The Trial The replacement of paper cases by

The Trial: The replacement of ‘paper’ cases by interactive online Virtual Patients (VP) in Problem-Based Learning (PBL) Terry Poulton, Trupti Bakrania, Sheetal Kavia, Jonathan Round, Emily Conradi & Sean Hilton The e-Learning Unit

Problem-Based Learning …a type of Virtual Patient

What we wanted from A Virtual Patient… Scenario. . Ability to take decisions Explore the consequences of those decisions … Immediate feedback to the student…

Linear PBL

Branched PBL

Problem-based Learning

VP/PBL TRIAL Year 1 students mini-trial (1 case) Year 2 students whole module trial Type of VP Groups Case 1 Case 2 Case 3 1 -5 Linear Branched Linear 6 -10 Branched Linear Branched Case 4 Case 5 Branched Linear Branched

Which method of PBL would you prefer to undertake in the future: 1 st yr Students (first term): Paper • Online with decisions (branched) • Online without decisions (linear) • 22% 74% 4% 2 nd yr Students (last term): Paper • Online with decisions • Online without decisions • 42% 56% 2% 2 nd yr Tutors (last term): Paper • Online with decisions • Online without decisions • 25% 63% 12%

Students I learnt more from having choices to make • I found the online decision cases more engaging • • I found the non-linear cases frustrating 4. 0 3. 9 1. 8 1 = strongly disagree, 5 = strongly agree Tutors • Students found the decision cases more interesting 4. 2 • It is easier to tutor paper-based cases 3. 0 • • Online PBL makes it harder to meet the LOBs Students spent more discussion time on the option steps “Students slowed down to discuss options , instead of rushing through the early parts of the case “ 2. 5 4. 3

Comments about ‘Decision-Making’ • Non-linear cases were definitely more stimulating. • More than once we deliberately went down the 'wrong' track to see what happened. Very useful to do this on a paper patient … • The biggest benefit I believe is the decision making. • Its not the decisions, it’s the consequences! Comments About ‘Paper’ • I was dreading this as I am used to scribbling all over the notes as we talk…Actually I found this OK. • Not having a paper copy of the tutorial makes everyone in the group look at the screen rather than at each other. . • I think probably as a year we are just used to the paper version !

Summary • The use of VPs in PBL was supported by students and tutors who believed the options created a more engaging session, and that students learned more • They disliked the absence of a paper handout. • They saw no value ‘in simply putting cases online!’ (the linear cases) • A re-run of the trial would relate linear/branching to exam performance

Outcome. A new programme To change the existing PBL curriculum, to create a more interactive, personalised model of course delivery with virtual patients at its core, To be delivered in the Transitional year between campus-based learning and clinical attachments, as Clinical PBL

Why G(eneration) 4? G 1 – Subject- or discipline-based G 2 - System-based G 3 - Case based, but linear G 4 – Interactive with options, consequences