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This research project developed a Virtual Reality (VR) training simulator for the CPR procedure. This is designed for use training school children. It can also form part of a larger system for training paramedics with VR. The simulator incorporates a number of advanced VR technologies including Oculus Rift and Leap motion. We have gained input from NHS paramedics and several related organisation to design the system and provide feedback and evaluation of the preliminary working prototype.

Cardiac circulation is traditionally difficult for students from both high school and colleges to learn biology due its complexity and dynamic process. Cadavers can be used as a good tool for students to learn cardiovascular system. Unfortunately, this approach comes with some major concerns because of the collapsed anatomic structures, and no blood flowing. Also cadavers are normally available only in medical schools. Human subjects especially cardiac patients are ideal for students to learn human circulation from the perspectives of both structures and functions. This, however, is infeasible due to ethical and other constraints. As such most students learn cardiac circulation by reading text books, attending to lectures, viewing images and perhaps manipulating heart models. In this paper, we will present our efforts developing augmented reality (AR) technology to enhance learning of cardiac circulation. More specifically, a book based AR app APPLearn (Heart) is designed to allow each and every student learning the cardiac structure and function by interactive playing.

With the advancement of science and technology, the application of artificial intelligence is of great significance in various fields, and it has been a huge driving force in the development of more and more fields. Through research on the application of artificial intelligence in distance medical teaching, virtual inquiry, distance education management, teaching video recording, etc., this article concludes that artificial intelligence can increase the efficiency of medical teaching, improve visual utility, and think more like human, thus it can better serve the people. The application effects of artificial intelligence in the field of medical education, especially for the improvement of the overall quality of medical students, provide much inspiration for the applications of artificial intelligence in medical education.

The purpose of this study is to observe the level of communication apprehension among engineering students in Polytechnic Malaysia and to examine whether the use of communicative activities may give solution to the issue of communication apprehension. The sample included first semester engineering Polytechnic students in Selangor. The study design was a repeated measures comparison between traditional (control) and communicative activities (experimental) groups. Data collected included results of pre-test & post-test design to address two main research questions. The repeated measures analyses determined that pre-test and post-test scores revealed there were differences amongst communicative activities groups compared to traditional method. The findings indicate that the students perform better in the post-test compared to the pre-test after the inclusion of communicative activities in the ESL oral communication skills classes. The findings showed the positive effects of communicative activities in reducing engineering students' communication apprehension and improving their ESL oral communication skills in polytechnic.

Pointing and calling is a method of preventing human error, which is widely used in Japanese industry. Pointing and calling also has the potential to reduce human error in hospital nursing duties. The development and evaluation of novel technologies are necessary to distinguish if pointing and calling is to be appropriately applied in this context. In this paper, we report on an automatic evaluation method for pointing and calling and present. the evaluation results from an experimental study of the simulated duties of 40 active nurses.

In May 2006, the Institut Superieur d'Ingenieurs de Franche-Comte (ISIFC) launched its own virtual firm, which was named Biotika® by students. Virtual means that this company has no real legal status. It is a pedagogic model; however, the situation scenario for the ISIFC student engineers is real. They are currently working in real conditions on the development of new medical devices and on the modernization of medical products. The need for these innovative medical devices was identified by the students during their second-year (6 weeks) internship in hospitals. Biotika® is open between March and December every year. The students are "recruited" following an imitation job interview and each is then entrusted with a mission (engineer, project manager etc.) in one of the company's four departments: Research & Design, Quality-regulatory affairs, Clinical investigations, and Public relations-marketing. The personnel of Biotika® work on the development of innovative medical devices and/or the preparation of CE or FDA certification for 2 days per week. Since its launch, Biotika® has developed eight products and obtained many grants and prizes from French research and governmental organizations. It is also certified ISO 13485.

A reflective practicum is a low-pressure, low-risk learning environment. In a reflective practicum a learner is educated in a professional practice and how to use reflection in the setting of that professional practice. An example of a low-pressure and low-risk learning environment is the use of embodied conversational agents (ECAs) in medicine to provide training for interviewing and diagnostic skills. However, such ECA experiences have not been used to teach how to use reflection in the setting of a professional practice. In this paper we present a framework that supports explicit reflective learning for ECA experiences. Using this framework, ECA experiences become a reflective practicum. This framework was applied to an ECA experience called the Neurological Examination Rehearsal Virtual Environment (NERVE), and created a sample experience called the NERVE Reflective Practicum (NERVE-RP). We conducted a user study in which second-year medical students (n = 76) used NERVE-RP and engaged in reflection based on the experience. The results of the user study show that students engage in valuable reflections during the experience including instances of critical reflection.

