2010-05-25

Meeting Information

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Attending: David, Nabil, Luke, Valerie, Logan 

Agenda Items

1 Review last 3 meetings

1. March 25
2. April 26 Developers meeting
3. April 27 Open working group meeting

April 26

David commented that there was a considerable celebration of the hard work done to complete the standard. Then the discussion focused on next steps for the working group. There are a number of things that came out that Rachel could speak to in detail. One important activity discussed was the potential role for the group in conformance testing and in serving as a reference point for implementers. It was a huge piece of work to get the standard out there. This group can now answer questions, contextualize, and share good practice related to architecture and development. That’s one activity. There was also further discussion about profiling, the notion that there are several types of VPs. Developer starting from scratch comparing branching systems with more linear systems like web sp would find interoperability challenges. Within like minded systems, there are similar architectural feature, and interoperability is more straightforward. Exchanging cases across families or profiles can be more problematic, particularly when you look at pedagogy. The context is lost. In addition, there was was an interesting and active discussion related to a more research focus. Several people said there is much we could be doing but questioned whether this is this role of the working group. the group is primarily focused around getting the standard out. If research is not in the purview of this group, how could we develop a community for research? Those are three broad themes he made a note of.

Nabil commented that we did celebrate the release of the standard. From that point, the outcomes of the group were met. One main discussion point was to redefine new goals for the working group. He stressed that if we stop here, we make same mistake so many specification developers do. We need to go through the whole lifecycle of the standard. That includes conformance testing, supporting tools, technical support or reference point, driving adoption. There are different activities that could drive adoption. We have to review the standard within 5 years. Either we take a break and review in a few years, or we propose new goals for the working group.  We are stumbling around profiles. To achieve the highest level of conformance is not a technical issue anymore – why you would want to have branching vs semilinear. That is something to research quickly. Profile efforts should not be a technically oriented effort.  Look at target users, what kind of virtual patients are in demand, and create profiles from there. This would expand the value of having a spec. We’ve been working with legacy systems, but we may want to think about new authoring tools and research related to VPs. This would extend the scope of why you would want to have VPs in standardized manner. The major work is remaining. How to do it. The group needs to pinpoint the strategic activities.

Luke agreed that David and Nabil had summarized the issues well. The main thing he took away is that it is important for us to maintain virtual patients as an active area rather than abandoning it. We should explore ways we can maintain it.

David summarized that there are advocacy and issues collection that the group could be taking forward. Rachel reminded the group that after 5 years you have to reaffirm a standard or revise it. Once we’ve had a period of time to implement, there will be issues that need to be addressed.  He endorses the advocacy approach.

Logan asked the group what constitutes a profile.

Valerie replied that was precisely the topic of conversation the group had on several previous calls. They had difficulty coming to consensus, but the idea was to make it easier for users of virtual patient repositories, such as MedEdPortal and eViP, to download cases that could import fairly easily in their system.

Nabil added there was some work around navigation models. The group tried different approaches. He recommended that we start from the end point. What kind of VPs are needed from an educational perspective? That is the missing link. A purely technical approach won’t lead us anywhere. In some cases a spec has 20 different profiles, which is problematic because then there is no true standard. You end up with your own spec. He recommended having as few profiles as possible. There must be educational value. What kind of profile do we need to create?

Logan commented they have a profile for their patient simulator that adds gender, age range, and other conditions conditions. It’s a significantly different concept of profile. He thanked the group for the clarification on what constitutes a profile.

April 27

Jb passed around an attendance list with contact details and questions to gauge new interest and ideas. Or perhaps even an extended group for research.  There were about 25 people there, including Rosalyn Scott from the Department of Veterans Affairs.

2 Roadmap for future work

David reported that he thought Rachel had said she would take away the conversation and draft new terms of reference for the group.

3 Compliance testing

Valerie commented that there was no progress to report, and that she anticipated the proposed process would change based ont he outcomes of the April 26 meeting.

4 Open discussion

Valerie told the group she had proposed some webinars related to Virtual Patients as part of an education plan submitted to the MedBiquitous Board of Directors. She recommended having a webinar targeted to educators and one targeted to technical developers. She asked the group if they had suggestions for educational leaders to participate in the webinar.

David agreed it was a great idea. While there are needs for standards, they should be informed by practice. In early days, a lot of teachers needed developers to come up with vps to realize their aspirations. This is a new phase. A webinar would be a way to reach more people.

Luke commented that he thought St. George’s would be happy to pitch in. He will ask Terry and Chara regarding participation, whether they would participate or perhaps someone like Jonathan Round.. 

Logan commented they are working on a project that would integrate the standards. There will be some conversations as far as how they can promote MedBiquitous within their simulations. Users include physicians, specialists, educational institutions, etc.

Nabil agreed webinars are a good way of reaching people who are hard to get. He added that we need some typology of educators. If they don’t know anything about VPs, that is one type, there is another who is more experienced. Different audiences would result in different webinars. A novice would want a summary of the current state of research. An intermediate user (one familiar with vps)would want more on using the standard, and how to benefit.  He recommended going between early adopters and the big majority – the people in the middle. Have them take care of majority. It’s not educators that makes decisions related to vps. He recommended looking at the literature and targeting the audience strategically. Any educator that dowbnloads virtual patients from mededportal ro evip is a good candidate for the webinar. They may have problems running the VPs.Those people should be our immediate targets.

Valerie asked when the eViP repository would be available.

David commented that at the moment they have pointers on the website, but not cases for download. Downloads will be available at the end of June.  He agreed that may be a way to recruit people. He added that we could tap into the larger audience to nail down what we mean by profiles and inform future directions for the specification. We could have a webinar where people tell us about what they are doing in VPs., a more open discussion. With regards to advocacy, need strong voices from the community that can articulate the benefits of standards based approach.  Jonathan is a good one, Rachel and JB are both eloquent as well.  They bring things other than the technical perspective. David added that an international mix of presenters would be important. Valerie agreed that was often an attractive point for those considering joining the working group – the international nature of the constituents.

Decisions

Action Items

• Valerie will contact Rachel and see if she has drafted terms of reference or anything that could provide a roadmap for future work.
• Valerie will send an email to the group regarding the webinar and request ideas for speakers/faculty and content as well.