by Andrzej Kononowicz, Jagellonian University, Krakow
In February 2023, when parts of Europe were still covered with a thick layer of snow, Andrzej Kononowicz, one of the iCoViP team members from Jagiellonian University, visited Lee Kong Chian School of Medicine in Singapore (LKCMedicine) to conduct a seminar lecture entitled: “Digital clinical reasoning education: where are we now, where should we go?”. Singapore, a city-state in South-East Asia, is located on several islands that are passed by a myriad of cargo ships. The climate characteristic for places near the equator is humid with a temperature of 30°C around the year, a pleasant change for a visitor from a country with long and cold winters.
LKCMedicine is a new medical school in Singapore, the outcome of a partnership between Nanyang Technological University and Imperial College London. The school officially opened in 2017 but admitted its first students already in 2013. The location of the university in one of the most densely populated areas in the world and the crossroad between the East and the West gives it an opportunity to be a meeting place for scientists and students from many cultures and backgrounds to improve healthcare for the well-being of patients. High among the goals of the university is excellence in medical research and the education of future healthcare professionals.
The host of the visit was professor Josip Car, who leads at LKCMedicine the Centre for Population Health Sciences (CePHaS). His research group forms one of the WHO collaborating centers for digital health education. The former joint work of Josip Car and Andrzej Kononowicz included two systematic reviews on the effectiveness of virtual patients and virtual reality. The current visit was a good opportunity to present recent developments in the field of technology-enhanced clinical reasoning education. The visit also included meetings with other experienced researchers like Professor Jennifer Cleland, Vice Dean for Education and Director of Medical Education Research at Lee Kong Chian School of Medicine, as well as Assistant Professor Lorainne Tudor Car who leads a research team in the area of Evidence-Based Medicine and is experienced in research synthesis on digital education for healthcare workforce development.
In his seminar, Andrzej Kononowicz showcased how the longitudinal blended-learning clinical reasoning curriculum produced by the DID-ACT project was extended by a collection of virtual patients for deliberate practice designed by the iCoViP project. Emphasized was the systematic development process of the international pool of virtual patients that involved the selection of cases characterized by many clinical and socio-demographic features being representative of the European population. The multi-step development workflow illustrated how complex it is to author virtual patients in an international team. Considering the former collaboration and extensive expertise in the literature review of the hosts, an important point was also to share the approach taken by the iCoViP project to produce guidelines for the integration of the virtual patient into medical curricula.
The discussion that followed the presentation was an inspiring moment for consideration of what should be the next steps and points for a potential future collaboration after the iCoViP project has ended. It was commented that even though the number of 200 cases in the collection is a remarkable achievement, it is by far less than the number of existing diseases. We discussed whether artificial intelligence could be used to help increase the number of available cases. The other questions regarded the potential of learning analytics to optimize the use of virtual patients from the collection. Finally, it was also considered how applicable this collection could be for use in South-East Asia.
Even though the short, four-day stay at LKCMedicine was filled with many exciting meetings with researchers at Nanyang Technological University, there was also a bit of time to experience Singapore and its many attractions. Unforgettable is the view of the bay with the iconic ArtScience Museum, Marina Bay Sands hotel, and Gardens by the Bay. A deeper impression of the spirit of Singapore gave a walk through the primary forest around the MacRitchie Reservoir, visits to Chinatowns and Little India districts, as well as the view from Sentosa island on the Singapore Strait. The city bay is guarded by Merlion, a mythical creature with the head of a lion and the body of a fish that is symbolic of the history and character of the city. Despite its stern look, there might also be some curiosity in the way the Merlion statue observed the visitor from Europe. We hope that the presented outcome of the iCoViP project will inspire and enhance the education and research endeavors of our welcoming hosts in Singapore.