Serious Games: The Virtual Patient specification

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The Virtual Patient – a common standard for medical simulations

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From Transforming Professional Healthcare Narratives into Structured Game-Informed-Learning Activities by Begg, et.al.



The Virtual Patient specification was developed to take advantage of the natural affinity for the branching narrative style of much of medical education. The Virtual Patient is a common standard by which patient cases can be structured in a manner that can be read by many game and simulation systems.

A virtual patient represents whichever characteristics of the patient are relevant to the current educational context.

The VP format contains these segments:

  • Patient History
  • Investigations
  • Differential Diagnosis
  • Final Diagnosis

This is specified using a standardized document structure for the description of the patient called CaseML .

What software can utilize Virtual Patients? 

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The Labyrinth system, developed at University of Edinburgh is one example of an elegant use of the standard without attempting high fidelity realism.

Excerpt from a sample Labyrinth Module

The Labyrinth system uses mostly text-based interaction, along with beeper windows, test results and various other messages and alerts that pop up to provide a realistic experience (See below).

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Moving up the realism scale a little, is this first phase of a project from the Imperial College of Medicine.

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This is a simulation focused on the case of one virtual patient in the area of Respiratory Medicine.
This particular case is a beginning approach to the problem of implementing a virtual patient using existing infrastructure based in Second Life (for those not familiar with Second Life, it is an open virtual world where you can interact with other people and create your own objects and environments.) 
This is the case of  a pneumothorax patient. I’m not convinced it was entirely successful: you waste a lot of time running from room to room to view tests and wash your hands and such but perhaps that is actually very realistic. This module was part of a medical curriculum. The second phase of this game will involve multiple patients. 
One thing these types of games have not yet concentrated on is to simulate doctor-patient communication in a realistic way. It is difficult to train people in that type of communication without lots of practice, so this is a desirable area for simulation games despite the technical hurdles of mimicing realistic human responses.
Dr. Fred Kron at U of Wisc. Madison is working on a massively multiplayer online game that would serve as a simulation of the medical experience with an emphasis on training doctors to communicate more effectively with their patients. Medical students would be put in virtual clinic settings, and have to deal with patients and doctors that could be virtual one moment and controlled by real players in the next. 

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