Expanding the use of Interactive Medical Ethics Cases across the UK:

The G4.5 ProjectMs Sheetal Kavia

Dr. Carwyn Rhys HooperProf. Terry Poulton

Overview

• What is an EVP?

• SGUL EVP trial in lectures

• Trial Feedback

• Going from G4 to G4.5

• G4.5 student and tutor Feedback

• What next

Virtual Patients & Ethical Virtual Patients

• A VP is…- “an interactive computer simulation of real-life

clinical scenarios for the purpose of medical and healthcare training, education or assessment”

• An EVP is…- same as above but with a heavy ethical, legal

and/or professional element

Ethics Lectures! The old way

SGUL Trial • We have used 5 cases

in actual teaching sessions (small and large group)

• Collected feedback from 601 students

• The feedback that we have received has been overwhelmingly positive.

Student’s opinions on the use of VPs in lectures

Key results

• Students agreed/strongly agreed that the EVPs were….

- Interesting (96.7%)

- Stimulating (95.1%)

- Generated interesting debate (88.7%)

- An improvement from static ethics cases used in lectures

(69.4%)

- More beneficial to be played within groups (95.1%)

• Grant from the Joint Information Systems Committee for £200,000 under its ‘Curriculum Transformation’ strand

• Aim: To create a more interactive problem-solving curriculum, to allow authentic practice of clinical encounters

• Deliver 2 formative assessment cases each week

• Integrate with other interactive learning tools to allow self, and group assessment of competency

G1 - Subject- or discipline-based G2 - System-basedG3 - Case based, but linearG4 - Interactive with options, consequences

Why Generation 4 (G4)?

Generation 4.5 (G4.5)

• JISC funded 12 month project to embed the benefits from the Generation 4 project

• The use of VPs in medical ethics curriculum

G4.5 Aims• Convert 5 EVP cases from text to video cases

- End of life/Mental Capacity – DNAR case- HIV confidentiality- Student professionalism – Drugs and alcohol abuse - Organ transplant case - Truth telling – virginity test

• Both video and text versions of the cases were offered

• Tutors were free to use the case as they wish

• Evaluate the cases using staff and student questionnaires

G4.5 Partners and Consortium

University of Leeds

University of Newcastle

St George’s University

University of Sheffield

University of Bristol

Durham University

University College LondonKings College LondonImperial College London

University of Southampton

Swansea University

University of St Andrews

Peninsula College of Medicine and Dentistry

Nottingham University University of East Anglia

Queen’s University Belfast

University of Manchester

University of BirminghamUniversity of Warwick

University of Leicester

Example of a Case Video

• http://www.youtube.com/watch?feature=player_embedded&v=fRCDhAcOZLQ

G4.5 Feedback

• 12 out of the 20 universities filled out the student feedback survey after using the EVPs a total of 1,858 responses were collected

• 21 staff responses were collected from 4 institutions

• Both text and video versions of all cases were used

• EVPs were using in each learning environment - SDL, PBL, Small group teaching(seminar), Large group

teaching (lecture)

G4.5 Student FeedbackStrongly Agree

Agree Neither A/DA

Disagree Strongly Disagree

EVPs will improve my understanding of how to apply ethical theory

24.3% 64.5% 8.6% 2.2% 0.3%

EVPs will improve my understanding of how to apply the law and professional guidance

21.4% 60.3% 14.0% 4.0% 0.3%

EVPs will improve my ability to reason ethically/Legally 25.6% 59.6% 11.6% 3.0% 0.2%

EVPs will improve my confidence when making ethico-legal decisions

23.6% 57.1% 14.8% 4.0% 0.4%

I found the EVPs stimulating engaging and interesting 30.2% 56.3% 9.8% 3.2% 0.5%

EVP cases should be modified so that they can be used for assessment purposes

8.2% 31.9% 33.1% 21.5% 5.4%

Student comments

Visual stimulation

Interesting Engaging

Discussion

Realistic

FunMemorableUnrealistic

Options Time consuming

Drastic

Limited options

Majority vote

G4.5 Tutor Feedback

• All feedback was from using the cases in PBL or small group teaching sessions

• 67% of the tutors had never used EVP cases before in their teaching

• 48% Tutors felt video EVPs were most effective and 38% thought both text and video were

• 75% Tutors thought they work best within small group teaching sessions

G4.5 Tutor FeedbackStrongly Agree

Agree Neither A/DA

Disagree Strongly Disagree

EVP cases are easy to use 52% 48% 0% 0% 0%

The EVP cases made it easier for students to identify key ethical issues

43% 38% 19% 0% 0%

EVP cases have the potential to improve my teaching sessions

48% 48% 0% 5% 0%

EVP cases should be modified so that they can be used for assessment purposes

14% 23% 29% 33% 0%

Tutor Comments

Engaging

Real LifeGenerating Discussion Interesting

Interactive

Everyone’s involved

Limited Options

Unrealistic

Media Quality

Guidelines to Support

What’s next?

• Analysis of results

• Publications

• Wider dissemination of cases

• Ethics VP app

Using the case in a lecture

• http://www.youtube.com/watch?v=Yixt8xzfFKk

Thank You

http://www.elu.sgul.ac.uk/g4-5/