Evaluating Virtual Patient Interaction Fidelity With Advanced Communication Skills Learners

Previous research in educational medical simulation has drawn attention to the interplay between a simulation’s fidelity and its educational effectiveness. As virtual patients (VPs) are increasingly used in medical simulations for education purposes, a focus on the relationship between virtual patients’ fidelity and educational effectiveness should also be investigated. In this paper, we contribute to this investigation by evaluating the use of a virtual patient selection interface (in which learners interact with a virtual patient via a set of pre-defined choices) with advanced medical communication skills learners. To this end, we integrated virtual patient interviews into a graduate-level course for speech-language therapists over the course of 2 years. In the first cohort, students interacted with three VPs using only a chat interface. In the second cohort, students used both a chat interface and a selection interface to interact with the VPs. Our results suggest that these advanced learners view the selection interfaces as more appropriate for novice learners and that their communication behavior was not significantly affected by using the selection interface. Based on these results, we suggest that selection interfaces may be more appropriate for novice communication skills learners, but for applications in which selection interfaces are to be used with advanced learners, additional design research may be needed to best target these interfaces to advanced learners.

Dynamic of Glucose Homeostasis in Virtual Patients: A Comparison between Different Behaviors

This work presents a mathematical model of homeostasis dynamics in healthy individuals, focusing on the generation of conductive data on glucose homeostasis throughout the day under dietary and physical activity factors. Two case studies on glucose dynamics for populations under conditions of physical activity and sedentary lifestyle were developed. For this purpose, two types of virtual populations were generated, the first population was developed according to the data of a total of 89 physical persons between 20 and 75 years old and the second was developed using the Monte Carlo approach, obtaining a total of 200 virtual patients. In both populations, each participant was classified as an active or sedentary person depending on the physical activity performed. The results obtained demonstrate the capacity of virtual populations in the generation of in-silico approximations similar to those obtained from in-vivo studies. Obtaining information that is only achievable through specific in-vivo experiments. Being a tool that generates information for the approach of alternatives in the prevention of the development of type 2 Diabetes.

Understanding virtual patients efficiently and rigorously by combining machine learning with dynamical modelling

Individual biological organisms are characterized by daunting heterogeneity, which precludes describing or understanding populations of ‘patients’ with a single mathematical model. Recently, the field of quantitative systems pharmacology (QSP) has adopted the notion of virtual patients (VPs) to cope with this challenge. A typical population of VPs represents the behavior of a heterogeneous patient population with a distribution of parameter values over a mathematical model of fixed structure. Though this notion of VPs is a powerful tool to describe patients’ heterogeneity, the analysis and understanding of these VPs present new challenges to systems pharmacologists. Here, using a model of the hypothalamic–pituitary–adrenal axis, we show that an integrated pipeline that combines machine learning (ML) and bifurcation analysis can be used to effectively and efficiently analyse the behaviors observed in populations of VPs. Compared with local sensitivity analyses, ML allows us to capture and analyse the contributions of simultaneous changes of multiple model parameters. Following up with bifurcation analysis, we are able to provide rigorous mechanistic insight regarding the influences of ML-identified parameters on the dynamical system’s behaviors. In this work, we illustrate the utility of this pipeline and suggest that its wider adoption will facilitate the use of VPs in the practice of systems pharmacology.

Petrha+

Role play and simulated patients are tools frequently used in undergraduate physiotherapy courses to help students gain familiarity with what they will find in future real-life encounters. However, these approaches have limitations when it comes to delivering diversity and repetition to a large number of students and are mostly bounded to the school's premises. Web-based virtual patient software can help to overcome these shortcomings as they equally require students to go through most of the steps of the physiotherapy process, and simultaneously offer unlimited diversity of cases and repetition opportunities and can be delocalized from physical schools. PETRHA + is an Erasmus+ strategic partnership of European high education institutions aiming at the improvement of a web-based serious game prototype designed to enhance physiotherapy students' clinical reasoning using virtual patients. The objective of this chapter is the presentation of the background context that led to the development of the serious game, its design features, functions, and ongoing and future developments.

