eViP - Overview
eViP stands for Electronic Virtual Patients. The aim of the eViP programme is to create a repository, or bank of 320 repurposed and enriched virtual patients (VPs), which will be made available under a Creative Commons License.
Electronic Virtual Patients
Why use virtual patients?
Virtual patients play a vital role in teaching medicine and other healthcare professions. Student-patient contact, which is at the heart of clinical competency, is declining in most member states.
Training is hampered by two important factors:
Electronic virtual patients (VPs) are now recognised by the medical education community as very effective tool for developing clinical reasoning.
- the healthcare budget constraints that increasingly limit clinical teaching; and
- the reduction in the time that patients stay in hospital.
A recent eViP survey showed that 55% of respondents use their own virtual patients, with the majority being used for independent, and problem-based learning.
Re-use and recycle!
VPs are time-consuming and expensive to produce from ’scratch’, and even leading e-learning institutions cannot produce a sufficient number to give full coverage of the medical or healthcare curricula.
To address this issue, eViP is a 3-year programme co-funded by the European Union and partner institutions to create a bank of repurposed and enriched multicultural virtual patient cases from across Europe.
The programme officially started in September 2007 and is due to finish in September 2010.eViP Web Site
|The vision of the eViP Programme is to create a shared online bank of 320 virtual patients (VPs), adapted for multicultural and multilingual use, for the improved quality and efficiency of medical and healthcare education across the EU.
The objectives of the eViP Programme are to:
- Collate VPs from partners’ existing collections and select cases for repurposing to local educational needs.
- Promote the inter-professional sharing of VPs between different healthcare disciplines such as medicine, nursing, physiotherapy and dentistry.
- Implement common technical standards for all VPs in collaboration with MedBiquitous.
- Restructure content to standards-compliant structure, metadata including the culture and language metadata of the partners (English, German, Dutch, Swedish, Polish, Romanian) and content packaging; all to enable “multi-lingual access”.
- Further enrich the content of the repurposed VPs with the addition of supporting resources e.g. supporting basic and clinical science resources, clinical skills videos, owned by the partner or in the public domain, or available under an appropriate Creative Commons License.
- Share enriched VPs with the wider EU community through an online referatory.
- Evaluate how the repurposed and content-enriched VPs meet the individual needs of the project partners and the wider community.
- Share templates and tools within the EU community for the easy creation of new VPs.
- Disseminate best practice guidelines for creating and sharing VPs and evaluation instruments for VPs and for learning & teaching activities using VPs
- Embed a sustainable model for the storage and retrieval of VPs beyond the lifetime of the 3-year Programme.
|eViP is a collaboration between nine universities located across Northern Europe and MedBiquitous (Europe) who lead the field of technical standards and specifications for e-based healthcare education:
- Karolinska Institutet, Sweden: The Karolinska Institutet is amongst the largest medical universities in Europe, and is the largest centre for medical research in Sweden. They play a pivotal role in eViP, leading both WP2 and WP3 phases of the programme. The Virtual Patient Lab, or VP-Lab within the Department of Learning, Informatics, Management and Ethics (LIME) is highly active in the development of virtual patients. In addition to VPs, researchers at the VP-Lab also create virtual environments in collaboration with forensic psychiatrists and specialists in criminal rehabilitation.
- St George’s University of London, UK: St George’s, University of London (SGUL) is the lead co-ordinator for the eViP programme. The eLearning Unit (ELU) at SGUL led the first phase of the programme, WP1, and continues to contribute to all other eViP projects. The ELU was established in 2001 to promote the use of educational technology in enhancing learning and teaching within the context of St George’s teaching and learning strategy. They have since been actively involved in the utilisation of emerging technologies, cutting-edge e-learning facilities, and evaluation of their learning approaches and techniques. The team from the ELU is involved in many other projects involving virtual patients and e-learning strategies, including PREVIEW which uses the Second Life platform to play virtual patient scenarios for paramedic students, and Generation 4 (G4) which incorporates virtual patients into their case-based curriculum.
- Ludwig Maximilians Universität (LMU), Germany: Medizinische Fakultat der LMU Munchen in Germany leads the ‘Exit and sustainability‘ phase of the eViP programme, which focuses on exit and sustainability of eViP Virtual Patients. LMU developed the CASUS virtual patient player, which is one of the VPs used as part of eViP. In addition to eViP and CASUS, LMU is activity involved in a number of other e-learning research programmes.
