title: Educational potential of a virtual patient system for caring for traumatized patients in primary care.
abstract: BACKGROUND
  Virtual Patients (VPs) have been used in undergraduate healthcare education for many years. This project is focused on using VPs for training professionals to care for highly vulnerable patient populations. The aim of the study was to evaluate if Refugee Trauma VPs was perceived as an effective and engaging learning tool by primary care professionals (PCPs) in a Primary Health Care Centre (PHC).
  
  
  METHODS
  A VP system was designed to create realistic and engaging VP cases for Refugee Trauma for training refugee patient interview, use of established trauma and mental health instruments as well as to give feedback to the learners. The patient interview section was based on video clips with a Bosnian actor with a trauma story and mental health problems. The video clips were recorded in Bosnian language to further increase the realism, but also subtitled in English. The system was evaluated by 11 volunteering primary health clinicians at the Lynn Community Health Centre, Lynn, Massachusetts, USA. The participants were invited to provide insights/feedback about the system's usefulness and educational value. A mixed methodological approach was used, generating both quantitative and qualitative data.
  
  
  RESULTS
  Self-reported dimensions of clinical care, pre and post questionnaire questions on the PCPs clinical worldview, motivation to use the VP, and IT Proficiency. Construct items used in these questionnaires had previously demonstrated high face and construct validity. The participants ranked the mental status examination more positively after the simulation exercise compared to before the simulation. Follow up interviews supported the results.
  
  
  CONCLUSIONS
  Even though virtual clinical encounters are quite a new paradigm in PHC, the participants in the present study considered our VP case to be a relevant and promising educational tool. Next phase of our project will be a RCT study including comparison with specially prepared paper-cases and determinative input on improving clinical diagnosis and treatment of the traumatized refugee patient.
authors: Department of Learning Informatics, Management and Ethics (LIME), Cultural Medicine Unit, Karolinska Institutet, Tomtebodavägen 18A, plan 3, SE-171 77, Stockholm, Sweden. Solvig.Ekblad@ki.se.
authors: Solvig
authors: S
authors: Ekblad
authors: Richard F
authors: RF
authors: Mollica
authors: Uno
authors: U
authors: Fors
authors: Ioannis
authors: I
authors: Pantziaras
authors: James
authors: J
authors: Lavelle
mesh_terms: D003863:Depression / Q000175:diagnosis; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D008016:Life Change Events; D008487:Medical History Taking; D016544:Patient Simulation; D010808:Physical Examination; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis; D013664:Teaching Materials; D014584:User-Computer Interface
references: Psychosom Med. 2007 Apr;69(3):242-8
references: 17401056
references: Health Serv Res. 2003 Jun;38(3):789-808
references: 12822913
references: J Behav Med. 2008 Aug;31(4):341-9
references: 18553129
references: J Gen Intern Med. 2006 May;21(5):424-9
references: 16704382
references: J Gen Intern Med. 1999 May;14(5):267-73
references: 10337035
references: Int J Qual Health Care. 2007 Apr;19(2):60-7
references: 17277013
references: Med Educ. 2009 Apr;43(4):303-11
references: 19335571
references: Acad Emerg Med. 2005 Feb;12(2):162-8
references: 15692140
references: J Nerv Ment Dis. 1997 Feb;185(2):102-7
references: 9048702
references: J Natl Med Assoc. 2006 Oct;98(10):1630-6
references: 17052054
references: Med Teach. 2010;32(10):845-50
references: 20854161
references: Med Teach. 2009 Aug;31(8):732-8
references: 19811210
references: Fam Med. 2002 May;34(5):383-9
references: 12038721
references: Arch Gen Psychiatry. 1988 Dec;45(12):1100-6
references: 3264145
references: J Eval Clin Pract. 2009 Dec;15(6):1190-5
references: 20367726
references: Med Teach. 2009 Aug;31(8):739-42
references: 19811211
references: Stud Health Technol Inform. 2008;132:357-62
references: 18391321
references: J Gen Intern Med. 2003 Jan;18(1):44-52
references: 12534763
references: Arch Pediatr Adolesc Med. 2002 Nov;156(11):1108-13
references: 12413338
references: Psychol Med. 2001 Apr;31(3):555-60
references: 11305864
references: J Am Acad Nurse Pract. 2007 May;19(5):215-20
references: 17489953
references: Curr Popul Rep Popul Charact. 1998 Mar;(507):1
references: 12293400
references: Nurse Educ Today. 2004 Feb;24(2):105-12
references: 14769454
references: Med Teach. 2010;32(11):e509-16
references: 21039093
references: Ann Intern Med. 2002 May 21;136(10):765-76
references: 12020146
references: J Nerv Ment Dis. 1998 Sep;186(9):543-53
references: 9741560
references: Gen Hosp Psychiatry. 2005 May-Jun;27(3):169-79
references: 15882763
references: Health Serv Res. 2003 Apr;38(2):613-30
references: 12785564
references: Science. 1977 Apr 8;196(4286):129-36
references: 847460
references: BMC Med Educ. 2010 Dec 04;10:91
references: 21129220
references: Public Health. 2006 Sep;120(9):809-16
references: 16876836
references: JAMA. 2005 Aug 3;294(5):571-9
references: 16077051
references: J Psychosom Res. 2002 Oct;53(4):849-57
references: 12377293
references: J Gen Intern Med. 2004 Feb;19(2):111-9
references: 15009790
references: BMJ. 2003 Nov 1;327(7422):1032-7
references: 14593041
references: Lancet. 2004 Dec 4-10;364(9450):2058-67
references: 15582064
references: J Gen Intern Med. 2004 Mar;19(3):221-8
references: 15009776
references: JAMA. 2002 Jul 24-31;288(4):475-82
references: 12132978
references: Ann Surg. 2002 Oct;236(4):458-63; discussion 463-4
references: 12368674