Simulation training using virtual patients can provide many benefits for nursing and medical students in learning patient interaction skills, especially since virtual patients can represent a wide range of patient scenarios and demographics that are not typically represented through roleplay or clinical rotations. However, creation of a single virtual patient scenario may take six months or more, so it is difficult to provide many unique scenarios during the course of a nurse's education. In this work, I propose the user-centered design, creation, and evaluation of a scenario-builder tool to enable nursing faculty to create their own scenarios, reducing development costs.

The biomedical engineering can be understood as the intersection of the engineering with medicine/biology areas. One of its applications is the design of efficient devices in physiological specific monitoring activities, which demands the knowledge of the physiological signals' characteristics and the acquisition methods. The use of innovative educational tools can make a remarkable impact on biomedical engineering education. A remote laboratory for physiological data acquisition has been developed to be used as a complementary tool in the students' learning process. This remote laboratory consists in different experiments for biosignals' acquisition, and it empowers the students to understand the physiological systems functioning. A demonstration will be performed using one of those remote experiments.

Self-directed learning is a potential methodology recommended in medical education to promote life-long learning. To promote self-directed learning skills and to make students life-long learners, self-directed learning sessions were conducted at Melaka Manipal Medical College (Manipal Campus), Manipal University, India. Students' knowledge in the topics was assessed in three formative assessments conducted during the course. This study was conducted to explore whether there is any change in students' readiness for self-directed learning as they experience the curriculum, and also to find out whether the change is reflected in students' academic performance in topics learnt through self-directed learning. To assess the change in self-directed learning readiness, self-directed learning readiness scale was administered to the students at the commencement and at the end of first year of the MBBS course. Students' scores in all three formative assessments were also collected. There was a statistically significant increase in self-directed learning readiness of students at the end of year compared to the commencement. Students' scores significantly increased in second and third when compared to first formative assessment. A weak positive correlation between the assessment scores was observed. The study demonstrated that students' readiness for self-directed learning was increased as they experienced the curriculum which was reflected in their academic performance.

From the perspective of education itself, information technologies propel unprecedented teaching approaches and modes as well as new education concepts. Therefore it is necessary to bring the various information technologies up to date into the curriculum of traditional Chinese medicine so as to boost the reform of teaching ideas and teaching modes. During the practice of wrist-ankle acupuncture (WAA) experiment teaching, the three-dimensional (3D) interactive technology is applied to optimize teaching contents and courses. It has achieved better effects. Furthermore, several experiences about the integration of information technology and teaching contents are summarized according to the evaluation of the application effect.

Physical therapists master manual examination techniques for testing impaired motor functions. We used a wearable robotic dummy joint that simulated disordered joint resistances to help physical therapists learn such techniques. This study developed a resistance model for a spasticity joint, and the dummy joint was used to present it. We assessed the simulated spasticity model using Modified Ashworth Scale (MAS), which is an evaluation criterion for spasticity seriousness that is widely used by physical therapists. The results of experiments involving two physical therapists showed that the model accurately expressed mild-to-severe symptoms of knee joint spasticity. It is expected that using the system in educational institutions for physical therapists will help students learn the typical levels of joint resistance caused by spasticity with different degrees of severity.

MyStory is a EU project which develops on intergenerational learning focusing on the therapeutic effect of story-telling for the elderly and on the socializing opportunities for the young, “internet savvy”, generation. MyStory encourages valorization of the tacit knowledge of both seniors and young people. The collection of films and interviews developed in the project provides materials which can be successfully employed in the study of various academic fields such as the history of medicine. The study of medicine and the understanding of key principles which govern a successful practice of medicine are enhanced by the use of this repository of testimonials. This article presents the manner in which MyStory can be and has been valorized for therapy with seniors as well as within the context of history of medicine courses.

The following document presents the development process of a new, educational tool that utilizes 3D modeling techniques, and augmented reality to enable third and fourth-graders to better visualize the digestive system. Moreover, results obtained from a questionnaire applied to two groups in a private school in Ciudad Juarez, Chihuahua, are presented. The questionnaire was composed of diagnose questions about the presented topic, as well as the use of it.

