Some studies say more than $200 billion are spent on unnecessary tests, treatments and procedures in health care annually. There are a variety of reasons for these high costs, including habit, financial incentives and fear of missing a diagnosis. Over the years, hospital systems nationally have been looking at ways to reduce these costs.
At the Jump Trading Simulation & Education Center, it all begins with education. In partnership with the University of Illinois College of Medicine Peoria (UICOMP), faculty from the school as well as OSF HealthCare have developed a high value care curriculum. The goal is to teach medical students and residents to consider the costs and risks of unnecessary diagnostic testing, and how to make better use of resources so that they provide real value for the patient.
Some of this education takes place in the classroom. But much of the learning application happens during simulation where learners can practice interviewing patients and giving physical examinations to make better decisions on testing, diagnosis and treatment. These simulations typically include the use of standardized participants acting as patients. Now, Jump is exploring the use of virtual standardized participants, so that students can practice any time and at any place.
Testing the virtual SP software
With a Dean’s Award from UICOMP, Jump is researching the effectiveness of using virtual standardized participant software to teach medical students and residents about high value care principles. The software allows learners to interact with virtual standardized participants from their computers instead of coming into Jump to participate in on-site simulations.
Using the software, learners are given a virtual patient along with some preliminary information like vitals and nurse’s notes. They type in a greeting and ask how the individual is; the virtual patient responds verbally with any complaints.
From there, students can ask questions about their patient’s symptoms, when their pain started and anything else that can help determine a diagnosis. They next perform a physical exam and receive a report on any physical findings. Students can then select their likely diagnosis.
After the virtual simulation, learners receive feedback on how they performed, how they did choosing the most likely diagnosis and treatment and the costs associated with their decisions. So far, about 50 residents and 120 medical students have had the chance to interact with virtual standardized participants and have given their feedback about the software.
Preliminary results show a correlation between learner performances in the virtual patient simulations and the high value care in-training exam. However, we also received feedback that more work needs to be done to enhance the abilities of the virtual patients.
If the software can be improved and tested again with successful results, the plan is to integrate virtual patients into high value curriculum. While there is an upfront investment of time and resources to develop virtual patients, we believe there are many advantages to using this technology. This includes the potential to decrease faculty time, and giving students the ability to repeat cases on their own time—ensuring confidence in their decision-making abilities.