1. Integrating two distinct Virtual Patient systems: Identifying challenges and the role of the MedBiquitous Virtual Patient standard Luke Woodham 1, Matthew Cownie 2, John Wright 2, Sheetal Kavia 1 1 St George's, University of London, 2 University of the West of England

2. A Post-PC World in Education Learners increasingly demand access to learning resources in a way that fits in with their own learning practices – In class – At home – When travelling This requires supporting a wide range of platforms and device types – web, phones, 7” tablets, 10” tablets, iOS, Android, Windows Phone, Blackberry, mobile web etc. This is expensive and time-consuming, beyond the means of most educational technology departments

3. MedAssess/MedEdCases Developed by SGUL in collaboration with iBOS Solutions MedAssess – Distributed internally for SGUL students – Staggered release of cases based around curriculum MedEdCases – Publicly available version on Apple app store – Currently includes 39 cases Available for iOS and Android devices Cases can be downloaded and played offline – no need for a permanent network connection

4. UChoose Developed by UWE Internal audience – Distributed internally for UWE students – Being incorporated into new nursing curriculum for September 2013 External audiences – General Practice – Acute Trusts Sophisticated Silverlight Case Editor Player requires Modern Web Browser (not IE 6) Player (and video) works on any Webkit compliant mobile device with continuous network connection (unless a case relies on a flash widget) Best mobile form factor is tablet

5. UChoose/MedEdCases Collaboration Aim: To allow learners to access their resources across all platforms How: By facilitating communication and transfer of case content between the two systems, ideally seamlessly so that published content can be easily pushed to both platforms. – “A standard to enable [VP] exchange across systems has the potential to scale their development and implementation across health professions education, including resource limited settings” – MedBiquitous

6. The role of the MedBiq VP Standard Designed to enable exchange across systems Both UChoose and MedEdCases were designed with knowledge of the standard – Data structures provide simple mapping of branching VP structure However: – MCQ elements less easily mappable, as not defined in the standard – Requires processing overhead of constructing XML formatting – SCORM packages designed for manual transfer, requiring human intervention

7. Collaboration Process so far Stage 1 - Formalise collaboration (NDA) – able to share and directly view each systems data structures Stage 2 - Generate a mapping from one system data store to the other directly – No need for intermediary XML mapping Stage 3 - Explore potential transfer mechanisms – Agreed SQLite for initial stages of collaboration Stage 4 - Implement and test exports to each system using SQLite Stage 5 – Consider future development plans with a view to “harmonising” the systems and data structures

9. Significant Challenges Differing ways of handling MCQs – Not covered directly by the MedBiq standard so interpreted differently Formatting of text content – ASCII or mark-up? What tags/formatting options are permitted? Media items – Supported formats, multiplicity of media items The transfer mechanism – Seamless publishing?

10. Future Work Alternative transfer mechanisms – Use of SQLite or indexedDB or OData ? We used a restricted feature schema Optional features such as mcq’s, counters, rules? Closer integration of systems – Potential to develop web APIs to allow content to be pushed between systems automatically – LTI standard for moodle/blackboard LMS’s

11. OData OData is a standardized protocol for creating and consuming data APIs. OData builds on core protocols like HTTP and commonly accepted methodologies like REST. The result is a uniform way to expose full-featured data APIs.

12. Does it translate? Does the system impact on a case’s design? Does the case author need to re-interpret parts of a case for use in the new system? The nature of the platform alters the user’s relationship and expectations of the content – Different form factor – Different interface – Different input methods – Different screen size Different activities, different affordance