Use of virtual medical cases as a learning tool in medicine

ABSTRACT

Diagnostics-related errors made by medical students represent a considerable issue for the field, as they very often have negative consequences that reduce learning effectiveness. This study proposes a means of ameliorating problems with diagnostic reasoning and improving the learning process. The description of a virtual case, containing necessary information, is used within a knowledge-based system for evaluation of medical students’ diagnostic abilities. This system is grounded in a branch-oriented model, where every decision reveals part of the information about the patient in each iteration, depending on the diagnostician`s choice, which supports evaluation of the flow of students’ thoughts. By fostering the acquisition of “negative knowledge” about typical cognitive errors in the medical reasoning process, the system helps eliminate learners` errors specific to any type of situation that the system might be set up to address in any given case. Descriptions of teachers’ inputs, the process model, the evaluation procedure for student’s performance, and a method for configuring virtual patient cases are provided. Apart from the accuracy of the diagnosis, other aspects such as patients’ comfort and the cost of the diagnosis are also taken into consideration when evaluating students’ diagnostic process.

KEYWORDS:

• Diagnostic education
• diagnostic errors
• medical training
• virtual patient record
• knowledge modelling

Acknowledgements

The support of FIM UHK Excellence project “Decision Support Systems: Principles and Applications 2” is gratefully acknowledged.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Vladimír Bureš

Vladimír Bureš received his bachelor degree in Financial Management (1999), master degree in Information Management (2001) and PhD. in Information and Knowledge Management (2005) at the University of Hradec Králové, Czech Republic. Currently, he holds the position of an associate professor at the Department of Information Technologies. He has already published five books (as author or a member of the authoring team) and tens of scientific papers published at several journals or in conference proceedings. He has attended both international and national research projects (e.g. 6th or 7th European Framework Program projects). In his research, he focuses on system dynamics, knowledge management, systems theory and application of ICT in areas such as education or business administration. He is a member of the System Dynamics Society or the International Council on Systems Engineering.

Pavel Čech

Pavel Čech received his Ph.D. degree in information and knowledge management at Faculty of Informatics and Management, University Hradec Kralove, Czech Republic. Since 2003 he is an assistant professor at the Department of Information Technologies at Faculty of Informatics and Management, University Hradec Kralove. Currently, his research is focused on data analysis and matching complex graph-based structures. He has been also working for the Faculty of Military Health Sciences, University of Defense on a research proposal titled Information support of crises management in health care. He was responsible for designing and implementing knowledge-based technologies as a decision support in an event of bio-chemical incident. He has been participating on several projects funded by EU Framework IST Programme focused on enhanced learning methods and techniques. He has been co-chair for a number of conferences on intelligent environments and has been organizing various other academic events.

Martina Husáková

Martina Husáková is an assistant professor at the University of Hradec Králové – Faculty of Informatics and Management. She specializes in ontological engineering, semantic web technologies, bioinformatics and development of multi-agent-based conceptual and simulation models. She teaches a subject named Ontologies and Semantic Web, Autonomous Systems, Introduction into the Object-Oriented Modelling and Technologies for Web Publishing. She is the author of the monograph focusing on the conceptual modelling of knowledge in immunology – Conceptual Modelling in Computational Immunology, Tomas Bruckner Publishing.

Zdeněk Kokštein

Zdeněk Kokštein is an employee of the University hospital in Hradec Králové and the Medical Faculty in Hradec Králové, Charles University, Czech Republic, and holds position of an associate professor. He also serves as the Deputy Head of Teaching at the Paediatric clinic. He is a member of the study programme committee for Paediatrics. He has already published more than 40 research studies in which he focuses on a broad spectrum of issues related to neonatal care.

Pavel Kříž

Pavel Kriz is a lecturer and researcher at the University of Hradec Kralove, Faculty of Informatics and Management (Czech Republic). His work covers the field of technology and computer science. His research specialties focus on programming languages, object modelling, databases, web applications, mobile applications and learning, learning management systems, indoor localization, location-based services and wireless networks. He has published studies in Mobile Information Systems impact journal, Journal of Telecommunication, Journal of Computer Networks and Communications and Lecture Notes in Computer Science series. He is also recognized as reviewer in the field of indoor localization and mobile systems.

Kateřina Krylová

Kateřina Krylová is currently working at the Department of Pediatrics at the Faculty of Medicine in Hradec Králové, Charles University, Czech Republic. She received her PhD in 2019 with the dissertation thesis focused on Thyroid gland in newborns. In relation to this topic, her research papers deal with thyroid or urinary iodine concentration.

