' clinical communication skills) comprising six themes were generated. Themes under students' user experience included: 1) attitudes toward virtual patient training, 2) virtual patient's role in student development, and 3) enhanced features and implementation suggestions. Themes under clinical facilitators' evaluations included: 1) insights on students' communication skills and 2) approaches to improve communication skills. An overlapping theme titled ‘value of technology in teaching communication’ comprised of mutual feedback from both students and clinical facilitators. Early implementation, continued accessibility, enhancing realism and technological improvements to the VCAAI were listed as key areas for program improvement, while increased situational sensitivity and language training are recommended to further enhance students' communication skills. ConclusionThe mixed attitudes toward virtual patient interactions and recognitions of the benefits of virtual patient simulations suggest the potential effectiveness of the use of virtual patients in teaching effective nursing communication skills. However, the lack of authenticity and other limitations need to be addressed before official implementations of such trainings with virtual patients to undergraduate nursing curricula.

Effective virtual patient simulators for medical communication training: A systematic review.

Despite the growing use of virtual patients (VPs) in medical education, few studies have explored the features and effectiveness of VP-based medical communication skills training. We undertook a systematic review to summarise the design and evaluation of VP-based medical communication skills training systems in order to identify features of successful cases. Following PRISMA guidelines, we searched four databases for studies published between 2006 and 2018. Using a refined classification scheme, we extracted data on instructional design (scenario and instructional intervention), technological design (modality and interaction), and evaluation (user experience, learning effectiveness and evaluator). We assessed the quality of studies using the Medical Education Research Study Quality Instrument (MERSQI) and the QualSyst standard assessment criteria. A total of 14 studies were included for review. Of these, 85.7% (n=12) were quantitative and 71.4% (n=10) involved undergraduate students. The most common VP training scenario was history taking followed by the delivery of bad news. Diverse instructional interventions, including tutorials, learning activities, and feedback, were embedded in the VPs. The first-person perspective animated within-screen size VP was a popular technological feature. Most evaluations concerned the reality of simulation (for user experience) and skill in expressing empathy (as a learning outcome). Of the eight comparative studies, half reported significant attitude or skill improvements in the VP group. The distinct features of VPs shown to be effective were well-designed instructional interventions (eg, a pre-activity with a protocol-informed tutorial), and post-activity (eg, debrief or reflection), scaffolding and human feedback, but not system feedback. Evidence-based VP training can enable students to gain communication skills in a safe and affordable learning environment. Elaborate technology alone cannot guarantee effective learning, but evidence-based instructional interventions can facilitate its optimal use and bring about better learning outcomes.

Learning clinical reasoning: how virtual patient case format and prior knowledge interact

IntroductionClinical reasoning has been fostered with varying case formats including the use of virtual patients. Existing literature points to different conclusions regarding which format is most beneficial for learners with diverse levels of prior knowledge. We designed our study to better understand which case format affects clinical reasoning outcomes and cognitive load, dependent on medical students’ prior knowledge.MethodsOverall, 142 medical students (3 rd to 6 th year) were randomly assigned to either a whole case or serial cue case format. Participants worked on eight virtual patients in their respective case format. Outcomes included diagnostic accuracy, knowledge, and cognitive load.ResultsWe found no effect of case format on strategic knowledge scores pre- vs post-test (whole case learning gain = 3, 95% CI. -.01 to .01, serial cue learning gain = 3, 95% CI. -.06 to .00 p = .50). In both case formats, students with high baseline knowledge (determined by median split on the pre-test in conceptual knowledge) benefitted from learning with virtual patients (learning gain in strategic knowledge = 5, 95% CI .03 to .09, p = .01) while students with low prior knowledge did not (learning gain = 0, 95%CI −.02 to .02). We found no difference in diagnostic accuracy between experimental conditions (difference = .44, 95% CI −.96 to .08, p = .22), but diagnostic accuracy was higher for students with high prior knowledge compared to those with low prior knowledge (difference = .8, 95% CI 0.31 to 1.35, p < .01). Students with low prior knowledge experienced higher extraneous cognitive load than students with high prior knowledge (multiple measurements, p < .01).ConclusionsThe whole case and serial cue case formats alone did not affect students’ knowledge gain or diagnostic accuracy. Students with lower knowledge experienced increased cognitive load and appear to have learned less from their interaction with virtual patients. Cognitive load should be taken into account when attempting to help students learn clinical reasoning with virtual patients, especially for students with lower knowledge.

