Development of an accommodative smartphone app for medical guidelines in pediatric emergencies.

One of the outcomes of a training concept for physicians and nurses concerning pediatric emergencies at the Heidelberg University Hospital was that the work and procedures in childhood emergencies could be simplified by replacing the existing paper-based guidelines with a smartphone app. Since the project funds for this were already used up, a group of students from the master program "Medical Informatics" of Heidelberg and Heilbronn Universities took over the development of the app. Particular attention was given to the need for compatibility with the variety of devices (device size and screen resolution) and platform independence. The guidelines themselves were scripted in HTML5, JavaScript and CSS (responsive web design); managed by a container programmed in Sencha Touch. Even though the app is not yet available in the App-Store due to the limited timeframe, the students gained a great deal of valuable experience in developing platform independent software for mobile devices.

Push and pull models to manage patient consent and licensing of multimedia resources in digital repositories for case-based reasoning.

Patient consents for distribution of multimedia constitute a significant element of medical case-based repositories in medicine. A technical challenge is posed by the right of patients to withdraw permission to disseminate their images or videos. A technical mechanism for spreading information about changes in multimedia usage licenses is sought. The authors gained their experience by developing and managing a large (>340 cases) repository of virtual patients within the European project eViP. The solution for dissemination of license status should reuse and extend existing metadata standards in medical education. Two methods: PUSH and PULL are described differing in the moment of update and the division of responsibilities between parties in the learning object exchange process. The authors recommend usage of the PUSH scenario because it is better adapted to legal requirements in many countries. It needs to be stressed that the solution is based on mutual trust of the exchange partners and therefore is most appropriate for use in educational alliances and consortia. It is hoped that the proposed models for exchanging consents and licensing information will become a crucial part of the technical frameworks for building case-based repositories.

Development and validation of strategies to test for interoperability of virtual patients.

Interoperability of e-learning resources requires the adherence to specific standards. In the domain of virtual patients (VP) a central role is played by the MedBiquitous' MVP specification and its application profile proposed by the eViP (Electronic Virtual Patients) project. An important factor in promoting a standard is the use of metrics for assessing the conformity of the resources to the constraints imposed by the specifications. The overall aim of this study was to explore strategies to test for conformance and investigate the capabilities and limitations of automated conformance testing. A four-level scale of conformance of virtual patient packages to the eViP profile is presented, as well as two implementations of conformance testing applications. The developed tools have been tested upon level two on a sample of four VP cases acquired from the eViP repository of virtual patients.

Enabling interoperability, accessibility and reusability of virtual patients across Europe - design and implementation.

Virtual Patients (VPs) have successfully been integrated into medical and healthcare curricula for a number of years. Lack of time and resources is a frequently reported problem encountered when developing VPs for teaching and learning. Consequently there is a need for cross-institutional repositories of VPs. The aims of the study were two-fold: to enable interoperability between virtual patient systems and to investigate if (and how) an application profile is implemented in four different types of VP systems. This European collaborative implementation of a blend of several specifications (Medbiquitous VP XML, Medbiquitous Healthcare LOM, and SCORM) is innovative and the study has shown a variation in how the application profile could be implemented.

Can design principles of traditional learning theories be fulfilled by computer-based training systems in medicine: the example of CAMPUS.

PURPOSE: Computer-based training (CBT) systems offer the potential to efficiently support modern teaching and learning. However, it is still unknown if a similar efficient learning experience built on sound learning theories and corresponding design principles can be created in the complex health care environment. The purpose of this paper is to analyse to what extent learning theories and corresponding design principles are relevant and can successfully be applied in computer-based training in medicine. METHODS: We use the case-based CBT system CAMPUS as an example for a CBT system currently used to enhance the medical teaching and learning experience. We apply two well-accepted learning theories (Bloom's taxonomy and practice fields) and related design principles to determine to what extent they are relevant and fulfilled in the context of CAMPUS. RESULTS: We demonstrate that in principle these learning theories and design principles can be implemented using computer-based training. However, not all design principles can be fulfilled by the system alone; rather the integration of the system into adequate -- traditional or virtual -- teaching and learning environments is essential. CONCLUSIONS: Traditional learning theories and design principles are a valuable means in designing adequate CBT systems in medicine. They can be successfully implemented in CBT systems for medical education if the system itself is adequately integrated into teaching and learning environments.

Computer-based Training in Medicine and Learning Theories.

Computer-based training (CBT) systems can efficiently support modern teaching and learning environments. In this paper, we demonstrate on the basis of the case-based CBT system CAMPUS that current learning theories and design principles (Bloom's Taxonomy and practice fields) are (i) relevant to CBT and (ii) are feasible to implement using computer-based training and adequate learning environments. Not all design principles can be fulfilled by the system alone, the integration of the system in adequate teaching and learning environments therefore is essential. Adequately integrated, CBT programs become valuable means to build or support practice fields for learners that build domain knowledge and problem-solving skills. Learning theories and their design principles can support in designing these systems as well as in assessing their value.

CAMPUS--a flexible, interactive system for web-based, problem-based learning in health care.

Care for patients is the best way to learn medicine and medical methods and skills. But the availability of real patients for learners is limited. Often the appropriate patient is missed or he can not be demonstrated to all students because of practical or ethical problems. A possible solution is the presentation of a clinical problem by a virtual patient using a simulative computer program. But such an approach means often a lot of work for the author of the case. We developed a flexible and realistic system, CAMPUS (www.medicase.de), which supports the case authors with appropriate vocabularies and a comfortable authoring tool. There are different kinds of case presentations to the users in accordance to the level of professionalism of the user and the scenario the program is used in. An evaluation within an internship has shown, that such pro-grams are judged as useful by medical students. But further studies are necessary to examine if the program will be used for the self-study and to develop further kinds of using scenarios within problem-based curricula.