Mapping Trends and Hot-spots of Virtual Simulation Research in Nursing: A Bibliometric Analysis

Background: Virtual simulation has been widely used in nursing education and nursing training. This study aims to characterize the publications in terms of countries, institutions, journals, authors, collaboration relationships, and analyze the trends of virtual simulation in nursing research.Methods: Publications regarding virtual simulation in nursing were retrieved from Web of Science core collection. Microsoft Excel 2010, VOSviewer were used to characterize the contributions of the authors, journals, institutions, and countries. The trends, hot-spots and knowledge network were analyzed by Citespace and VOSviewer.Results: We identified 611 papers between 1999 and 2021. The number of publications grew slowly until 2019, after that, it got a sharp increase in 2020 and 2021. The USA, Canada and Australia were three key contributors to this field. Centennial College, University of Ottawa, and Ryerson University were three major institutions with a larger number of publications. Verkuyl M was the most productive and highest cited author. Clinical Simulation in Nursing, Nurse Education Today, Journal of Nursing Education were the three productive journals. "virtual patients," "nursing students," "clinical simulation," and "communication skills" were the frontier topics in recent years.Conclusion: Using the Virtual patients to train nursing students, developing more reliable and objective assessment methods to validate learning outcomes might be the recent and future hot-topics.

Use of a real-time virtual patient simulation for interprofessional distance education: A pilot study

Objective: To evaluate the use of cloud-based virtual patients as a tool for engagement in interprofessional distance education (IPDE). Methods: Five pairs of final-year pharmacy and final-year nursing students interacted with an autonomous, real-time, cloud-based virtual patient (VP). They were debriefed after completion of their case and completed a questionnaire on the relevance of the VP to core IPE competencies. Results: The virtual patient approach was considered to be able to cover 25 of the 39 core IPE competencies. From a thematic analysis, there was evidence of students learning from, with, and about each other. Conclusions: The use of cloud-based autonomous VPs could be a successful tool for IPE.

Mapping Trends and Hot-spots of Virtual Simulation Research in Nursing: a Bibliometric Analysis

Background: Virtual simulation has been widely used in nursing education and nursing training. This study aims to characterize publications in terms of countries, institutions, journals, authors, and collaboration relationships, and analyze the trends and hot-spots of virtual simulation in nursing.Methods: Publications concerning virtual simulation in nursing were retrieved from Web of Science. Microsoft Excel 2010, VOSviewer, and Citespace were used to analyze the characteristics of this field. Results: We identified 611 papers between 1999 and 2021. The number of publications grew slowly until 2019, and got a sharp increase in 2020 and 2021. The USA, Canada and Australia were three key contributors to this field. Centennial College, University of Ottawa, and Ryerson University were three major institutions with a larger number of publications. Verkuyl M was the most productive and highest cited author. Clinical Simulation in Nursing, Nurse Education Today, Journal of Nursing Education were the three productive journals. "virtual patients," "nursing students," "clinical simulation," and "communication skills" were the frontier topics in recent years.Conclusion: Virtual patients simulated more clinical situations to train nursing students, developing more reliable and objective assessment methods to validate learning outcomes might be the recent and future hot-topics.

Bayesian Augmented Clinical Trials in TB Therapeutic Vaccination

We propose a Bayesian hierarchical method for combining in silico and in vivo data onto an augmented clinical trial with binary end points. The joint posterior distribution from the in silico experiment is treated as a prior, weighted by a measure of compatibility of the shared characteristics with the in vivo data. We also formalise the contribution and impact of in silico information in the augmented trial. We illustrate our approach to inference with in silico data from the UISS-TB simulator, a bespoke simulator of virtual patients with tuberculosis infection, and synthetic physical patients from a clinical trial.