Home Authoring, deploying, and managing dynamic Virtual Patients in Virtual Clinical Environments
Article
Licensed
Unlicensed Requires Authentication

Authoring, deploying, and managing dynamic Virtual Patients in Virtual Clinical Environments

  • LeRoy Heinrichs , Parvati Dev and Dick Davies EMAIL logo
Published/Copyright: May 30, 2015
Become an author with De Gruyter Brill

Abstract

Following their introduction at the beginning of the 21st century, interactive or dynamic Virtual Patients are beginning to be used more widely in clinical education. They can be seen as being at the end of a continuum of simulation technical complexity, having been earlier developed on a wide range of “media”: human actors, paper, video, physical mannequins, etc. This paper focuses on the current emergent more complex Virtual Patients in three-dimensional (3D) immersive clinical environments. In these environments, in silico 3D patient avatars interact directly in response to virtual clinical interventions undertaken by avatars, each of which is controlled by one or more users. The paper explores the issues of authoring, deploying, and managing these real-time, dynamic Virtual Patients using as an example the immersive clinical environment CliniSpace. As clinician-accessible Virtual Patient authoring is now becoming available in immersive clinical environments, so these wider clinical and managerial non-technical issues are coming rapidly to the fore.


Corresponding author: Dick Davies, Exec. Producer for Ambient, Ambient Performance, Suite 336, 43 Bedford Street London WC2E 9HA, UK, E-mail:

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Immediaconnection. [Online] 2015 [cited 2015 January]. Available from: http://www.imediaconnection.com/content/6165.asp. Accessed January 2015.Search in Google Scholar

2. Stokowski S. Medscape. [Online] 2015 [cited 2014 January]. Available from: http://www.medscape.com/viewarticle/780819. Accessed January 2015.Search in Google Scholar

3. Heinrichs WL, Davies D, Davies J. Virtual worlds in healthcare: applications and implications. In: Arnab S, Dunwell I, Debattista K, editors. Serious games for healthcare: applications and implications. Hershey, PA: IGI Global, 2013:1–22.10.4018/978-1-4666-1903-6.ch001Search in Google Scholar

4. Talbot TB, Sagae K, John B, Rizzo AA. Sorting out the Virtual Patient: how to exploit artificial intelligence, game technology and sound educational practices to create engaging role-playing simulations. Int J Gaming Comput Mediat Sim 2012;4:1–19.10.4018/jgcms.2012070101Search in Google Scholar

5. Sauvé L, Renaud L, Kaufman D, Marquis JS. Distinguishing between games and simulations: a systematic review. Educ Technol Soc 2007;10:247–56.Search in Google Scholar

6. Heinich R, Molenda M, Russell JD, Smaldino SE. Instructional media and technologies for learning, 5th ed. Englewood Cliffs, NJ: Prentice Hall, 1996.Search in Google Scholar

7. Heinrichs WL, Fellander-Tsai L, Davies D. Clinical Virtual Worlds: the wider implications for professional development in healthcare. In: Bredl K, Bösche W, editors. Serious games and virtual worlds in education, professional development and healthcare. Hershey, PA: IGI Global, 2013:221–40.10.4018/978-1-4666-3673-6.ch014Search in Google Scholar

8. Taleb R, Botterbusch H. Legal and ethical aspects of teaching in selected virtual worlds: a review of the literature. In: Hai-Jew S, editor. Virtual immersive and 3D learning spaces: emerging technologies and trends. Hershey, PA: IGI Global, 2010:170–93.10.4018/978-1-61692-825-4.ch009Search in Google Scholar

9. Bell MW. Towards a definition of virtual worlds. J Virtual Worlds Res 2008;1:2. http://dx.doi.org/10.4101/jvwr.v1i1.283. Accessed January 2015.10.4101/jvwr.v1i1.283Search in Google Scholar

10. Wikipedia. Virtual world. [Online] 2014. Available from: http://en.wikipedia.org/wiki/Virtual_world. Accessed January 2015.Search in Google Scholar

11. Nickerson M, Pollard M. Mrs. Chase and her descendants: a historical view of simulation. Creative Nurs 2010;16:101–5.10.1891/1078-4535.16.3.101Search in Google Scholar PubMed

