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9а также усилении мотивации учебно-познавательной деятельности к получению знаний;
3) должна осуществляться организация активного взаимодействия трех субъектов профессиональной подготовки морских специалистов, а именно: учебного заведения (преподавателя) - студента как будущего специалиста - информационно-технологической образовательной среды;
4) в морском ВНЗ должно обеспечиваться благоприятное поле педагогических возможностей для формирования профессионального опыта будущего морского специалиста как личностно значимого;
5) в процессе профессиональной подготовки будущих морских специалистов должна быть реализована интеграция традиционных средств обучения и новых (информационных, дистанционных) как главных факторов повышения интенсивности и результативности учебного процесса, а также разнообразие форм, методов и средств профессиональной подготовки будущих морских специалистов в условиях информационно-технологического образовательной среды.
Таким образом, реализация выделенных нами условий должна обеспечить повышение эффективности профессиональной подготовки будущих морских специалистов с использованием избыточной информационно-технологического образовательной среды, включающей разнообразные средства образовательных технологий, информационно-
коммуникационных средств, тренажеры и современные технические средства обучения.
Список литературы
1. Дорожкин Е.М., Зеер Э.Ф.. Методология профессионально-педагогического образования: Теория и практика (теоретико-методологические основания профессионально-педагогического образования). Образование и наука. 2014. №. 9 (118). - С. 4-20.
2. Мойсеенко С.С. Социально-педагогические условия продолженного профессионального образования морских инженеров : дис. ... д-ра пед. наук : 13.00.08. Калининград, 2004. - 337 с.
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4. Огуй С.В. Методолопчш основи фор-мування оргашзацшно-методично1 компетентносп майбутшх фахiвцiв сфери обслуговування. Вюник КрНУ iменi Михайла Остроградського. 2019. Вип. 3 (116). - С. 58-63.
5. Осадчий В.В. Система шформацшно-техно-лопчного забезпечення професшно1 шдготовки майбутшх учителiв в умовах педагопчного ушвер-ситету : дис. ... д-ра пед.. наук : 13.00.04. Вшниця, 2013. - 573 с.
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VIRTUAL PATIENTS AS COMPONENT OF PROBLEM-BASED LEARNING ON THE BASE OF E-LEARNING TECHNOLOGIES AT MEDICAL EDUCATIONAL PROCESS
Garas M.
PhD, Associate Professor of the Department of Pediatrics and Pediatric Infectious Diseases,
Higher State Educational Establishment of Ukraine "Bukovinian State Medical University"
Abstract
The article describes the international experience of implementing the case method and virtual patient scenarios during problem-oriented training using electronic technologies. Models, forms and benefits of scenarios of virtual patients in the educational process of medical students are presented.
Keywords: problem-based learning, case method, virtual patients, medical education.
Problem-based learning (PBL) has been widely adopted as a way of integrating knowledge acquisition, teamwork, and problem-solving skills using active learning techniques within small-group settings [1]. However, PBL has remained relatively unchanged since it was introduced with paper cases — the principal medium around which PBL activities are organized. Even the use of the Internet has, at least so far, had limited impact on the design of the PBL case or the activities that are structured around it [2].
There are a number of educational technologies that share certain characteristics with PBL [2]. E-learn-ing is the use of Internet technologies to enhance knowledge and performance. E-learning technologies offer learners control over content, learning sequence, pace of learning, time, and often media, allowing them to tailor their experiences to meet their personal learning objectives. In diverse medical education contexts,
e-learning appears to be at least as effective as traditional instructor-led methods such as lectures. Students do not see e-learning as replacing traditional instructor-led training but as a complement to it, forming part of a blended-learning strategy. A developing infrastructure to support e-learning within medical education includes repositories, digital libraries, or virtual environments. Innovations in e-learning technologies point toward a revolution in education, allowing learning to be individualized (adaptive learning), enhancing learners' interactions with others (collaborative learning), and transforming the role of the teacher. The integration of e-learning into medical education can catalyze the shift toward applying adult learning theory, where educators will no longer serve mainly as the distributors of content, but will become more involved as facilitators of learning and assessors of competency [3].
Using e-learning to present case studies of PBL has been the key to creating virtual patient scenarios as
a educational technologies that share PBL. For instance, virtual patients are on-screen learning resources that typically present a clinical problem for learners to solve or manage, and in doing so involve aspects of both PBL and simulation [4]. A key limitation of using paper-based cases is that they can only unfold in a single direction giving learners little or no opportunity to influence the outcome of the case. There are other teaching modalities in medical education that employ cases, including simulation, case-based learning, and virtual patients, reflecting the role of the patient case as "the primary, vicarious means of shaping clinical judgment for new learners and experienced practitioners alike" [2].
Virtual patients are interactive online tools that present learners with simulated patient encounters [5]. They are used in a range of contemporary medical educational settings, including small-group learning, lectures, self-directed learning, and assessment [1, 4], as well as in other disciplines such as nursing [6] and primary care [7]. Virtual patients are generally Web-based which allows for a wide range of resources, such as multimedia or multiple-choice questions, to be included in their design. The use of virtual patients has been linked to the development of learners' clinical reasoning skills by allowing them to be active participants in a clinical situation, interpreting the available information, and making decisions based on what they know [8].
