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BACKGROUND Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a leading cause of mortality and morbidity. Patient knowledge about AF and its management is paramount but often limited. Patients need to be appropriately informed about treatment options, medicinal adherence and potential consequences of non-adherence, while also understanding treatment goals and expectations from it. m-health applications experienced an explosion both in their availability and their acceptance as “soft interventions” for patient engagement and education. However, the prolific nature of such solutions revealed a gap in evidence base regarding their efficacy and impact. Virtual Patients (VPs), interactive computer simulations, have been used as learning activities in modern health care education. VPs demonstrably improved cognitive and behavioral skills and thus they have been effectively implemented across undergraduate and postgraduate curricula. However, their application in patient education has been rather limited so far. OBJECTIVE This work aims to implement and evaluate the efficacy of a mobile deployed VP regimen for the education and engagement of AF patients on crucial topics regarding their condition. A mobile VP application is developed with the goal of each VP being a simple scenario with a set goal and very specific messages and will be subsequently attempted and evaluated. METHODS A mobile VP player application is created so as to be utilized for the design of three educational scenarios for AF management. A pseudo-randomized control trial for the efficacy of Virtual Patients (VPs) is planned to be executed in three sites in Greece, Ukraine and Kazakhstan for AF patients. After recruiting and exclusion, patients from Greece, Kazakhstan and Ukraine are aimed to participate in the study. The A Welch’s t-test will be used to demonstrate the performance of patients’ evaluation of the VP experience. RESULTS Our study is at the development stage. A preliminary study regarding the system’s development and feasibility has started in December 2022. The results of our study are expected to be available in 2023 or when the needed sample size is achieved. CONCLUSIONS This study aims to evaluate and demonstrate the first significant evidence for the value of VP resources in outreach and training endeavors for patients’ empowerment and healthy habit building on AF.

Background Virtual Patients (VPs) may improve cognitive and behavioral skills better than traditional methods do. The aim of this paper was to investigate challenges faced by teachers and students in order to effectively implement VPs across undergraduate and postgraduate curricula. In addition, differences in student and teacher perceptions that could impact curricular integration of VPs were explored. Methods A two-phase descriptive study was performed: 1) evaluation of the VP design process and curricular integration, conducted upon academic medical teachers; 2) evaluation of learning and clinical reasoning experiences with VPs, from the students’ perspective. Results The results of this study document high acceptance of VPs by both medical teachers and students (n = 252).VPs seem to fulfill most needs as set by course directors, while they satisfy student needs and create perceptions of improved knowledge and clinical skills reasoning. Conclusions Medical educators have encountered educational challenges upon transforming the curriculum. To develop VPs, academic institutions have to pay equal attention to the needs of potential adopters and VP authors. Strategic development and use of VPs may motivate more widespread integration of VPs and lead to a high quality medical education system.

Education has tapped into gaming to increase engagement and facilitate knowledge retention through experiential modalities. There have been several high technological intensity digital laboratories where learners are engaged with the subject matter through various activities. There are also several low intensity web-based solutions that familiarize learners with curriculum material but in less experientially intensive manners. A ubiquitous approach to highly impactful, low cost, high reusability gamified educational approach is a versatile mixed reality educational environment. Using prolific technologies such as inexpensive augmented reality (AR) headsets and a versatile low maintenance database (DB) back-ends, a real-world environment can be transformed with 3D graphics and audio to various educational spaces of highly impactful content. Such a simple implementation is presented here for virtual patients in medicine. A simple DB back-end supports a presentation front-end developed in Unity, utilizing the "vuforia"-mixed reality platform. Based on this implementation, future directions are explored.

Chronic pain is a lifelong issue, being one of the main causes of disability, affecting a great number of people worldwide, many of which often avoid seeking medical advice from pain experts and/or demonstrate poor adherence to their therapeutic plan. One of the most important steps in achieving a manageable course of disease, is the ability of self-management. We aimed at applying a method of systematic patient education and self-management through the use of Virtual Patients (VPs), a well-established method for educating medical doctors and students but never before targeting patients. Two VPs scenarios were designed, tested and evaluated by patients with rheumatic disorders, achieving a SUS score of 88/100 “Best Imaginable”, alongside with positive reviews from the participants. The positive feedback from the patients supports the potential of VP educational paradigm to educate these patients and equip them with disease coping skills and strategies.

Education has tapped into gaming to increase engagement and facilitate knowledge retention through experiential modalities. There have been several high technological intensity digital laboratories where learners are engaged with the subject matter through various activities. There are also several low intensity web based solutions that familiarize learners with curriculum material but in less experientially intensive manners. A ubiquitous approach to highly impactful, low cost, high reusability gamified educational approach is a versatile mixed reality educational environment. Using prolific technologies such as inexpensive AR headsets and a versatile low maintenance Database(DB) back ends, a real world environment can be transformed with 3d graphics and audio to various educational spaces of highly impactful content. Such a simple implementation is presented here for virtual patients in medicine. A simple DB backend supports a presentation frontend developed in Unity, utilizing the "vuforia" mixed reality platform. Based on this implementation future directions are explored.