APPLICATION OF VIRTUAL PATIENTS ON AN OPEN ACCESS PLATFORM FOR THE DEVELOPMENT OF CLINICAL THINKING IN A DISTANCE LEARNING ENVIRONMENT

Clinical education is the classic teaching method in a medical school. However, in recent years, there have been several trends in medical education that impede full-fledged clinical education, including pandemic emergencies that are forcing medical universities to switch to distance learning. We offer an innovative teaching method based on the use of virtual patients on an open access platform for the development of clinical thinking in a distance learning environment, which has proven to be effective.

Use of virtual patient software to assess student confidence and ability in communication skills and virtual patient impression: A mixed-methods approach

Background and purposeKnowledge related to the use of virtual patients (VP) in pharmacy education is limited in relation to student satisfaction with this learning technique. This project aimed to assess students' confidence and impressions in using their communication skills with a VP and to evaluate their skills using this technology. Educational activity and settingThis explanatory mixed-methods study was conducted with first-year doctor of pharmacy students. Fourteen survey items that addressed confidence in student abilities and VP impressions were analyzed. Mann-Whitney U tests were conducted to compare pre- and post- scores. Student reflections were reviewed to obtain primary themes and concerns. Descriptive statistics were used for student grades. FindingsOut of 205 students, 203 completed the pre-survey and 163 completed the post-survey. Responses regarding pre-post confidence indicated statistically significant improvement (p < 0.001) for 8 of 10 survey items as follows: understand history taking, conduct an organized interview, elicit subjective information, ask follow-up questions, ask questions related to severity, document subjective data, document objective data, and organize an interview. Regarding their impressions toward VPs, student responses were improved and statistically significant (p < 0.001) for 1 of 4 survey items (tools are easy to use). Forty-two students stressed the need to improve their written communication skills in the self-reflection. The average grade for subjective data was 31.48% and for objective data was 93.66%. SummaryThis VP program improved student confidence in their verbal and written communication skills despite low subjective data scores.

Implementing and evaluating virtual patient cases within a team‐based learning pedagogy in a therapeutics course sequence

IntroductionAccreditation Council for Pharmacy Education (ACPE) requires that pharmacy curriculum stresses active learning. This allows students to listen, read, write, discuss, and reflect on their approach to course content through various methods. ACPE advocates use of innovative, active learning teaching methods to develop necessary skills students need to problem‐solve, think critically, and effectively work as a team. We have successfully implemented team‐based learning (TBL) throughout therapeutics curriculum; however, there is still a critical need for students to practice what they have learned through an interactive fashion. Use of virtual patients has been previously evaluated in non‐TBL courses and has resulted in improved student learning. Thus, using virtual technology could bridge the gap between TBL and providing “real‐life” patient‐centered care.ObjectivesTo evaluate short‐term learning outcomes and student perception of implementing virtual simulation within a TBL therapeutics course series. We expect that virtual simulation will add another unique action‐based learning experience within TBL.MethodsFaculty developed virtual patient cases using branched‐outcome decision‐making processes and integrated them into six TBL sessions throughout the therapeutic courses in the second (two sessions) and third years (four sessions) of pharmacy school. Students completed virtual patient cases in groups and pre‐simulation/post‐simulation assessments were completed. Assessments and activity evaluation were used to measure student learning and perceptions. Pre‐simulation/post‐simulation assessments included 12 lower‐level and 9 higher‐level learning questions.ResultsUse of virtual patient cases resulted in significantly higher post‐simulation scores compared with pre‐simulation scores (P &lt; 0.001). Increases in student's learning of lower‐ and higher‐level domains (P = 0.02 and P = 0.11, respectively) were observed. Seventy‐four percent of students agreed that virtual cases were effective in learning therapeutic clinical application, and 80% believed these cases stimulated their critical thinking.ConclusionIntegrating virtual patient cases into curriculum may enhance student's ability to critically think and apply their knowledge to real health care world.