Tomáš Nacházel

Tomas Nacházel is currently a Ph.D. student and lector in the Faculty of Informatics and Management at the University of Hradec Králové. His research interests focus on agent-based models, where he deals with agents' artificial intelligence and evolutionary development. Besides virtual economics models, he develops an artificial life model, which serves as a platform for experiments with his new approaches to artificial intelligence, evolution, and optimization in large-scale models.

Daniela Ponce

Daniela Ponce is an Assistant Professor in the Department of Information Technologies at the University of Hradec Králové, Czech Republic. She received her Ph.D. in Economic Informatics from Economic University in Bratislava, Slovakia. Her current research interests include knowledge modelling, knowledge engineering, and multicriteria decision-making models. She has published papers in high-impact journals such as Information Sciences, Plos One, Fuzzy sets and systems or PeerJ.

Petra Poulová

Petra Poulová is a vice-dean of the Faculty of Informatics and Management at the University of Hradec Kralove and the chairman of the Board Technological Centre of Hradec Kralove. She received her PhD in Educational Science from Charles University, Prague, and associate professor in Systems Engineering and Informatics from the University of Hradec Kralove, Czech Republic. Her research interests include IT in teaching and learning or database and information systems. She has published over 120 referred journal articles, book chapters and conference papers.

Aleš Ryška

Aleš Ryška graduated at the Charles University, Medical Faculty in Hradec Králové (MD – 1994), Ph.D. in pathology (2001), board certification in pathology (2000). He is working at the Fingerland Department of Pathology, Charles University Medical Faculty in Hradec Králové, Czech Republic (full professor of pathology since 2007). Currently, he is the head of the department. He is a member of several scientific societies and editorial boards (e.g. International Academy of Pathology – Czech Division – president, European Society of Pathology – president elect, or Editorial board Virchows Archiv – Associate Editor). His professional interest aims at diagnostics of lesions of the breast, thyroid and salivary glands, as well as in predictive pathology and quality control in pathology. He has been a principal investigator and co-investigator of 16 research projects. Professor Ryška is an uthor and co-author of 175 full-text articles in peer-reviewed journals and of multiple book chapters. He was an invited speaker at multiple national and international meetings (Germany, Brazil, Hungary, Portugal, Romania, Serbia, Slovenia, Croatia, Austria, Australia, Poland, Macedonia, Ireland, Bulgaria, Spain, Netherlands, UK, USA).

Ilja Tachecí

Ilja Tachecí graduated at the Charles University, Medical Faculty in Hradec Králové (MD – 1999), Ph.D. in internal medicine (2010), board certification in internal medicine (2002) and gastroenterology (2006). Working at the 2nd Dpt. of Internal Medicine – Gastroenterology, Charles University Medical Faculty in Hradec Králové, Czech Republic (Associate Professor of internal medicine since 2018). Currently, he serves as a deputy head of the department. He is a member of several scientific societies and editorial boards (e.g. Czech Society of Gastroenterology – scientific secretary, or Editorial board of the World Journal of Gastrointestinal Endoscopy). His professional interest comprises therapeutical gastrointestinal endoscopy including ESD, POEM and NOTES techniques and small bowel diagnostics. He has been a principal investigator and co-investigator of seven research projects. Associate professor Tachecí is an author and co-author of 100 full-text articles in peer-reviewed journals and of multiple book chapters.

Petr Tučník

Petr Tučník is an assistant professor and a senior lecturer (since 2011) at the University of Hradec Kralove, Department of Information Technologies, where he has been a faculty member since 2006. Dr. Tucnik completed his Ph.D. in “Systems Engineering and Informatics” at the University of Hradec Kralove. Title of his Ph.D. Thesis was “Selected Problems of Design of Automated Trading Systems for Commodity Trading”. His undergraduate studies were completed at Silesian University in Opava with Master Thesis “Intelligence and Cognitive Processes of Multicriterial Decision-making in Multiagent Systems”. His research interests lie in the areas of autonomous systems (multi-agent systems), futures trading, business processes and modelling, and ambient intelligence. He has experience with numerous research projects both as a team member and principal investigator. He is a reviewer of several international journals (e.g. Expert Systems with Applications) and member of programme committees of various conferences (e.g. KEOD since 2016).

Marek Zanker

Marek Zanker is a Ph.D. student of Information and Knowledge Management at the Faculty of Informatics and Management, University of Hradec Králové, Czech Republic. He deals with development of system dynamics models in various domains. He also focused on the complex network analysis and application of systems thinking in managerial practice.