Today the concept of virtual patients combines science, advanced computer technology and innovative game-based learning. Technology of teaching based on virtual patients built on the role principle, according to which the student feels in the place of the doctor, sees the consequences of making their decisions (regarding the diagnosis and algorithm of treatment of the patient), and is also responsible for the consequences of their actions. The reality of the professional situation creates a special emotional atmosphere that promotes learning material and improves the quality of learning [2, 3].
The design of virtual patients generally follows 1 of 2 models: linear or branching [9]. Branching virtual patients are based on a decision tree that allows learners to make decisions at selected option points, thereby changing their path through the case. In contrast, learner interactions with linear virtual patients do not change the narrative of the scenario. Different paths can have different consequences, which can help learners to develop their clinical reasoning skills in ways that are safe, structured, and rich in feedback and instruction. Research into the effective use of simulation for learning has identified the benefits of feedback and repetitive practice [2, 10-11]. Virtual patients are a form of simulation and many of these factors have been used to guide their design [12]. Low-fidelity simulations, such as virtual patients, have a number of advantages over high-fidelity mannequin-based simulations. For instance, they are cheaper to produce and deploy and can (by being Web-based) be scaled to larger numbers of concurrent users. Indeed, Norman et al [13] argue that there is little educational advantage in using high-fidelity simulations over lower fidelity solutions, whereas Maran and Glavin [14] make a distinction between "engineering fidelity" and "psychological fidelity." Low-fidelity simulations, such as virtual patients, arguably have a low level of engineering fidelity (ie, the degree
to which the physical characteristics of the task are represented) that can reduce their cost without reducing their psychological fidelity (ie, the degree to which skills of the task are captured by the simulation) [8].
The general criteria for selecting problem-oriented situations in creating virtual patient scenarios could be the following:
- existence of objective reality problem, which is important for students in terms of professional orientation or their life experience;
- lack of completeness of information to solve the problem presented in the situation, which necessitates the search for additional information;
- contradiction of the problem, which implies different perspectives on its solution, different approaches;
- the possibility of its decision taking into account the level of students' readiness, their knowledge of the subject area, related areas, possessing relevant intellectual skills;
- the possibility of forecasting the further development of the situation [13].
Virtual patients have been used for many years. Paper-based cases and patients have been used for many years and certainly since the explosive growth of the web in the '90s the use of virtual patients has spread into many areas of healthcare delivery and education. Performing a web search on 'virtual patients' will find three distinct forms of virtual patient applications: research, electronic Patient records and education. As an educational technology a patient case or presentation is used for educational purposes allowing students to work with real world problems and scenarios. Virtual patients for education are often hypothecated and designed to address particular topics or educational objectives and they are the key component of the PBL approaches exemplified by Universities such as McMas-ter or Maastricht.
A virtual patient therefore is a set of data that describes an individual as a patient (i.e., the subject of some kind of healthcare activity). This may be data about a real patient, a hypothecated patient or some combination of the two. The concept of virtuality is based on the patient being modeled in data rather than as an embodied entity. The concept of 'virtual case' is often interchangeable with that of virtual patient in healthcare although a case is in fact a slightly broader concept. A case may involve several individuals and outside medicine it has a number of domain-specific meanings, for instance in law, engineering and sociology. One particular aspect therefore about cases is that they include the context of a scenario as well as its subject.
There are many different ways that a virtual patient may be used in an educational setting. For instance, the role of the learner may take many forms with respect to the patient: the student may take the role of the physician, the patient (or their family or friends), a third-party observer, a tutor, another participant in the healthcare process or any other active or passive role in the scenario. The learner may be acting independently, or under the guidance of a tutor or instructor, or in a collaborative setting with their peers. If there is any amount of longitudinal activity then different combinations of all three may be involved [9].
The virtual patient/case learning process may be set up to take many different and distinctive forms:
- the learner may progress through a predetermined scenario where each step is predetermined and interaction prescribed (directed mode);
- the learner may start from scratch with a first patient presentation clerking their patient and building up the patient or case data from observations and interactions with the scenario or patient (blank mode);
- the learner may view and appraise or review an existing patient or scenario. For instance this may be as an example of good (or bad) patient management in a case conference (critique mode) or as a means to rehearse skills such as diagnosis or prescription (rehearsal mode);
- the learner may use a case or patient as a mechanism to address particular topics. For instance the patient may be a means to present scientific topics, particular clinical skills or management issues. In this situation the case or patient is the secondary medium rather than the primary substance of the activity (context mode);
- the learner may use a scenario or patient to explore personal/professional aspects of the patient-doctor relationship. In this situation the case is intended to promote and guide reflective thinking regarding issues such as conduct, communication and ethics (reflective mode);
- the banks of patients or scenarios may collectively address broad issues of healthcare such as patient management, clinical governance or public health (pattern mode).
The virtual patient/case learning process may be naturalistic or formalized. For instance a case activity that was set up to deal with issues of communication would be concerned with the naturalistic nuances of a consultation whereas one that was set up to address issues of diagnostic pathways would consider the formal evidence and decision aspects of the same consultation [9].
Problem-based learning is an innovative educational technology, launched in medical education with a number of benefits, which allows it to be recommended for wider implementation in medical universities, especially at the stage of higher education reforming.
«Virtual Patient» is an innovative interactive learning technology that allows medical students to fully immerse themselves in the diagnostic and therapeutic process with the help of a computer model of a real clinical situation, to take independent decisions from the diagnostic and treatment tactics, to see and understand the consequences of their decisions, without violating the patient's rights and safety.
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