Presentation given at AMEE 2010 outlining a conceptual model for the creation of learning activities involving virtual patients derived from a parent patient case.

2. Reasons for this presentation

3. Case based learning smörgåsbord Mezze of diverse designs and applications Simulated patients, PBL triggers, paper cases, simulation scripts/scenarios, virtual patients etc Where to start? Same difference?

4. Chalk and cheese?

5. Warwick Medical School UK’s only graduate-only school, rural & urban, affluence & deprivation group-learning, professionalism and IPE themes case-based template: HEIDR - history, examination, investigation, diagnosis & therapy (management) … biological, clinical & social science dimension

6. Northern Ontario School of Medicine Northern, rural, remote and aboriginal focus strong family practice, cultural and IPE themes Narrative template: characters, person and POV, plot, pace and density, frame of action, regional issues … socio-cultural and inter-professional dimension

7. Ingredients of our cases

8. Case template Therapy Diagnosis Investigation Examination History Case template POV Pace Frame Characters & culture Plot

9. Maybe we have the wrong perspective? Maybe we are too focused on VPs as artifact rather than on the context in which they are used

10. Case template Schematic Narrative Game Simulation ‘Object oriented’ parent case child VPs activity/context focused

11. Ingredients & flavours Schematic Narrative Game Simulation type Presentation-based Character-based Rule-based Performance-based basis Assessing patterns Developing strategies Rehearsal Dealing with complexity skills HEIDR Socio- cultural Win/lose competition Mannequins activity

12. Compositional constructs Schematic Narrative Game Simulation Schematic Narrative Game Simulation

13. Contextual constructs Biological sciences Behavioural sciences Ethics and values Medical practice Case template Form and function Social interactions Dealing with dilemmas Managing patients

14. In practice Case template Schematic Narrative Game Simulation Contextual use Compositional construct Form and function Social interactions Dealing with dilemmas Managing patients

15. For us all to think about (not quite recommendations)

16. Don’t try and swallow too much in a ‘super’ VP Better to have more small VPs than few big ones

17. Activities should be no more complex than the assigned learning outcomes VPs as simple as possible, but no simpler

18. … it’s the context, stupid! The same case/VP acquires different meaning (and utility) depending upon where and how it’s used No wonder it’s difficult comparing VPs…

19. There is a difference between… activity encoded within a VP vs activity constructed around a VP

20. Therefore… seek alignment between encoded and constructed activity framed by the context of the integrated curriculum

21. Bon Appétit!