VP Orientation & Training
- Why is faculty development on the use of virtual patients (VPs) needed?
- How to buy-in staff to participate in faculty development?
- How to effectively train faculty in using VPs?
The reviewed literature is unanimous in the recommendation that faculty development is a crucial factor in a successful curricular implementation of VPs (e.g., [Berman 2009, Haag 2010, Kleinheksel 2017]). It is in general true that each curriculum renewal requires faculty development [Kulasegaram 2018], but we can also give more specific reasons to justify that for VP faculty training. Contemporary teachers have seen in their lives thousands of lectures, but just a handful of VPs (if any at all) [Posel 2012]. Sometimes these are not the technical skills that are lacking. For instance, Dafli et al. 2019 showed in her study that the majority of surveyed teachers (~80%) felt their IT skills were sufficient to author VPs [Dafli 2019]. The point is that the teachers should also know the learning activities around the VPs and how to assess and provide the students with feedback based on those activities. Teachers sometimes blame the new method for the educational failure, whereas the problem lies in their lack of proficiency in the application of the method [Nordquist 2012]. Lack of a sufficient number of adequately trained tutors makes many VP implementation scenarios infeasible [Hege 2007].
Teachers are often reluctant to participate in faculty development activities giving many reasons [Sudacka 2021]. The success depends on finding a good buy-in for the teachers’ participation [Kulasegaram 2018]. Top-down methods require that educators feel that their effort in developing their teaching skills will be acknowledged by their supervisors [Posel 2012]. This can be achieved for instance by awarding them with additional credit points or certificates recognized in their evaluation. Faculty can be also motivated by their students who expect their teachers to be familiar with the VPs integrated in the curriculum [Huwendiek 2013] and may express this in negative teacher evaluation. Academic teachers are often also researchers, so they expect to be presented with some evidence that the new method works [Nordquist 2012, Posel 2012]. Finally, it is motivational for teachers to participate in faculty development if the courses are tailored to their individual needs (“learner-centered” faculty development) [Kulasegaram 2018].
There is only limited research published so far on how to effectively train faculty in using VPs. Teachers are often highly experienced in their medical fields, but when it comes to the use of new educational methods like VPs, they shift from experts to novices which makes them feel insecure [Nordquist 2012]. Therefore, their clinical experience should be acknowledged in the training and it also helps when the facilitators who conduct faculty development courses are valued in the local setting [Gillham 2015]. Since teachers are often very busy and complain about lack of time for faculty development, it is recommended to offer them a spectrum of short courses that target particular skills from which they can select those that meet their particular task in the curriculum (e.g. case author, small-group facilitator, assessor). This will also give them the possibility to effectively refresh their skills when needed [Kulasegaram 2018]. Teachers also have their preferences regarding the faculty development method: e.g. some prefer face-to-face workshops close to their workplace, webinars in the evenings, or e-learning modules that need to be accommodated [Kulasegaram 2018]. An international collaboration of teachers from Scotland and Malawi demonstrated a successful curricular implementation of VPs with faculty development as the key enabling factor [Dewhurst 2009]. It consisted of a series of three closely supervised workshops in which faculty members first developed VPs in small groups. Next, they discussed how to implement those in their teaching. Less formal approaches to faculty development involve building communities of practice where the teachers can post messages when instant feedback is needed [Steinert 2021].
We should always remember that the technology behind VPs is just one of many factors when implementing them in curriculum. The success of implementation often hinges on human factors. Teachers are the key stakeholders that need to be convinced on the utility of VPs and adequately prepared. Faculty development events are a good opportunity to do that.
- Is user training on the technology/pedagogy of VPs necessary and if so how should it be performed?
To successfully implement a new learning activity or a tool into the curriculum it is important to identify, discuss, and reflect on both students’ and faculty’s expectations and preconceived notions [Nordquist 2012]. Guiding students on the VPs prior to the encounter is necessary and may have a direct positive effect on perceived learning [Berman 2009, Nordquist 2012]. Moreover, as some students may struggle with the technology associated with VPs learning platforms, it is vital to guide them through those systems, to avoid distraction from the actual learning experience [Naumann 2016].
Familiarization with the VP system and with the concept of VPs should take place upon the first exposure to the cases, for instance with use of an introductory presentation. During initial demonstration of the system, students can be given a patient monitoring form to aid the systematic collection and processing of information or tutor instructions [Dahri 2019, Hirumi 2016]. Orientation and training on VPs can also be done as near-peer teaching (i.e. postgraduate trainees) allowing active engagement of both parties [Kulasegaram 2018].
What also might be helpful during orientation process, is to use the student information system, online platforms or course handbooks, to post requirements, instructions (written or video tutorials) or send reminders about the due assignments [Hirumi 2016, Nasir 2017]. Students find it very important to know how the VPs were integrated in the curriculum and aligned with other educational activities. Hand-outs and/or an online timetable, with links to related VPs could be very helpful [Huwendiek 2013].