Medical education has always been about experiential hands on training to prepare future doctors to create the necessary skillset to deal with the sensitive and immediate nature of their work. Contemporary experiential technologies such as Virtual and Augmented reality offer a realistic but consequence free test-bed in which to interact safely and cope with emotional challenges pertaining to the realistic tasks simulated through these media. This work describes the design guidelines and workflow for incorporating these novel virtual assets in medical education through serious role play learning episodes. This approach consists of the case selection, the identification of roles, information flow and narrative requirements, implementation of technological narrative tools and implementation of the learning episode. Using a specific example of case transfer through this model we describe the process, outline implementation, assessment and technological considerations. Finally rationale for this work as a counterweight to technological hype fluctuations and integration of these media into the mainstream curricula is discussed.

Background: Since their inception, virtual patients have provided health care educators with a way to engage learners in an experience simulating the clinician’s environment without danger to learners and patients. This has led this learning modality to be accepted as an essential component of medical education. With the advent of the visually and audio-rich 3-dimensional multi-user virtual environment (MUVE), a new deployment platform has emerged for educational content. Immersive, highly interactive, multimedia-rich, MUVEs that seamlessly foster collaboration provide a new hotbed for the deployment of medical education content. Objective: This work aims to assess the suitability of the Second Life MUVE as a virtual patient deployment platform for undergraduate dental education, and to explore the requirements and specifications needed to meaningfully repurpose Web-based virtual patients in MUVEs. Methods: Through the scripting capabilities and available art assets in Second Life, we repurposed an existing Web-based periodontology virtual patient into Second Life. Through a series of point-and-click interactions and multiple-choice queries, the user experienced a specific periodontology case and was asked to provide the optimal responses for each of the challenges of the case. A focus group of 9 undergraduate dentistry students experienced both the Web-based and the Second Life version of this virtual patient. The group convened 3 times and discussed relevant issues such as the group’s computer literacy, the assessment of Second Life as a virtual patient deployment platform, and compared the Web-based and MUVE-deployed virtual patients. Results: A comparison between the Web-based and the Second Life virtual patient revealed the inherent advantages of the more experiential and immersive Second Life virtual environment. However, several challenges for the successful repurposing of virtual patients from the Web to the MUVE were identified. The identified challenges for repurposing of Web virtual patients to the MUVE platform from the focus group study were (1) increased case complexity to facilitate the user’s gaming preconception in a MUVE, (2) necessity to decrease textual narration and provide the pertinent information in a more immersive sensory way, and (3) requirement to allow the user to actuate the solutions of problems instead of describing them through narration. Conclusions: For a successful systematic repurposing effort of virtual patients to MUVEs such as Second Life, the best practices of experiential and immersive game design should be organically incorporated in the repurposing workflow (automated or not). These findings are pivotal in an era in which open educational content is transferred to and shared among users, learners, and educators of various open repositories/environments. [J Med Internet Res 2014;16(6):e151]

The aim of this work is to present the technical issues around the design and implementation of an OSCE station (Objective Structured Clinical Examination) in electronic format, so as to be used in the fields of medical education. The presented e-OSCE examination - through the interactive web pages developed - is aimed to be used to assess applied knowledge, clinical reasoning and professional attitudes in the context of a basic clinical skill: intravenous cannulation. Candidates are rated on their medical knowledge of the physical and psychological issues involved in the questions. They are also rated on their ability to manage the issues raised in this case and perform the procedure appropriately and competently with regard for the patient safety and comfort. Two programs, complementary to each other were used for the design of the electronic OSCE; VUE, for the design of the logical path, and OpenLabyrinth, as an activity modeling system. They allowed the schematization and the creation of the on line interactive educational activity. OpenLabyrinth had to be installed in the local server and be configured. Moreover, the application is compatible with the latest technological standards proposed by MedBiquitous, which allows the interoperability, accessibility and reusability of the educational content.

Recent technological developments have enabled the use of virtual three dimensional platforms for educational uses. In this paper, an application based upon the Opensim platform for use within medical education and development of clinical skills is presented together with its associated repurposing so as to reconstruct and change this environment so that it fits different medical specialties. The objective of this work was to present the repurposing aspects of modifying a learning environment and adapting it to the needs of different medical specialties in an effort to reuse (and therefore share) learning content among several specialties. Initially, a 3-Dimensional environment was created by using the Opensimulator platform for use in the era of cardiology. Thereupon, the virtual environment was modified so as to be oriented to the needs of psychiatry educational needs. The reconstruction of the learning environment and context and the reformation of the educational scenario offer the ability to reuse it adapted to the needs of each medical domain. In tandem, educational standards were adopted, specifically, the IEEE Learning Object Metadata (LOM), to enable the description of this medical content and to support academic teachinng. The long term scope of this work within the overall developments in the area of advancing the repurposing of medical educational content is discussed.