Georg Carina, Zary Nabil
Center for Learning and Knowledge (CLK), Department of Learning, Informatics, Management and Ethics ( LIME), Karolinska Institutet, Stockholm, Sweden.
J Med Internet Res. 2014 Apr 10;16(4):e105. doi: 10.2196/jmir.2556.
Research has shown that nursing students find it difficult to translate and apply their theoretical knowledge in a clinical context. Virtual patients (VPs) have been proposed as a learning activity that can support nursing students in their learning of scientific knowledge and help them integrate theory and practice. Although VPs are increasingly used in health care education, they still lack a systematic consistency that would allow their reuse outside of their original context. There is therefore a need to develop a model for the development and implementation of VPs in nursing education.
The aim of this study was to develop and evaluate a virtual patient model optimized to the learning and assessment needs in nursing education.
The process of modeling started by reviewing theoretical frameworks reported in the literature and used by practitioners when designing learning and assessment activities. The Outcome-Present State Test (OPT) model was chosen as the theoretical framework. The model was then, in an iterative manner, developed and optimized to the affordances of virtual patients. Content validation was performed with faculty both in terms of the relevance of the chosen theories but also its applicability in nursing education. The virtual patient nursing model was then instantiated in two VPs. The students' perceived usefulness of the VPs was investigated using a questionnaire. The result was analyzed using descriptive statistics.
A virtual patient Nursing Design Model (vpNDM) composed of three layers was developed. Layer 1 contains the patient story and ways of interacting with the data, Layer 2 includes aspects of the iterative process of clinical reasoning, and finally Layer 3 includes measurable outcomes. A virtual patient Nursing Activity Model (vpNAM) was also developed as a guide when creating VP-centric learning activities. The students perceived the global linear VPs as a relevant learning activity for the integration of theory and practice.
Virtual patients that are adapted to the nursing paradigm can support nursing students' development of clinical reasoning skills. The proposed virtual patient nursing design and activity models will allow the systematic development of different types of virtual patients from a common model and thereby create opportunities for sharing pedagogical designs across technical solutions.
研究表明，护理专业学生发现在临床环境中翻译和应用理论知识很困难。虚拟病人已被提议作为一种学习活动，可支持护理专业学生学习科学知识，并帮助他们将理论与实践相结合。尽管虚拟病人在医疗保健教育中越来越多地被使用，但它们仍然缺乏一种系统的一致性，无法在其原始环境之外重复使用。因此，需要开发一个在护理教育中开发和实施虚拟病人的模型。
本研究的目的是开发和评估一个针对护理教育中的学习和评估需求进行优化的虚拟病人模型。
建模过程首先回顾了文献中报道的理论框架，以及从业者在设计学习和评估活动时使用的理论框架。选择结果-现状测试（OPT）模型作为理论框架。然后，以迭代的方式对该模型进行开发和优化，以适应虚拟病人的特性。通过教师对所选理论的相关性及其在护理教育中的适用性进行内容验证。然后在两个虚拟病人中实例化虚拟病人护理模型。使用问卷调查学生对虚拟病人的感知有用性。结果采用描述性统计进行分析。
开发了一个由三层组成的虚拟病人护理设计模型（vpNDM）。第1层包含病人故事和与数据交互的方式，第2层包括临床推理迭代过程的各个方面，最后第3层包括可测量的结果。还开发了一个虚拟病人护理活动模型（vpNAM），作为创建以虚拟病人为中心的学习活动时的指南。学生们认为全局线性虚拟病人是一种将理论与实践相结合的相关学习活动。
适应护理范式的虚拟病人可以支持护理专业学生临床推理技能的发展。所提出的虚拟病人护理设计和活动模型将允许从一个通用模型系统地开发不同类型的虚拟病人，从而为跨技术解决方案共享教学设计创造机会。
