Tools for Creating Virtual Integrated Care Scenarios Case Study

Mary Jo Kreitzer, the director of the Center for Spirituality and Healing on the Twin Cities campus, Louise Delagran, an education specialist at the center, and their development team are creating a set of templates designed to illustrate different parts of a typical patient care scenario. Faculty members and other experts in the health sciences will be able to create online scenarios without any knowledge of Web programming by entering the details of the scenario and the interaction into an easy-to-use Web-based input tool. Their students will be able to interact with the simulated patients, select care plans based on the interactions, and obtain feedback online.

Instructional Goals

Interest in complementary and alternative medicine (CAM) is stimulating changes in the health sciences. One of the strategic goals of the Center for Spirituality and Healing is to integrate core CAM competencies into the Academic Health Center's health professional training programs. As part of an analysis conducted by an instructional designer at the center, faculty members in nursing, medicine, and pharmacy have indicated in interviews that patient case studies are a key instructional strategy. Specifically, integrated-care scenarios could meet the following instructional needs:

model integration of care (different health care providers working together as a team),
model relationship-centered care,
teach complementary medicine approaches, and
provide authentic patient issue scenarios.

Technology Strategies

However, the instructional designer who conducted the analysis also identified obstacles to creating these scenarios, such as the limited availability of content experts, the cost of their time, and the need for the scenarios to apply across disciplines.

Kreitzer and Delagran decided to develop the templates using Macromedia Flash software and the input tool with extensible markup language (XML) so that faculty members can develop the scenarios on their own, select the templates relevant to their disciplines, enter data easily, and see it immediately formatted online.

A student using a typical scenario might see the following screens:

Introduction: Text introducing the patient and his or her symptoms is displayed.
Goals: A list of goals the student should meet by applying methods learned in class is displayed.
Patient interaction: A photograph of the patient is displayed. The student can type a keyword in a search box and a list of possible questions to ask the patient are displayed.
Patient response: Text of the patient's answer, such as "I've been having trouble sleeping," is displayed like speech in comics. The student can select a button to get text clues about the patient's "Body Language," such as "The patient is becoming frustrated." A box also is displayed with text feedback such as "It would be inappropriate to ask that question at this point in the interview. A more appropriate question to ask first is: 'Do you have a community of support?'"
Reflect on interaction: Questions about the emotions of the patient, care provider, and others are displayed for the student to consider.
Feedback on interaction: Key questions and statements the student chose and did or didn't respond to and ineffective questions or statements the student chose are displayed.
Plan of care: The student can select care options from a list of possibilities.
Patient response: Text of the patient's response to the suggested treatment is displayed.
Feedback on plan of care: Lists of appropriate and inappropriate care options the student selected are displayed along with appropriate care options the student did not choose.
Follow-up plan: The student can type in a follow-up plan.
Summary: Text summarizing the interaction and the suggestions on the feedback screens are displayed.

A faculty member or other expert using the input tool will see a table in which he or she can type patient and student questions and statements. He or she also will be able to consult a workbook containing instructions about how to use the tool and instructional design tips. Kreitzer and Delagran also plan to offer workshops to faculty members in April 2004 and will be available to consult with faculty members about how to use the tools.

Learning Outcomes

Kreitzer and Delagran expect to finish the initial templates and the input tool by March 2004. They plan to use formative evaluation methods to obtain feedback from representative faculty members in medicine, nursing, and pharmacy departments and summative evaluation methods to obtain feedback from students who use the tool. See their TEL grant proposal (PDF) for details.

Related Resources

You need Acrobat Reader software to view portable document format (PDF) files. You can download it for free from the Adobe Acrobat Reader page.