Trainee perceptions on the usefulness of virtual patients &

other support during the pre-registration training year

Jessica Thompson, Simon White & Stephen Chapman

Outline

• Background on virtual patients (VPs)

• VPs used in this research

• Aims of this research

• Methods adopted

• Pre-registration trainees perceived levels of support

• VPs as a training tool

• Conclusions

Virtual Patients: Background

• ‘A specific type of computer-based program that

simulates real-life clinical scenarios’[1]

• Various tools described as VP’s in the literature

- Still photos, video clips, mannequins, avatars and

immersive virtual reality simulations[2]

eViP, St Georges, University of London[3]

SimMan[4]

KAVE (Keele Active Virtual Environment)[5]

Virtual Patients: This Research

• Interactive, asynchronous avatars

• Interact via multiple choice and free-typing questions

• Animated responses

• Outcome based on user input

• Feedback

http://www.keelesop.co.uk/vp_childillness/

Pharmacist Pre-registration Training

• The General Pharmaceutical Council (GPhC) provide a

training manual

• Competence against performance standards

• Variation in pre-registration training[6][7]

Aim

» Wider Research:

- To evaluate the effectiveness of interactive clinical avatars

at supporting pre-registration training.

» Specific Focus:

- To explore pre-registration trainee’s perspectives on the

level of support in pre-registration training.

- To determine whether VP case studies

would be a useful resource in the

pre-registration training year.

Methods

» Wider Research:

• Pharmacy pre-registration trainees 2014-2015

• Completed VP or non-interactive case studies

- Emergency hormonal contraception

- Renal function

- Childhood illnesses

• Knowledge assessed

Methods

» Specific Focus:

• Purposive sampling for telephone interviews

• Semi-structured interviews

• Framework analysis

Interview Demographics

• 20 telephone interviews –

- 9 VP group

- 11 control group

• 85% female : 15% male

• 50% community : 50% hospital

• Lasted ~45 minutes

Support in pre-registration training

» How much support did trainees feel they

received during the year?

0123456789

10

A lot Moderate A little

No

. o

f tr

ain

ees

Perceived Level of Support

Support in pre-registration training

» What kind of support did trainees receive?

Training Provider

Study days

Role Plays

OSCEs

Study Time

Other Resources

CPPE

On-Track

Mock Exam

Past Papers

Themes

Novelty UsabilityLearning

Styles

Application of

Learning

Pre-registration

Sector Variation

“…I haven’t used anything like this before…it’s up-and-coming

technology…”

Respondent 75: Community, Female

“…I did find the virtual cases much more interesting to do as

part of the training; I think the paper cases are just a bit boring to

do…”

Respondent 96: Community, Female

Novelty

Usability

“…having the flexibility to go and use an online resource makes

it easier, because we’re so busy in pre-reg …”

Respondent 136: Hospital, Male

“…difficult to find reputable resources. These cases which are

easy to access are up-to-date...”

Respondent 50: Hospital, Female

Learning Styles

• 100% of trainees in the VP group provided comments relating

to them learning better through practice

“...I learn better by doing and they [the VP cases] helped the

information stick in my mind more...”

Respondent 96: Community, Female

“…help individuals identify how they learn best.”

Respondent 60: Community, Female

Application of Learning

• 100% of trainees in the VP group reported that the VP

allowed them to apply their learning

“…it [the VP] is another way to utilise skills and practice what

you’re learning.”

Respondent 136: Hospital, Male

“…a chance to practice in a safe environment…I have applied

that learning to day-to-day real life practice…”

Respondent 75: Community, Female

Application of Learning

‘…I even referred a patient to get EllaOne when she was more

than 3 days over, so I actually used what I’d learnt in practice.’

Respondent 60: Community, Female

Variation in Pre-registration Sectors

“…everybody has such different experiences and support…I

definitely felt more prepared for the exam and future…”

Respondent 58: Hospital, Male

“...over the counter cases because they don’t have all that

exposure… for those who don’t work in a hospital setting; maybe

like renal function or liver function….it’s

finding a balance between them.’

Respondent 96: Community, Female

Conclusions

» VPs were reported to:

– be more enjoyable and usable

– allow trainees to learn in different ways

– be a potential way of ‘bridging the gap’ in variation between

sectors

– allow application of learning in a safe environment before

qualification

» Results indicate the VP could be a valuable

training tool and an area for further investigation

References

[1] Association of American Medical Colleges Institute for Improving Medical Education, Effective Use of Educational

Technology in Medical Education. Colloquium on Educational Technology: Recommendations and Guideline for Medical

Educators. March 2007.

[2] Chapman S (2012). The Use of Simulation Technology in the MPharm Programme. A report to the Pharmacy

Schools Council

[3] St George’s University of London, elu.London e-learning unit. (2017).

https://labyrinth.sgul.ac.uk/mnode.asp?id=qgxlrdbarsx9qarsx9qgxlrdb1rx7jz

[4] Laerdal, SimMan®. (2017). https://www.kynectiv.com/platforms/decisionsim

[5] Keele University, KAVE. (2017). https://www.keele.ac.uk/pharmacy/digital/kave/

[6] Blenkinsopp, Marshall, Roberts et al. (2015) General Pharmaceutical Council Survey of 2013/14 Pre-registration

Trainees

[7] GPhC. (2015). Meeting of the Council, Thursday 10 September 2015.

Thank you