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Time Allocation

Guiding questions:

  1. How much time should the students have for VPs activities?
  2. Should time for VPs be regulated at all?

The problem of time allocation is interconnected with all the previous themes. The literature strongly recommends that students should have adequate time allocated to work on VPs, because this is an overall important aspect when integrating e-learning into the curriculum [Edelbring 2011, Hege 2007]. In this section, we will discuss what can be considered an “adequate” time.

Generally, the time used for case completion will be dependent on the type of learning objectives (e.g. emergency medicine may need different time allocation than psychiatry), but also on the stage of the study programme (more time will be needed in the beginning of the curriculum and less towards the end). Some research indicates that time used for interacting with the system varies a lot, the majority of students access the system the day before a seminar and SP/VPs encounter, and just a few went beyond specified minimum requirements [Hirumi 2016]. If a VPs panel is used with a few clinical cases to be solved, tutors should recommend the students not to accumulate work on the last day before the deadline, but divide it equally in time. 

According to the literature, students appreciate dedicated time for self-study with VPs as they can work at their own pace with each case [Huwendiek 2013, Radon 2011]. Despite some of the VPs being designed to be completed within 45 min  (one academic hour), a wide range of time spent on working on the cases was observed. In the study by Dahri et al. (2019), year 3 students perceived 60 min of time to be inadequate and year 1 and 2 indicated 90 min allocated for the case work to be adequate [Dahri 2019]. On the other hand, students during clerkships spent 15-20 hours, completing around 20 cases [Berman 2011]. If you would like to assess how much time students spend on each case, learning analytics can be used.

Time will play an important role also during the exams. Students who took the exams on a VP without time constraints used approximately twice as much time as students with the time limit. This first group utilized half as many inquiries of the patient history, physical examination, and lab/imaging tests than were used by students from a second group, indicating that the time-constrained students used a ‘shotgun approach’ to try to collect as many ‘required’ inquiries as possible. Interestingly, in terms of obtaining the correct diagnosis, the majority of the students (91%) who took the untimed exam were successful, but of those with the time limit, only one-third (31%) correctly diagnosed the VP exam case, despite their higher number of queries [Gunning 2012].

When preparing to incorporate such activities like VPs into the teaching, it is crucial to consider also how much time and effort faculty need to invest to support a case-based course and whether this is feasible [Hege 2007, Nagji 2020]. Students would like to get feedback on their performance which often cannot be completely automated. The curricula with VPs have to be updated and modified, and this may take a substantial amount of teachers’ time that should be rewarded [Radon 2011].

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