In Development

Move from linear to real-life collective learning experiences.

BACKGROUND

The Virtual Clinical Experience project aims to bring together learning design and technology expertise to create a learning and technology approach to virtual clinical environments at scale. Students will be at the centre of our solution when creating and building a learning environment that strengthens learning. Patients will be at the centre of the design to ensure patient safety, consent, and acceptability.

The Virtual Clinical Experiences will facilitate real-life interactions between students and medical professionals in a synchronous delivery mode. The project will involve a multidisciplinary team of students and medical professionals in a primary care setting. Scalability will be tested in a feasibility study and rolled out across various professional and geographical areas.

PARTNERS

Imperial College London, Tessellate Education LTD

END-USERS

Physician, Students, Patients

SOLUTION

Virtual Clinical Experience – a system for virtual clinical learning environments at scale.

RESULTS

Preparing learners for clinical practice by developing a compound learning experience to reflect integrated clinical practice.

Challenge

The number of learners needing to gain clinical practice experience is increasing across medical and healthcare professional settings in response to the clinical workforce need.

This is happening alongside a change in where and how patients are cared for with a shift to community and primary care. The result is inefficient access to learning opportunities which is a challenge for funders and education providers. This was exacerbated during the COVID-19 pandemic, with limited patient exposure impacting place-based learning experience and availability. This problem spans all clinical placement environments in acute hospital trusts, community trusts, primary care settings and care providers such as Hospices. The pandemic has highlighted this challenge but was present before and will remain after the pandemic has resolved.

Recent experiments have shown virtual clinics to be effective for education and training, and we will leverage the power of these technologies for this virtual clinical experience project. By implementing a remote telepresence solution and learning experience – individual healthcare professionals and clinicians can see patients in various environments and collaborate in real-time and interact with students who signed up for the sessions in real-time.  This solution would provide clinical learning environments free from geographical boundaries, bring efficiencies with scale and personalization for the learner based on their educational needs.

Design

We aim to bring together learning design and technology expertise to create a learning and technology approach to produce virtual clinical environments at scale.

Students will be at the centre of our solution, creating a learning experience and environment that strengthens learning outcomes. Patients will be at the centre of the design to ensure patient safety, consent, and acceptability.

The virtual clinical experiences will facilitate ‘live’ interaction between students and medical professionals in a synchronous delivery mode. We aim to focus on a range of settings as outlined above and a range of learners and medical professionals across the multidisciplinary team in a primary care setting. This approach should identify and overcome the most challenging arenas for wider implementation. These will then be tested in a feasibility study and rolled out across various professional and geographical areas.

 

Integrating virtual clinical environments.

This project focuses on the primary care and community environment using mobile and discreet technologies to advance the preparation for clinical placement activity.

Some clinical environments pose a unique set of limitations resulting in reduced exposure to valuable experiences in place-based education. These limitations can range from challenges with provision (learning environment capacity), person (patient factors) or place (geographical location). Provision (learning environment capacity): Some clinical environments can provide a rich set of learning opportunities. Yet the capacity of the specialised services limits the number of learners that can attend clinics: – Community specialist clinics (e.g., MSK /Dermatology/Genetics Clinic); – Primary care consultations (multi-professional clinics). Place (geographical location): As patient care is increasingly focused on community-based care (NHS Long Term Plan), more people are being discharged from the hospital to ongoing care at home. To realise the potential for medical, health, or allied professionals in education, less traditional settings need to be explored like Nursing Homes, Home visits, Community, and specialist nursing clinics. Person (patient factors): Due to unique challenges with some clinical conditions, learner exposure is reduced. This is either because clinical presentations are rare or individual conditions make it more difficult for patients to be safely and comfortably assessed by medical, healthcare, or allied health professionals. In this project, we aim to utilise the benefits of XR technology to teach students how to consult and assess people with clinical conditions that would prove a barrier to traditional methods of place-based education like when patients who are suffering from dementia or adults with learning disabilities.

By integrating the three factors mentioned above, learners can personalise their clinical placement learning by signing up for virtual clinical experiences based on their own educational needs. The technology and learning design would allow bespoke development of a weekly virtual clinical experience timetable. Students could access this platform to enable them to expand their learning experiences.

We will be developing the pedagogical aspects of delivering virtual clinical experiences exploring the correct numbers of learners, a mix of learners, portal format for the educator and learner.

Technology

Synchronous and asynchronous opportunities for learning.

The project aims for both synchronous and asynchronous opportunities for learning – building a library of resources and providing live educational experiences.

Synchronous opportunities for learning: The physician wears Microsoft’s HoloLens glasses to live stream the clinical environment, bringing students virtually to the patient from their own homes. Students can see and hear the patient and interact with the physician via voice, instant messaging, and remote assist function to ask questions, elicit clinical signs and discuss important learning points. Devices will be connected to the institutional Wi-Fi network and secured using mobile device management software. User accounts will be restricted and protected with multi-factor authentication.

We will obtain institutional approval concerning data protection, confidentiality, and information sharing. This requires collaboration between learning designers and SMEs/practitioners to design for the learning experience.

Asynchronous opportunities for learning: Often, much preparation is required to be developed to give to students, especially case notes and patient records. These sessions often need technical support and TA support. Sessions will be recorded to build a resource for students to access when and where they need it.

Today
We chose to work with SPRIGS, because they share our passion for innovation, and help us to translate new ideas into well designed software solutions Thomas Hurkxkens, Lead New Media, Imperial College London

The Virtual Clinical Experience is a 2-year project aiming to graduate from SPRIGS in 2022.

Project deliverables: – Learning design solution for (live) virtual clinical experience; – Live Sessions of Virtual Clinical Experiences in key areas; – Pilot study feasibility of the virtual solution; –  Roll-out plan and transfer of knowledge; – Evidence-base to support high quality virtual clinical experience that achieves defined learning outcomes.

5 phases of delivery: 1) Portal design; technology and learning design set-up; research design; user test of portal and technology; 2) Trial of technology; learning design and initial research results; design of pilot at scale; 3) Scaling trial to key areas; validating results research; 4) Validating technology/learning design and roll-out plan; 5) Established service.