Selected Projects
The Virtual Patient Project
The Client
The Carl J Shapiro Institute for Education and Research, a joint venture of Harvard Medical School and Beth Israel Deaconess Medical Center.
The Challenge
Teaching hospitals provide medical students with an opportunity to work with patients in a supervised setting, but as hospital stays get shorter, students have diminishing access to the full spectrum of illness and recovery. Also, increasing requirements for clinical productivity are having the effect of limiting the time that faculty can devote to teaching.
The Solution
The Institute responded by initiating a program to create a series of fully interactive "virtual patient" programs. These case-based multimedia programs allow a student to work with a patient through multiple encounters, to examine the patient, to ask questions, to order diagnostic tests and to make decisions about treatment. The student has access to consultations with virtual experts and is given feedback and correction by a virtual supervisor.
While experience with real patients is still central, virtual patients can supplement such experience and fill in gaps. They help students gain greater familiarity with medical theory and practice, including underlying physiological and biological principles.
Our Role
We created the technical infrastructure for this project. For details see the Technology and Responsibilities sections below.
Our Client's Feedback
"This has been a challenging project for a number of reasons, not least of which is the fact that we're attempting to model accurately real-life medical cases, including essentially all the decision making that our students will face in actual practice. A simple template-based model would not be sufficently flexible for the variety of cases offered, but creating each program from scratch would be prohibitively expensive."
"Brightworks has been of major help in designing and implementing an approach that uses modular blocks of code and an authoring database..."
"We feel fortunate to have had Brightworks' help on this project..."
(You can read the full text here.)
Screen Shots from Virtual Patient #3, "A Woman with Osteoporosis"
Introduction by author and attending physician, Susan Greenspan MD.
Video of patient expressing her concerns.
The student can ask the patient questions and get her responses...
...perform a physical examination...
...and order diagnostic tests (shown here), therapies and consultations.
The student then gets feedback from their attending physician on the choices that they've made...
...and is encouraged to modify those choices, if appropriate.
This process repeats itself through multiple encounters (seven in this case) each of which includes a) information gathering, b) decision making, and c) feedback.
In this case study, encounter two is a telephone consult...
Responsibilities
Brightworks:
- Brainstorming user-interface and program design with client
- Programming specification
- Program architecture and database design
- Lingo programming
Client:
- Educational design
- Script development
- Acquisition and processing of images, audio, and video
- Entering of program specifics into database
- Quality assurance testing
Technology
We implemented a framework that allowed multiple cases to be created with a minimum of custom programming per case. The primary authoring tool was Macromedia (now Adobe) Director. Specifics for each module were entered into a Filemaker database during authoring, then incorporated into the program using the V12 Database plug-in.
Sophisticated object-oriented Lingo programming allows the program to dynamically display educational content based on both a) information in the database and b) previous user choices.