2010-08-19

Meeting Information

Attending: Rachel Ellaway, JB McGee, co-chairs; Susan Albright, Jörn Heid, Valerie Smothers, Dan Walker, Luke Woodham.

Agenda Items

Rachel commented that she could only stay for a few minutes, so relayed her thoughts to the group. The key question is where should this group go? There have been many discussions, with a number of potential work projects identified, such as profiles, certification, and search, and then there are ANSI mandatory requirements to review the standard. The real question is how much value our work provides. What is sustainable and useful that people will put effort into? People won’t put effort into profiles, because there is not much real benefit perceived. Rachel suggested having conversations with AAMC around the virtual patient economy and have that should direct our efforts.
JB agreed the discussion all falls under the same umbrella, where do we go next. We may need to look around and see what the broader needs are, where AAMC is going, and how the working group fits into the larger environment.

Susan commented that she had some concerns. Some virtual patients are different than others. If one type of virtual patient is successful at clinical decision making, but another is not, that is something worth distinguishing. All virtual patients are not equal, so how do you make comparisons unless people declare what they are doing?

JB replied that Susan’s comment gets to the larger role of educating the public. He questioned whther it was the group’s role to do that. Susan replied that if we don’t who will? She added that there should be a way for people to declare what kind of virtual patient they have created.

Valerie asked whether a new pedagogical model element was called for.

Luke replied that they indicate the form of virtual patient currently in evip metadata. But the field is not mandatory.  JB agreed we should look at that and adopt some of the evip terminology. Luke replied that currently it is restricted to 3 values, but there may be other types of virtual patients in the future. He advised against being overly restrictive in such a list.

Valerie asked if there were other evip extensions the group should examine and see what should be included in the standard.

JB asked whether we are going down a path of working on the next version of the spec? He added that we probably don’t want to abandon the standard, and we will need to work on version 2.

Luke commented that evip uses metadata not extensions, not extensions to the three virtual patient files. The extensions would be to healthcare lom.

Valerie commented that the Virtual Patient Working group could certainly advise the Learning Objects working group on additional elements to be included in healthcare lom. She recommended discussing on the next call.

JB asked the group to confirm that they are in agreement to work on version 2 of the standard. The group replied yes.

JB commented that in parallel the group can work on research and implementation. Working on the specification is closer to the group’s purview. JB questioned whther the group wants to engage directly in dissemination and adoption activities. How do taxonomies or nomenclatures evolve? We can provide a field in the specification, but the specification may not define what those values should be. There is information in the literature.

Susan commented that she was reading research on virtual patients, and thrown in at the end was an indication that the model used was string of pearls. She questioned how the literature will evolve if we don’t have consistent names.

JB agreed that the people in this group are well poised to write an article on nomenclature and call attention to the problem in the research community.

Susan asked if MedBiquitous gets involved in dissemination. Valerie replied that MedBiquitous has several dissemination methods, including the annual meeting. We can also do webinars on specific issues. In past discussions, the group had recommended having webinars targeted at more novice to intermediate users, but that would require the help of those who design and develop virtual patients.

Susan commented that a manuscript may be a good place to start. Luke agreed, adding that might lead onto certification.

Valerie commented that at a minimum MedBiquitous could publish a document as a best practice guideline. We can then include the terminology in the appropriate standard.

JB commented that those on the call are a small group that shows up consistently. He asked whether there were any suggestions for maintaining a good level of activity going forward. Valerie replied that activity increases participation typically. Dan agreed, saying that involvement will increase based on self interest.

JB suggested that in parallel, members of the group create a manuscript around different types of virtual patients. Those with interest will show up for those conversations. He questioned whether all members should be listed as authors on such a publication. Valerie recommended an acknowledgement for members of the working group not participating in creating the manuscript. Susan recommended putting out a call and seeing who responds.  

Jörn asked if there are implementation lists or showcases with other working groups. When you go on the website, you don’t see the systems. We can get more attention if we show which systems are using the standard.

Valerie commented that there is an implementers list linked from the home page. She added that we could expand on that.

JB commented that the implementers list could be featured in a newsletter.

Valerie agreed to send a note around to the group to gather information for a virtual patient implementers page.

1 Implementation updates

Valerie asked if there was news regarding the evip implementation. Luke replied that the repository will be live by the end of the month. Currently the referatory is live, with links to play virtual patients, but not to download. Content packages are due at the end of this month. The evip team is working to bring the packages together with metadata.

JB applauded evip’s efforts, adding that the project makes the specification more valuable.

2 Dissemination and adoption support

3 Roadmap for future development

4 Research

Susan commented that some important articles have been published. Uno Fors et al did a randomized controlled trial vs other approaches. The virtual patient based approach did better. Long term retention was better, too. The article appears in Medical teacher, in the issue before the current issue. The article is well done from a research standpoint.

Mark Triola and David Cook also had an article in academic medicine, providing a meta-analysis of Virtual Patient research. 

5 Open discussion

Valerie remarked that the Call for abstracts for the MedBiquitous spring meeting is underway. It will take place May 9 – 11 in Baltimore.

JB remarked that the annual digestive disease meeting is conflicting.

Dan commented that he has not yet replied to the invitation to join the discussion list. Valerie agreed to add Dan to the discussion list. She added that everyone can subscribe to newsletter via the website.

JB offered to share the minutes with Rachel and see if she agrees with the plan.

Decisions

• The group will begin work on version 2 of the specification
• We will examine evip metadata extensions on the next call.

Action Items

• Valerie will contact AAMC to clarify their virtual patient needs.
• Valerie will send a note around to the group to gather information for a virtual patient implementers page.
• Valerie will add Dan to the discussion list