- Universität Heidelberg, Germany: The Centre for Virtual Patients is part of the Medical Faculty of the University of Heidelberg. It supports medical educators with the creation of virtual patient cases, and assists with the integration of virtual patients into a medical curriculum. Since 1999 it has gathered experience in designing and implementing virtual patients and has been awarded repeatedly for its work. The Centre for Virtual Patients partners with many national and international projects. The CAMPUS Virtual Patients shell was established by our centre. It is in use in many German and international medical education programs, and is continuously undergoing further development. As a partner of the eViP project the Centre for Virtual Patients participates in building a bank of repurposed virtual patients. In collaboration with MedBiquitous it contributed significantly to implementing common technical standards for all virtual patients and is collaborating with Maastricht University on development of evaluation tools.
- Universiteit Maastricht, The Netherlands: The Universiteit Maastricht Faculty of Medicine has led WP5 project of the eViP programme, an area that focuses on the assessment and evaluation of eViP VPs and associated resources. The Faculeit der Geneeskunde, Universiteit Maastricht specialises in problem-based learning (PBL), and it was the second university in the world to adopt this method of teaching as the main form of medical education.
- The University of Warwick, UK: Warwick Medical School (WMS) was established in 2000 and forms the Faculty of Medicine at The University of Warwick, one of the UK’s top ten universities, with an acknowledged reputation for excellence in teaching and research. WMS has grown rapidly and is making significant national and international contributions to education and research in health. The eViP team at WMS, led by Dr David Davies, is helping to bring the latest developments in e-learning to a wide audience.nOur main role in the eViP Programme is work package lead for awareness & dissemination. This exciting responsibility gives us the chance to use new forms of communication to tell everyone about the developments in eViP including progress on virtual patients, and to also bring you news of the institutions and individuals that make up the eViP partnership. So whether you are reading this web site, subscribing to our weblog or YouTube channel, or following us on Twitter, you can be sure WMS will keep you up to date of the latest news about virtual patients.
- Uniwersytet Jagiellonski, Poland: Jagiellonian University was founded in 1364 by the Polish King Kazimierz Wielki (Casimir the Great). It is the second oldest university in Central Europe and the oldest university in Poland. Among famous students of Jagiellonian University are Nicolaus Copernicus, Pope John Paul II and the Nobel laureate in Literature Wis?awa Szymborska. Jagiellonian University comprises currently 15 faculties with over 50 000 students. Jagiellonian University Medical College has participated in the eViP project from the beginning in 2007. The project is coordinated by the Department of Bioinformatics and Telemedicine headed by Prof. Irena Roterman-Konieczna. Our role is to bring together medical subject matter experts and computer specialist working on virtual patients. We contribute to all eViP projects but focus especially on the VP repurposing and enrichment phase of the eViPprogramme. Virtual patients were scarcely used in teaching at our institution before the eViP project. By repurposing virtual patients from our eViP project partners (especially from LMU Munich) we hope to create in short time a large collection of case-based learning resources that can be introduced into the curriculum.
- Universität Witten/Herdecke, Germany: The Universität Witten/Herdecke is the most recent addition to the eViP programme. This university is involved with the repurposing and enrichment of eViP VPs.
- Universitas Iuliu Hatieganu Cluj-Napoca, Romania: The mission of “Iuliu Hatieganu” University of Medicine and Pahrmacy Cluj-Napoca, Romania, is to promote population quality of life through excellence in medical education, research and health care. As a partner in eViP project, the Department of Medical Education supports the use of computer simulations and virtual patients for students learning and assessment.
eViP also works closely with MedBiquitous (Europe) and the University of Northern Ontario in Canada:
- Northern Ontario School of Medicine, Canada: The Northern Ontario School of Medicine, Canada is a project collaborator with eViP. Professor Rachel Ellaway from NOSM is a key contributor to the technical work carried out within the eViP as part of the Standards Implementation phase.
- MedBiquitous Europe: MedBiquitous is a consortium of leading experts, institutions, commercial and non-commercial organistations dedicated to the implementation of heathcare information technology standards. Medbiquitous and St George’s University of London have formed MedBiquitous Europe specifically to promote the use of MedBiquitous technical standards for heathcare education throughout Europe – and these technical standards are being employed for the eViP programme.
|There are six individual eViP projects that take place beneath the eViP ‘umbrella’, with each project being led by an institution but with input from all eViP partners.
|Project 1: Pilot study and evaluation
The pilot study was the initial phase of the eViP programme. Here, each partner explored the feasibility of repurposing and enriching Virtual Patient (VP) examples selected from the existing VP collections. These were repurposed and enriched in different ways, and for different purposes.
Partners obtained feedback from the staff regarding the repurposing and enrichment of VPs, and also student feedback from those who had used the repurposed VPs.
