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Meeting Information


August 4, 2011


10 EDT/15 BST/16 CEST

Attending: Rachel Ellaway and JB McGee, Chairpersons; Susan Albright, Valerie Smothers, Michael Steele, Dan Walker, Luke Woodham

Agenda Items

1 Review minutes of last meeting

The minutes were accepted as submitted.

2 Discuss poll regarding additional requirements for certification

Valerie continued with a review of the results of the poll found on the link to the agenda. There were six replies, including two 2 members of the Technical Steering Committee and four members of this committee. Three individuals thought we should validate with a minimum set of required components (option B);, two people voted for validation only (option A); one person voted for a two level process (option E). 

Rachel noted there weren’t a large number of poll responses, option B was the highest rated but not in a significant way, so she suggested moving forward with option B.  Rachel wanted consensus on pursuing option B pending feedback from members, to come up with a minimum of each of those components. Dan questioned whether the media file was really required? Rachel answered if we were going purely by the schema requirements (option A), then a package with no dams would validate.  Valerie further explained it’s about the authoring tool not the specific case.  Would we certify an authoring tool that wouldn’t include media?  Valerie added that she did not know of any authoring tools that did not support the use of media. 

Rachel reminded the group to bear in mind, we’re not pursing the import certification; having additional requirements for certification would go further towards ensuring commonality. It’s more about broadening the guarantee that we are providing that goes along with this model.  She suggested continuing with the media requirement.  The group agreed to proceed with option B: an exported package that validates with a minimum required set of component elements - one or more media files, one or more VPD elements, one or more DAM elements.

Rachel recommended the group begin some testing as a next step.  Use of a validation tool might assist with something that cannot be validated by the schema.  Some things have to be looked at manually; certainly the requirements and media resources would need to be checked manually.  There is not a machine executable test for validation right now. Rachel asked Valerie what she would like from the group. Valerie answered an agreement on the exact steps in the process that would be used for certification.  Valerie has drafted some of those but it needs to be updated.  She encouraged members to use Jorn’s tool if it is going to be part of that process.  Valerie mentioned she had trouble using the validation tool, and she needs to work with the system administrator to get the problem solved, she was not able to install and use it locally.  She mentioned it would be helpful having testers of the certification process before we put it forth as a certification process to test validation tools and to test the larger process.  Nabil shared with Valerie that Jörn’s validation tool was more up to date.  Valerie suggested talking to Jörn if his tool reflects the most recent version of the standard. Luke said he could attest to Jörn’s tool and that version 4.8 reflects those changes.  He added that we would have to go into the tool and replace the schema file.  

Valerie shared that Jörn’s tool validates links within the Virtual Patient package; and that is good from a package perspective, but she’s not sure how significant that is from a certification perspective. That would more likely be an author error than a tool error.  JB shared that it seemed like it would be a nice extra step to export a file and see if it is identical to the one you just analyzed.  Rachel emphasized that we need to make an informed decision so we can guarantee authoring tools to third parties. 

JB asked if we were going to charge certification. A free service could be relatively automated, tells you when exported cases are valid or not.  Valerie clarified we were planning to charge for this. Rachel suggested bringing the cost to the Executive Committee for discussion.  She also suggested 1) Valerie do a download and Luke walk her through the experience he has gone through and make a report for the next call and 2) have Valerie rework the certification process and send that out to the group for review and decision on the next call.  Valerie confirmed the need to go back to the executive committee and talk about the cost.  Susan asked if Valerie factored in technical assistance in the costs she provided the group and Valerie said she didn’t but that would be something to consider. Rachel commented the online testing tool could be made available to do submissions and it can happen without financial commitment.  Valerie commented that using the schema files will eliminate problems before the certification process. Rachel encouraged group to use the XML files to validate and test locally.

Valerie agreed to develop a protocol for MedBiquitous use and a guide for those submitting for certification.  Valerie mentioned the guide is on the Wiki, under the Virtual Patient work group space.  Valerie will bring the costs and risks to the next Executive Call so we can make recommendations back to the group.  The next call is scheduled for September.  

3 Discuss open source validation tools: Jorn's and Nabil's

 Valerie asked earlier in the call whether anyone else had tested Jörn’s validation tool.  Dan replied no, he hadn’t and Luke said he used it during eVIP.

4 Discuss timing and goals for v2

Rachel explained that version 2 of the standard was accredited in 2010 and comes up for reaffirmation again in 2015, which means we have to start the process no later than 2013.  Rachel asked if there was a log to the changes being made to that version.  Valerie knew of no issues brought forward for version 2 yet.  Susan mentioned we only have one of the exit and entrance rules.  The group added that there are other issues to consider, including virtual world standards and specifications, considered immature currently, and scorm/adl changes, and data related to visual authoring of nodes.

JB shared that the phrase VP is starting to be used in electronic medical records to signify a record created from many sources. Rachel asked the group if there are changes to version 2 that would engage the larger community. Susan mentioned CLIPP.  Rachel commented that it’s based on a subscription model and is regularly reviewed and updated. The business model is such that they don’t want people to take their material and take it elsewhere; that makes things worse for them rather than better. They see it as a threat and at the moment there is not interest in this.  Most materials are multi-media learning packages.  JB questioned whether there should be a distinction between linear cases and branching ones. Susan questioned whether JB was excluding non-branching cases from the definition of virtual patients. JB clarified that he was not, but added that there had been confusion regarding the definition of virtual patient in the past.

JB asked Valerie to review the options for moving forward. Valerie commented that from an ANSI perspective if the group decides not to make changes to the standard, we can reaffirm standard, which says the standard is still good. Alternately, we can create a new version, or withdraw the standard completely. Rachel shared that we need to have a watchful eye on what’s happening elsewhere, she is not convinced how it syncs with other simulation techniques.  There is no standard mannequin scenario format currently.  If that gets standardized though SSH, that will change our space, and make it possible to connect virtual patients to mannequin simulators.  Michael commented that TATRC is enthusiastic about developing a physiological simulation engine that could provide opportunities for additional virtual patient functionality. Valerie mentioned that Bruce Jarrell works at University of Maryland and is funded by TATRC to develop a GI physiological simulator.  JB commented that the interface is almost a separate thing, almost like a plug in for VP. A physiology engine is a decision point that has unlimited number of variables and potential branches.  JB suggested putting that topic on next meetings’ agenda and he encouraged having a few people in that community participating on the calls.

5 Open discussion 

Luke mentioned the AMEE meeting in Vienna; there will be a Virtual Physiological Human symposium.

The next meeting is Sept 15th when we will have AMEE meeting feedback. 


The group agreed to proceed with option B: an exported package that validates with a minimum required set of component elements - one or more media files, one or more VPD elements, one or more DAM elements.

Valerie will develop a protocol for the certification process and a guide for those submitting tools for certification.

Action Items

Valerie will present certification costs to the MedBiquitous Executive Committee.

Valerie will revise the certification process for option B and resend to the working group

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