This paper describes the development currently being conducted into serious games which pursue some form of benefit in the field of health care. Although serious games are associated with software developments, developing them in the area of health care involves studying the associated multimedia technology and paying attention to aspects related to interaction with the game. Serious games for health cover matters related to education and medical treatment, rehabilitation and psychological treatment. This paper includes a review of some relevant serious game and examines new trends in this field.

Education of anatomy is a challenging but crucial element in educating medical professionals, but also for general education of pupils. Our research group has previously developed a prototype of an Augmented Reality (AR) magic mirror which allows intuitive visualization of realistic anatomical information on the user. However, the current overlay is imprecise as the magic mirror depends on the skeleton output from Kinect. These imprecisions affect the quality of education and learning. Hence, together with clinicians we have defined bone landmarks which users can touch easily on their body while standing in front of the sensor. We demonstrate that these landmarks allow the proper deformation of medical data within the magic mirror and onto the human body, resulting in a more precise augmentation. Refereed/Peer-reviewed

The problems that health professionals faced may involve engineering practicalities, e.g., the design of efficient devices in physiological specific monitoring activities. Therefore, it is important to know the type and characteristics of the physiological signals and how to acquire them. This paper presents the conceptual model for physiological data acquisition in a new remote didactic environment. This comprises two different approaches: human physiological and electromechanical simulators data acquisition. The insights on the data acquisition system development are described, emphasizing the added value of this new innovative educational tool for biomedical engineering., The authors are grateful to the Portuguese Foundation for Science and Technology (FCT) for funding through the R&D project FCOMP-01-0124-FEDER-022601 (reference FCT PTDC/CPE-PEC/122329/2010).

Repository-based learning is a constructivist learning and training approach well adapted to professionals that want to continuously update their knowledge. The development of repositories with scientific quality and easy to be used requires a large investment, they are not yet so common in most scientific areas. Nevertheless, medicine exhibits already a big potential for this kind of self-training, or personal based learning (PBL). This paper introduces the Atlas RL-EYE, a repository of clinical cases, images, videos and related information in the area of Ophthalmology. For a given clinical case, the repository stores different instants with their diagnostic grounding. Surgical videos are presented when relevant. The repository contains also stereoscopic full HD 3D videos. A small script, intended not to be exhaustive but concise, accompanies each retinal pathology.

In this study, I propose and practice the PBL (Problem Based Learning) contents to learn the difficulty of supporting disaster relief efforts, the importance of communication, and human networks. I conducted a PBL practice with Twitter for premedical students in the seminar. In this practice, I took the damage situation of the East Japan great earthquake and tsunami disaster into account and prepared for the scenario. Participant students played roles as individual doctors. The results of the practice were that it was not completed well. Some patients are not helped due to miscommunication. However, students are considered to learn much from this practice. By the questionnaire and the report, they express that they found it difficult to help at the disaster; they found it important to communicate. They also learned of the importance of human networks.

Advances in the medical field require new and progressive ways to intensify surgical resident training and surgical skills learning. To address this need, in addition to traditional training using realistic surgical objects, simulator-based training programs have been widely adopted. Both training methods need constant presence of a competent surgeon to assess the surgical dexterity of a trainee, which is not only costly but also very subjective. This paper proposes a novel video-based approach for assessing the trainee's hand and tool movements in minimally invasive surgical training. Videos capturing surgical training actions are analysed to automatically extract major skill measuring features and to provide real-time performance feedback to the trainee. The method has the potential of being extended to skill evaluation in real surgeries at low cost.

The process of medical training and evaluation in Brazil has been supported by several resources in order to graduate more qualified students. These resources include atlas, photos, movies, cadavers, animations, real patients, standarized patients(actors) and anatomical manikins, among others. For the reality of medical schools in a developing country as Brazil, high-end manikins are too expensive. This paper describes the validation of the Augmented Reality Environment for Life Support Training (ARLIST) system, built on the top of conventional manikins, used in cloth shops, during three editions of the Selection Exam for the Medical Residence Program of Sao Lucas Hospital, reaching a total of 450 users of this system. The use of manikins in these exams has showed that there is great potential for using this kind of technology in this process in medical schools, since the results were promising and resources as cadavers and experimental animals are increasingly scarce.

