Virtual patients help boost safety and quality care in medicine
Credit to Author: Pamela Fayerman| Date: Sun, 01 Dec 2019 19:53:55 +0000
No humans are harmed in the medical training invented by Dr. Karim Qayumi and his team of CyberPatient developers.
The interactive software technology developed in Vancouver is designed to let medical students make mistakes on computer-generated “patients” and is intended to fill gaps in medical learning by offering virtual patients that mimic medical scenarios, just as flight simulators teach pilots.
The multimedia software offers a slew of symptoms and diseases to diagnose, and some “patients” even need immediate surgery. Medical learners using the technology are instantly corrected when they use their computer mouses to select, for example, the wrong scalpels in the surgery-simulation scenarios. Or make bad surgical cuts, in the wrong order or the wrong places.
Errors, even those that would theoretically kill patients through poor diagnostics, prescribing or treatment selections, are intended not to humiliate medical school and physician users but to prevent them from making medical mistakes in real life. In simulation, mistakes can easily be fixed by clicking the computer mouse on another selection.
Now ready for use by medical schools and hospitals around the world, the technology Qayumi is unveiling has been many years in the making. In 2002, the first iteration of CyberPatient that he and UBC patented was a bit before its time and limited to abdominal problems whereas the latest version has about 120 diverse cases. In the first prototype, built by Qayumi’s son, Tarique when he was a UBC student, bandwidth was inadequate and internet speed was too slow, Qayumi says, “so we waited 15 years for the technology to catch up with the idea.”
Qayumi, a UBC surgery professor and now-retired cardiovascular surgeon, says the online medical training tool could revolutionize medical learning, patient care quality and safety assessments. “It’s all about making safer environments for patients but it also has the ability to reduce the costs of health care,” he said, explaining there are cost-effectiveness measures built into the program so that if a user selects an approach to an illness that is more costly than an equally effective intervention, they will be prompted to consider a lower-cost approach.
Dr. Karim Qayumi demonstrates a web-based program that allows doctors to hone their skills on animated patients in a virtual world.
Qayumi, founder of the UBC Centre of Excellence for Simulation Education and Innovation, said it cost about $1.3 million to create CyberPatient with plenty of help from the Centre for Digital Media, and grants from agencies like the National Research Council and the Industrial Research Assistance Program. It will sell to subscribers for $150 a user per year. Medical faculties will get bulk buying discounts; UBC and Vancouver General Hospital will earn royalties.
“As a UBC professor, whatever I do, whatever I dream about, is intellectual property that belongs to UBC,” he said, adding that the technology has been licensed to Interactive Health International (IHI) a Vancouver startup of which Qayumi is CEO-president.
Qayumi, who immigrated to Canada from Afghanistan in the early 1980s, said developing countries will pay nothing under a corporate social responsibility program. He is already in discussions with medical schools in various African countries like Ethiopia and Sudan to offer CyberPatient at no cost through IHI’s non-profit affiliate, CanHealth International.
“It’s difficult for students in some countries to attain the level of education that we have here so I feel we have this obligation to share our knowledge and technology and UBC has been very supportive of this,” he said.
Medical education approaches are always evolving but Qayumi said textbook learning, along with lectures and simulation mannequins that breathe, bleed, blink and even give birth, are all fundamental components that can be augmented with innovative computer-based learning guides. Medical schools have, for many years, also hired actors to feign symptoms so medical students can practise doing patient histories and examinations.
Rachel Zhao, a first-year medical student at UBC, said that last summer before medical school began, she participated in a study that compared CyberPatient software to actors. She was first randomized to the technology arm of the study and then students switched to practise on actors. Assessors were in the room observing each student.
“I’ve always been interested in technology. I found the cyber program was helpful. It made me feel more confident the second time around with the actors and helped make sense of why we ask the questions we do. The limitation is obvious that these are not real patients. The tone of voice of the computer-generated patients is flat and uniform and there’s no sense of urgency, but with the actors, they are encouraged to use facial expressions and their voice changes to describe things like pain.”
Second-year UBC medical student Hannah Kapur said the online platform of CyberPatient is easy to use and the simulation-style training “will help reduce anxiety when (students) get to the hospitals.”
Computer-guided medical education, $200,000 simulation mannequins, and artificial intelligence have all been demonstrated to help medical learners develop the skills they need before they step into clinics and hospitals. Study results on the comparison between CyberPatient and actors haven’t been published yet since research only recently was completed, but Qayumi said he is confident the results will be impressive.
Twitter: @MedicineMatters