Teaching hospitals the world over face increasing difficulties in sourcing real patients who exhibit every conceivable ailment which medical students need to learn to diagnose and treat. An e-learning approach using interactive computer simulations known as virtual patients is one way to solve the problem, but in which settings is the use of these virtual patients most effective? Engineer and lecturer Martin Riemer and his co-author Martin Abendroth, a medical doctor, have spent the past year studying the use of virtual patients by hundreds of students at the University Medical Centre Hamburg-Eppendorf, Germany, and their findings shed light on how best virtual patients should be integrated into the curriculum.
Patience as a virtue
The development of precise virtual patients has been a slow but rewarding process, and these virtual patients are proving to be very useful. Riemer says that many medical students have a traditional approach to learning with few e-learning materials involved in their sometimes solitary book-based study routine where they cram as much medical knowledge as humanly possibly into their brain. Developing the virtual patient concept and then integrating it into the curriculum is thus a novelty. “Our early virtual patients were fictitious,” he says, “but for well over a year now we’ve been taking anonymous data from real patients. You have to work with real data to avoid the students asking questions like ‘Can that really happen?’ or ‘Are these real laboratory findings?’ The medical data we use is authentic, though we use fictitious faces to protect their privacy.”
The study design
As the integration of virtual patients in medical training courses gains ground, it is important to understand which virtual teaching methods work best in the real world. Riemer and Abendroth sought to find out whether students engage best with virtual patients in online courses, seminars, or smaller classroom settings. They examined a group of 400 online students, a group of 250 students in classroom seminar groups and a number of groups of between five and seven students involved in either classroom or online learning. The online students were classified according to how many courses they had completed. The researchers measured the students’ participation and evaluated their feedback on the benefits and shortfalls they saw in the use of virtual patients.
Using virtual patients in a small, classroom-based group proved the most effective way to engage students. Most students responded favourably to each case when they were able to discuss the findings with their peers. Riemer says, “I can see virtual patients replacing at least traditional paper cases in Problem-Based Learning as they offer a wider variety of media, allow non-linear solutions and students cannot cheat by looking at a later page.” In reviewing his current findings, he says, “I had to correct the assumption in my OEB 2010 contribution that non-linear structured virtual patient cases are preferred by students near the end of their formal education: they prefer linear cases as they take up less time to ‘solve’.” So although the medical students have been slow to turn to Wikis and other collaborative learning tools, cooperating with their peers in diagnosing virtual patients is proving popular, making the virtual patient a real part of the curriculum.
Martin Riemer was recently named Teacher of the Year 2011 in a poll conducted among students at Faculty of Medicine at the University of Hamburg-Eppendorf. His OEB 2011 presentation is entitled Which Kind of Teaching Method Using Virtual Patients Is Most Attractive to Medical Students? He will speak on Friday, December 2nd, 2011, at 16.30 – 18.00