title: What are effects of a spaced activation of virtual patients in a pediatric course?
abstract: BACKGROUND
  Virtual patients (VPs) have a long tradition in the curriculum of the medical faculty at the Ludwig-Maximilians-University (LMU) Munich. However, the pediatric VPs were not well integrated into the curriculum and hardly used by students.
  
  
  METHODS
  Therefore we created and implemented a self-contained E-learning module based on virtual patients (VPs), which was embedded into the pediatric curriculum.Students taking this course were divided into two groups. For Group A the virtual patients were activated in a timed order ("spaced activation"), whereas Group B could work on all VPs from the beginning.We investigated the performance of these two groups concerning usage pattern including number of sessions and session duration, score on questions integrated into the VP and results of the intermediate exam.
  
  
  RESULTS
  The integration of the VPs into the pediatric course was successful for both groups. The usage pattern for the spaced activation turned out to be more balanced, however we did not find any significant differences in the results of the intermediate exam, the score on questions included in the VPs nor in the time students spent working on the VPs.
  
  
  CONCLUSIONS
  Our study showed that the spaced activation led to a more balanced VP usage pattern with a lower peak of sessions at the end of the course. Further studies will have to investigate whether a spaced activation of VPs leads to favorable long-term learning outcomes.
authors.affiliation: University Children's Hospital Salzburg, Salzburg, Austria. es.maier@salk.at
authors.forename: Esther M
authors.initials: EM
authors.lastname: Maier
authors.forename: Inga
authors.initials: I
authors.lastname: Hege
authors.forename: Ania C
authors.initials: AC
authors.lastname: Muntau
authors.forename: Johanna
authors.initials: J
authors.lastname: Huber
authors.forename: Martin R
authors.initials: MR
authors.lastname: Fischer
mesh_terms: D003194:Computer-Assisted Instruction / Q000379:methods; D003479:Curriculum; D006801:Humans; D010372:Pediatrics / Q000193:education*; D013663:Teaching / Q000379:methods; D013997:Time Factors; D014584:User-Computer Interface
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