Web-based simulation of Patients
Computer based patient case simulation systems (CB-CSS) have during the recent years been developed to allow students to "meet" more and better cases than are available in most university clinics. However, three major problems exist with most CB-CSS today: They are expensive to develop, trained programmers are needed and teachers/clinicians cannot develop and adjust cases to fit their own needs.
The Web-SP project (Web-based Simulation of Patients) tries to solve these three problems, and still allow very realistic and highly interactive simulations of clinical cases, delivered and edited via the Web. Most important case simulation features are available, including: interactive history taking, complete physical examination (inspection, auscultation, palpation, percussion, vitals, neurological exams etc.), complete lab section including chemical labs, X-ray, MRI, ultrasound, CT, physiology lab, pharmacology lab, pathology lab etc.), diagnosis and differentials, therapy, interactive session feedback, integrated references and online database sources. All functions are freely chosen by the user and are available at any time, except the detailed feedback, which only is displayed when the user has submitted a diagnosis and therapy proposal. The teachers have access to a detailed interaction log, for debriefing and other discussions with the students.
To develop cases, the teacher might by means of a web-based case construction interface start by choosing from a female or a male patient, and then change the data needed to build a case. This is very straightforward and simple since all normal data (like history answers, clinical images, X-rays, lab values) are already available. The only thing needed is to for example switch a normal x-ray with a pathological one through a built-in authoring interface.
The Web-SP system is based, among other things, on experience and knowledge derived from other case simulation projects of our department and from a number of national and international projects, where the ISP project (Interactive Simulation of Patients) is the most important (http://isp.lime.ki.se).