The Cooperative Learning in Engineering Design curriculum can be enhanced with structured and timely self and peer assessment teaching methodologies which can easily be applied to any Biomedical Engineering curriculum. A study was designed and implemented to evaluate the effectiveness of this structured and timely self and peer assessment on student team-based projects. In comparing the 'peer-blind' and 'face-to-face' Fair Contribution Scoring (FCS) methods, both had advantages and disadvantages. The 'peer-blind' self and peer assessment method would cause high discrepancy between self and team ratings. But the 'face-to-face' method on the other hand did not have the discrepancy issue and had actually proved to be a more accurate and effective, indicating team cohesiveness and good cooperative learning.

This paper discusses the need for technology education for physicians. A discussion of a series of technology related medical accidents is presented first, followed by a discussion of the types of technologies a physician uses on a daily basis. A set of technology education competencies is presented in a hierarchical format.

Blackboard network teaching platform provides teachers with convenient and handy tool modules to create, release, and manage online exams. It aims to reform the online examination methods. In this study, an exploration was made on medical information retrieval item bank based on blackboard network teaching platform. How to use the tool modules of blackboard network teaching platform to build item banks was described. And the significance of the construction of online test for teachers to conveniently test the students was discussed. Finally, some suggestions about the construction of item bank based on blackboard network teaching platform were provided.

Training with simulators based on virtual reality has been the focus of several projects in the last years. In this context, collaborative activities require the use of networks and approaches to join users in a single environment. However, some questions still remain open as a challenge for the design of simulators for teams in medicine: what are the requirements of these simulators? and how to evaluate team activities? These questions are discussed in this paper to provide an architecture for evaluation of teams in collaborative trainings based on virtual reality.

This paper describes the development of a system for medical training of the pleural puncture protocol, built based on virtual reality techniques and performance analysis of the head mounted display (HMD) in this system. The system includes 3D geometric models for a virtual operating room and the virtual patient's anatomy, and the modules required to promote the training of users. One of the contributions of this work is to analyze the impact of the use of HMD, model xSight 3120, and conventional monitors in learning the procedure of pleural puncture through simulations, considering the items: visual discomfort, time to perform tasks and success and error rates.

The MasteringChemistry® is one of the most useful and widely used online tutorial, homework, and assessment system for the science courses. When using MasteringChemistry®, students remain engaged in learning. They use it more than other available assistive-learning technologies, and value it as much as face to face tutoring. The aim of this work is to investigate the efficiency of MasteringChemistry® in teaching Biochemistry course for nursing students at the College of Health Sciences- University of Bahrain. When using MasteringChemistry® we have noticed a significant increase in the percentage of students' final grades, especially those with A's. Students also perceived MasteringChemistry® as one of the best factors that had the greatest impact on their success in the course.

Central Venous Catheterization (CVC) involves the insertion of a catheter through the subclavian or jugular vein and into the heart when the patient requires a large influx of drugs. With the target veins so close to the lungs and vital arteries, mistakes during this procedure can be fatal. Unfortunately, it is particularly challenging for students to learn this procedure and is often practiced by novice students on live patients as current simulators are ineffective. Simulators on the market are expensive, inconvenient, and often anatomically inaccurate, leading to improper student training. To address the shortcomings of current simulators, our patent-pending design includes features such as a fully rotatable head and proper anatomical landmarks. Our training simulator is ultrasoundable and can replicate both the pulsing of the arteries and the expanding of the veins under changes in fluid pressure. In addition, our simulator comes with training software allowing for tracking of students as they progress through the curriculum. We are currently performing usability testing of our prototype. Novice residents and expert practicing doctors perform CVC on our simulator for assessment of accuracy, ease of use, and training effectiveness in comparison to commercially available simulators.

This short paper proposes the development of three different applications for health education with the aid of Augmented Reality. Some figures of current development prototipes are also show and future works are proposed. We expect these applications will help extend health education to students' homes from all educational stages and expect to minimize some problems related to anatomy education in college, such as costs for obtaining corpses and lack of skilled professionals.

The use of virtual reality (VR) systems for education can improve the learning process in health, providing more motivation and realism to users. In general, specific devices are used to increase immersion and, in general, demand an adaptation period. Natural Interaction (NI) can provide an intuitive way to interact in VR systems since it can improve and make the communication between users and the system easier. The present work investigated NI techniques provided by VR frameworks for health. As a result, was designed a structure to integrate NI techniques into a framework.

