The Project | Aims & Objectives | Outcomes | Repurposed Virtual Patients |
The project developed, ran and quality assured a technology enhanced Paediatric module using repurposed learning materials sourced externally to the institution. The aims were comfortably achieved.
One point highlighted in the project is the necessity for reusable learning objectives to have some very special value or uniqueness if they are ever to be re-used, unless there is additional funding to effectively bribe the users to use them. This is not always a popular argument, but every evaluation carried out by the St George’s team (and certain other projects such as ACETS) has always pointed in this direction and in this instance so does the questionnaire from the Critical Friend Partnership Group. It examined student responses to a number of repurposed learning objects produced by the groups in the partnership. Outcome: Students preferred textbooks under normal circumstances, and students commented that the repurposed learning objects may in some instances may only offer information that could be included in a textbook. This may explain the very high approval rating for the St George’s style Virtual Patient in the evaluation. The very factors which increased the time taken to repurpose Virtual Patients i.e. adding choices and consequences, was the element that students described as most important to their learning.
The process of Repurposing:
Repurposing proved an efficient process for transforming content form one healthcare culture to another if structures of the cases were similar; there was clearly a considerable amount of conservation between two European healthcare systems i.e. similar structures in terms of patient progress form general practitioners to hospital medicine, and a similar approach in terms o f history taking, examination, management etc., in comparison with, say, North American healthcare. It only took approximately one hour to repurpose a case from the linear system to an English adapted linear model, but then to develop a branching model it took approximately 10 hours more.
Clearly though it is still a saving of time (by repurposing; in comparison with a de novo creation (estimated at 10-120 hours), this saving is now a smaller proportion of the entire effort.
However, there are several less tangible advantages:
- the repurposer now has a case to start from;
- the outline and suggested format may also be very helpful to a new case writer;
- if the number of cases is large enough, then a case can be chosen that most closely fits the need of the creator or students. All three of these advantages reduce the need for unnecessarily large amount of creative input on the part of the repurposer.
Students were enthusiastic to try out the Virtual Patients, and once started, highly motivated to choose correct options. In all the analyses of student feedback (two questionnaires and a focus group within the REViP trial) they believed Virtual Patients provided excellent learning, in a context which mimicked the decision making processes of their chosen profession. It provided them with opportunities to practice clinical reasoning, then take decisions and explore the consequences of their decisions.
Virtual Patients were believed to be adaptable to a range of learning styles. Students picked out not only the learning by collaborative discussion and tutorials which they had experienced, but in their judgement it would also provide opportunities for individual safe practice, personal revision, and self-assessment. Students described Virtual Patients as quick and easy-to-use, easily integrated into their study time and available anytime, anyplace. A few issues were raised, which were mainly technical and therefore reasonably easily addressed.
In summary, though they never use this phrase, students were describing the Virtual Patient as an excellent tool for personalised learning and in a comment fundamental to the purpose of the REViP project, there were too few Virtual Patients, and students wanted more.