Collaborative use of virtual patients after a lecture enhances learning with minimal investment of cognitive load

Background: The use of virtual patients (VPs), due to their high complexity and/or inappropriate sequencing with other instructional methods, might cause a high cognitive load, which hampers learning.Aim: To investigate the efficiency of instructional methods that involved three different applications of VPs combined with lectures.Method: From two consecutive batches, 171 out of 183 students have participated in lecture and VPs sessions. One group received a lecture session followed by a collaborative VPs learning activity (collaborative deductive). The other two groups received a lecture session and an independent VP learning activity, which either followed the lecture session (independent deductive) or preceded it (independent inductive). All groups were administrated written knowledge acquisition and retention tests as well as transfer tests using two new VPs. All participants completed a cognitive load questionnaire, which measured intrinsic, extraneous and germane load. Mixed effect analysis of cognitive load and efficiency using the R statistical program was performed.Results: The highest intrinsic and extraneous load was found in the independent inductive group, while the lowest intrinsic and extraneous load was seen in the collaborative deductive group. Furthermore, comparisons showed a significantly higher efficiency, that is, higher performance in combination with lower cognitive load, for the collaborative deductive group than for the other two groups.Conclusion: Collaborative use of VPs after a lecture is the most efficient instructional method, of those tested, as it leads to better learning and transfer combined with lower cognitive load, when compared with independent use of VPs, either before or after the lecture.

The use of virtual patients to develop musculoskeletal reasoning skills in undergraduate physiotherapy students: a qualitative evaluation of student experience

The use of virtual patients to develop musculoskeletal reasoning skills in undergraduate physiotherapy students: a qualitative evaluation of student experience

Medical students' attitudes towards the use of virtual patients

AbstractAn increasing number of virtual patients (VPs) are being used in the classroom, which raises questions about how to implement VPs to improve students' satisfaction and enhance their learning. This study developed and validated a scale that measures acceptability and attitudes of medical students towards the use of the VP education tool in the classroom.This mixed method study first explored attitudes with 11 students in two focus groups. Later on, eight experts performed item reduction and transformation through three rounds of the Delphi‐study method, and an initial version of the scale [virtual patient integration rating scale (VPIRS)] was developed. The scale was administered among 138 medical students to determine its reliability.A total of 88 medical students responded to the final version of the VPIRS. Principal component analysis was performed in order to determine questionnaire domains. The final, validated scale contains 25 items in four domains, with a reliability of 0.864. The identified domains are as follows: (1) acquiring and maintaining knowledge, (2) facilitation of learning, (3) inauthentic learning and (4) disadvantages of learning.To the best of our knowledge, this is the first time a VP rating scale has been developed. VPIRS allows for targeted engagement with students regarding learning and evaluation with VPs, thereby providing opportunities for student‐centred teaching.

Virtual Patient Case Sharing Across Two Schools of Pharmacy

Objective. To expand the use of virtual patients at 2 schools of pharmacy through virtual patient case sharing. Design. Faculty members at two schools of pharmacy collaborated to expand the use of virtual patients. Two simulation programs, vpSim and DecisionSim (Decision Simulation, LLC, Chadsford, PA), were used to create interactive patient cases for a required course and an elective course at the different schools. Each school developed cases for their own use and then shared the cases with the other school. Assessment. The development, sharing, and subsequent modification of cases were examined using a standardized data collection form completed by both schools. Survey instruments were used to gather data regarding faculty perception and student satisfaction. Pre- and post-tests were administered to assess student learning. Five cases were developed and shared between the institutions. The time spent constructing new cases (22 hours/case) was significantly longer than the time spent modifying the shared cases (1.2 hours/case). Faculty members and students were largely satisfied with case sharing and the use of virtual patient cases, respectively. Virtual patients significantly enhanced student learning of material (mean score: 3.2 vs 3.6 on a 5-point scale). Conclusions. The sharing of virtual patient cases may allow institutions to overcome barriers to implementation of virtual patient programs, namely faculty resources, while improving student learning and satisfaction.

The use of virtual patients in assessment of postgraduate general surgical trainees – A pancreatic cancer model

The use of virtual patients in assessment of postgraduate general surgical trainees – A pancreatic cancer model