12. Hester RL, Brown AJ, Husband L, Iliescu R, Pruett D, Summers R, et al. HumMod: a modeling environment for the simulation of integrative human physiology. Front Physiol 2011;2:12. Published online 2014. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3082131/. Accessed January 2015.10.3389/fphys.2011.00012Search in Google Scholar PubMed PubMed Central

13. Moss R, Grosse T, Marchant L. Virtual patients and sensitivity analysis of the Guyton model of blood pressure regulation: towards individualized models of whole-body physiology. PLos Comput Biol 2012;8:e1002571.10.1371/journal.pcbi.1002571Search in Google Scholar PubMed PubMed Central

14. Heinrichs WL, Kung SY, Dev P. Design and implementation of rule-based medical models: an in silico patho-physiological trauma model for hypovolemic shock. In: Proc. MMVR2008, Long Beach, CA: IOS Press, 2008:159–64.Search in Google Scholar

15. Lemmens HJ, Bernstein DP, Brodsky JB. Estimating blood volume in obese and morbidly obese patients. Obes Surg 2006;16: 773–6.10.1381/096089206777346673Search in Google Scholar PubMed

16. Poulton T, Balasubramaniam C. Virtual patients: a year of change. Med Teach 2011;33:933–7.10.3109/0142159X.2011.613501Search in Google Scholar PubMed

17. Arciaga P, Windokun A, Calmes D, Dev P, Shaheen M. Technology innovations abstract initial experience with the use of virtual simulation to teach students interprofessional education: the Charles R. Drew University (CDU) experience. Sim Healthcare 2013;8:608.10.1097/01.SIH.0000441700.97589.53Search in Google Scholar

18. CMU. Available from: http://www.cmu.edu/teaching/designteach/design/learningobjectives.html. [Online] 2014. Accessed January 2015.Search in Google Scholar

19. Dev P, Heinrichs WL, Youngblood P, Kung S, Kusumoto L. Virtual Patient model for multi-person Virtual Medical Environments. AMIA Annu Symp Proc 2007:181–5.Search in Google Scholar

20. Bearman M, Cesnik B, Liddell M. Random comparison of ‘virtual patient’ models in the context of teaching clinical communication skills. Med Educ 2013;25:824–32.10.1046/j.1365-2923.2001.00999.xSearch in Google Scholar

21. Heinrichs WL, Dev P, Davies D. Patients should not be passive! Creating and managing active Virtual Patients in Virtual Clinical Environments. In: Schoten B, Fedtke S, Schijven M, Vosmeer M, Gekker A, editors. Games for health. Wiesbaden: Springer Vieweg, 2014:56–61.10.1007/978-3-658-07141-7_8Search in Google Scholar

22. Foronda C, Gattamorta K, Snowden K, Bauman E. Use of virtual clinical simulation to improve communication skills of baccalaureate nursing students: a pilot study. Nurse Educ Today 2014;34:e53–7.10.1016/j.nedt.2013.10.007Search in Google Scholar PubMed

23. Stokowski L. www.medscape.com. [Online] 2013 [cited 2015 April 22]. Accessed January 2015.Search in Google Scholar

24. Kim SH, Lee JL, Thomas MK. Between purpose and method: a review of educational research on 3D virtual worlds. J Virtual Worlds Res 2012;5:1.10.4101/jvwr.v5i1.2151Search in Google Scholar

25. Heinrichs WL, Dev P, Davies D. The Virtual Sim Centre: extending and augmenting in-house simulation centres. BMJ Sim 2014;1(Suppl 1):A12.10.1136/bmjstel-2014-000002.27Search in Google Scholar

26. Liaw SY, Chan SW, Chen FG, Hooi SC, Siau C. Comparison of Virtual Patient simulation with mannequin-based simulation for improving clinical performances in assessing and managing clinical deterioration: randomized controlled trial. J Internet Med Res 2014;16:e214.10.2196/jmir.3322Search in Google Scholar PubMed PubMed Central

Received: 2015-3-29
Accepted: 2015-4-24
Published Online: 2015-5-30
Published in Print: 2015-6-15

©2015 by De Gruyter

Downloaded on 8.11.2025 from https://www.degruyterbrill.com/document/doi/10.1515/bams-2015-0009/pdf
Scroll to top button