A patient simulator thermometer was designed to meet the demands of training students in a simulated clinical environment. This is achieved through the use of an instructor interface, Bluetooth signal generation, and a student interface which simulates a clinical temporal thermometer.

Taking the example of Wrist-Ankle Acupuncture teaching in Chinese Medicine, it is analyzed in details that how to apply virtual reality (VR) technology into the medical experimental instruction. A medical virtual teaching system is constructed and its functions, design of main modules as well as choices of teaching media are introduced. Moreover, the most important techniques during the course of system development are also disclosed. This system has received a positive assessment after being put to practical teaching use.

This work involves the design and development of a training system for minimally invasive surgery skills in the specialty of otolaryngology. The purpose of the system is to give experience to the surgical residents. The design and development of training modules is required to provide the surgeon with a practical interaction environment, as well as an assessment methodology. The proposed methodology consists of a series of tasks which develop and evaluate the skills based on precision and time. A digital evaluation system developed in MATLAB records and evaluates the implementation of tasks and works as the communication interface between surgeon and a PC.

As various technologies been incorporated into education and training, the evolution of e-learning also takes its turn in many universities. In Malaysia, the evaluation of motivational dimensions of the application is considered vital as e-learning had been embedded and integrated as part of teaching and learning assistance tool in many universities. The aim of this research is to investigate the dimensions of motivation of dental students in using e-learning as part of their learning-assisted-tool. The adapted questionnaires from Website Motivational Checklist (WebMAC) professional were distributed to 144 dental students from a Malaysian public university. The motivational dimensions investigated are meaningful, stimulation, easy-to-use and organization. The outcome of the study revealed that the e-learning website can be improved to increase the motivational dimensions. Some improvements on meaningful, stimulation and easy-to-use motivational dimensions are being required.

We report the development and initial deployment of the Escape Platform, a printed circuit board (PCB) and software base for instructional use in two engineering courses at Rice University: the capstone Senior Design course and the Introduction to Computer Engineering course. The capstone course includes interdisciplinary teams of seniors in Electrical, Mechanical and BioEngineering while the Computer Engineering course is targeted at freshman and sophomore Electrical Engineers and Computer Scientists. In this paper we describe hardware and software features of the Escape Platform and the related content in courses in which it will be used. The first deployment of the Escape Platform in these courses is currently underway; we provide some initial observations of the Escape Platform's utility.

In this study, we proposed and developed support system to make teaching materials of catheterization. Main functions of proposed system are multiplying and attending can make teaching materials himself easily. Especially, we improved Interfaces in proposed system, and decide suitable equipment for operating-room.

One of the key instruments for orthodontic patient evaluation is the cephalometric analysis that is used for diagnosis, treatment planning and evaluation. In clinical practice it is important to train students for a correct cephalometric analysis in order to master both lateral and postero-anterior cephalograms. The combination of lateral and postero-anterior analysis for a multimodal analysis is gaining importance in order to be able to evaluate the anatomical structure also in the frontal plane which allows for a better evaluation of asymmetry and craniofacial widths. In this work we present the educational and pedagogical idea that inspired the design of the software tool for learning postero-anterior cephalometric landmarking. The tool can be used in conjunction with a tool for latero-lateral cephalometric analysis offering a blending of approaches that can offer, in a multimodal way, a broader view and evaluation of the clinical situation.

In this paper the development of the electrical bioimpedance topic as a part of the traditional master's course of Biomedical Electronics is discussed. A description of this part of the course and analysis of it is given together with explanations to the way of discussing the electrical properties of the biological objects, tissues and organs in the course. Discussion of measurement of the Electrical Bioimpedance, and of the electronic means for this purpose are also presented. All this is done in connection with the problematics of providing the students the e-learning facilities over the Internet.

In medical education, more than in other areas, practices are used characterized as “learning by doing” and “learning through examples”. Video and videoconferencing are effective tools which can play an important role in this process.