Each partner institution selected the appropriate VP cases for the pilot study from the existing VP collections and repurposed an existing VP from one context to another.
In addition, some VPs could be “content enriched”, which means that additional multi-media, animations, and supportive material that would enhance the VP could be added.
As part of this initial pilot study, a total of 19 VPs were repurposed and enriched.
The pilot study also enabled eViP partners to develop their expertise in a variety of areas. For example, Karolinska Institutet is heavily involved in repurposing VPs to different cultures and languages focused on repurposing and enriching VPs for assessment. On the other hand, Jagiellonian University, Poland, successfully adapted LMU Munchen University’s VPs for their own culture. LMU, which already had a large VP collection for Continuing Medical Education purposes, focused on repurposing the VPs for undergraduates.more information
|Project 2: Standards implementation
The aim of Project 2 was to develop a project-wide eViP application profile of the MedBiquitous VP standard (the ‘eViP VP Profile’), which was tested on the pilot VPs.
The eViP profile was then implemented in all member institutional virtual patient players and authoring systems – typically as an import/export converter between the standard’s XML format and the databases in partner applications.
After this stage, third-party tools that supported the eViP VP profile (and related standards) were tested, including a basic player as required in the MVP specification.
A simple consent and licensing model for clinical recordings and other media was created to allow for the exchange of VPs without incurring medico-legal problems. This was expressed using standard DRM (digital rights management) techniques.more information
|Project 3: VP repurposing and enrichment
The work completed in Project 3 forms the core of the eViP programme, and although it has presented many challenges, it is well under way. The objectives of this project mainly involves the repurposing and enrichment of the VPs, and can be divided into the following sections:
- The identification and establishment of an inventory of all possible VP cases from partners, and the identification of any intellectual property right (IPR) issues;
- Identification of the existing VPs which were to be repurposed, based on medical and healthcare specialties, to different cultures and languages;
- Repurposing of VPs so they were ’standards compliant’, with metadata and packaging, for multi-lingual access: ‘normalisation’ and enrich content using partner’s existing resource collections;
- Repurposing a subset of normalised new VPs into new disciplines;
- Repurposing normalised new VPs into new cultures;
- Peer review of VPs for each culture;
- Evaluation of metadata schemes for eViP virtual patients; and
- Population of the eViP referatory with 320 VPs.
|Project 4: Awareness & dissemination
Project 4 is largely concerned with raising awareness about the eViP programme, publishing the Best Practice Guidelines and developing an online community using social networking tools and other available software. The activities of this project can be listed as follows:
- Prepare and engage the medical education and educational technology communities by promoting the role of virtual patients in curricula;
- Engage with institutions outside project partnership to prepare the groundwork for eViP;
- Publish good practice guidelines for developing and repurposing virtual patients and associated e-learning materials;
- Foster a community of collaboration between institutions through exchanging virtual patient e-learning materials via the eViP project web site;
- Maintain an eViP project weblog and wiki to document progress and sustain awareness of project activities; and
- Gather preparatory data from wider community leading to exit & sustainability activity involving market research, community acceptance of repurposed VPs, and preliminary business modeling.
|Project 5: Assessment & evaluation
The assessment and evaluation phase of eViP aims to evaluate the possibilities of enriching existing Virtual Patients (VPs) for different educational needs and contexts. These evaluations will provide invaluable information about how different eViP partners use VPs.
In December 2008 eViP established an Assessment and Evaluation Reference Group (AEG) to coordinate the activities of the partners to address deliverable D5.3 in which the VP designs and VP integrations, or ’scenarios’ are evaluated. The goal will be to address as many independent variables as possible and research their effect on use, reaction and learning.
The specific deliverables for this project are as follows:
- Evaluation of the possibilities of enriching existing VPs for different education needs and contexts;
- Evaluation of how prospective users – students, teachers and curriculum designers – perceive the assets or intermediary products of a small set of enriched VPs, during the process of enrichment;
- Evaluation of the possibilities of blended learning scenarios with existing VPs to improve the quality and efficiency of healthcare education in the European Union; and
- Evaluation how prospective users perceive the blended learning scenarios during the implementation of a small set of enriched VP’s in different educational settings.
|Project 6: Exit & sustainability
Exit & sustainability is concerned with how to sustain the work carried out in eViP beyond the time frame of the programme. The project aims to provide the following:
- An eViP sustainability model;
- 40 out of 320 Virtual Patient cases to be freely available under the Creative Commons License (CCL);
- 280 cases will be available for free in host systems after registration at local repositories (CC share alike);
- 320 downloadable content packages available on request; and
- The provision of Best Practice examples through the eViP portal.