Laboratories are a means by which students take a hands-on approach and practice concepts learned in class lectures under real or close-to-real world settings. This provides a kinesthetic method of learning which rounds out the auditory methods typical of a lecture course. Unfortunately, many students spend most of the lab time troubleshooting their experiment instead of deepening their understanding of the concepts taught in class. This causes frustration and anxiety amongst students. In our opinion, this is due to a lack of knowledge of equipment used in the lab as well as training on different equipment in previous classes. We have developed a video tutorial series for our Biomedical Measurements class that teaches basic circuit building, equipment set-up, and equipment use — students may watch these videos before the lab and at any moment during the lab. Thus far, post-semester surveys have indicated that all respondents, whether bio-electrical, pre-medical, or bio-mechanical concentration in biomedical engineering, find the video tutorials helpful in the lab. The incorporation of technology in the lab session ensures that the lab time is spent deepening conceptual knowledge instead of troubleshooting circuits.

Most industrial projects require a team of engineers from a variety of disciplines. The team members are often culturally diverse and geographically dispersed. Many students do not acquire sufficient skills from typical university courses to function efficiently in such an environment. The Global Engineering Teams (GET) programme was designed to prepare students such a scenario in industry. This paper discusses five biomedical engineering themed projects completed by GET students. The benefits and success of the programme in educating students in the field of biomedical engineering are discussed.

Objective To provide a quantitative program that can assess the teaching effectiveness of tongue diagnosis skills training. Methods 2116 cases were selected in the Medical Examination Center of Beijing TongRen Hospital who undergoes a health examination in June 2011 to December. By taking the digital tongue figure and extract the digital tongue color values (L*, a *, b *), this study used the colorimetric method to quantify the information of the tongue color. And cluster analysis method was used to get the cluster centers of the various types of tongue color. Results All types of tongue color gathered in lilac pink, pink, orange, pink color areas around. Three-dimensional scatter plot shows the data clustered for the 11 regions, visible in the tongue color category vector clearer state of aggregation, split between each other clear and gathered evenly. Conclusion Based on the colorimetric method this study not only offers the basis of quantization for the diagnosis of tongue color teaching but also found objective criteria for learning outcomes assessment.

Based on the characteristic of the course of the medical immunology, there are many advantages with case based study (CBS) and multimedia teaching method. By using case based study (CBS) in medical immunology, the study enthusiasm of laboratory medicine students can be fully aroused. Moreover, multimedia will help students to understand the case easily and help them to expend their thinking and develop the inner potential. Compared to the traditional teaching method, multimedia CBS teaching model not only achieved good results, but also greatly improved the students and teachers qualities.

Medical microbiology is an important part in microbiology teaching. However, there are some problems in our experiment teaching now, we endeavor to work out countermeasures and believe that the experiment teaching level and teaching quality will be improved after improve.

Application of internet and multimedia technologies on periodontology clinical teaching and learning is introduced. After digital processing, the simulated E-learning can help to supplement the deficiency of clinical education resources. The actuall effect shows that education efficiency is improved evidently, and multi dimensional interaction and resources sharing are realized as well.

Medical Imaging is a key training component in Biomedical Engineering programs. Medical imaging education is interdisciplinary training, involving physics, mathematics, chemistry, electrical engineering, computer engineering, and applications in biology and medicine. Seeking an efficient teaching method for instructors and an effective learning environment for students has long been a goal for medical imaging education. By the support of NSF grants, we developed the medical imaging teaching software (MITS) and associated dynamic assessment tracking system (DATS). The MITS/DATS system has been applied to junior and senior medical imaging classes through a hybrid teaching model. The results show that student's learning gain improved, particularly in concept understanding and simulation project completion. The results also indicate disparities in subjective perception between junior and senior classes. Three institutions are collaborating to expand the courseware system and plan to apply it to different class settings.

With an aim to improve teaching quality of medical bridging curriculum, facilitate Tibetan medical education reform, and promote the quality of talents, we have carried out course feature specific multimedia teaching in bridging medical curriculum and have studied noteworthy problems, which popped up in teaching, in combination with live cases of Tibetan higher education as well.

The Deteriorating Patient Activity (DPA) is a real-life educational simulation that prepares medical students to effectively approach emergency situations through a role play where their instructor plays the role of a patient whose state is rapidly deteriorating. Although proven engaging and effective in improving student decision making, DPA is difficult to carry out since it requires students and medical instructors, all busy people, to be available at the same time and location. The present paper describes the “Digital” Deteriorating Patient Activity (DDPA), an agent-based tutoring system developed to allow learners to train on simple DPA cases so they can face more complex cases when meeting a human instructor.