Design Patterns in Casebased Education

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Design Patterns in Case-based Education Rachel
Ellaway, David Topps, Richard Witham, Alexia
PreselloNorthern Ontario School of Medicine
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Design Patterns

• Design patterns descriptions, templates or
  arrangements of components that can used and
  reused in larger designs
• Origins in computer science (OO)
• Pattern vocabularies, syntax, style
• Pattern metaphors, similes, narratives
• DPs in education lecture, PBL, MCQ, OSCE
• Educational DPs learning design and Learning
  Design

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Case

• case narrative is the primary, vicarious means
  of shaping clinical judgment for new learners and
  experienced practitioners alike

Montgomery, K. (2006). How Doctors Think
clinical judgment and the practice of medicine.
New York, Oxford University Press
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Case Based Education

• Circumscribed set of events and actions around a
  patient presentation
• Problem based learning McMaster/Maastricht/Calga
  ry
• Variants inc NOSM case-based learning
• Case-based assessment KFQ, long and short cases
• CBE patterns physician identities, research,
  problem solving, group work, non-subject-expert
  facilitation, higher Miller competencies

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Virtual Patients Artificial patients physiology
simulators (human physionome) Real patients
reflected in data - electronic patient records
(EPRs) Physical simulators, mannequins,
models Simulated patients (actors,
role-play) Electronic case-studies and scenarios
an interactive computer simulation of
real-life clinical scenarios for the purpose of
medical training, education, or assessment
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• Inukshuk
• 60 VPs with Canadian flavour
• Creative commons
• NOSM, Laurentian, Confederation, Ryerson,
  McMaster
• Medicine, nursing, midwifery, interprofessional
  topics
• Midnight train rides
• Hiking
• Snow shovelling
• Porcupines
• 100 authors working in OpenLabyrinth

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VPs everywhere

• Integrated Distributed Educational Applications
  of Simulation IDEAS
• HSVO integration with SimMan and others
• VERSE integration with Second Life
• Phase III MD exam
• Others Calgary UG expansion, Univ London,
  Edinburgh
• All using OpenLabyrinth lots of
  examples/samples
• Parallel work in eViP (MT Special Edition in the
  fall)

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OpenLabyrinth
Nodes, links, media Tracking, counters,
rules Feedback, consequence Strategy,
conditional Random, avatars
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Identifying Pattern
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VP Pattern Types

• Topological
• Procedural
• Educational
• Narrative
• Game
• Feedback
• Consequence
• Challenge
• Role

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Topologies Flat case - PBL Linear railroad
tracks interactive - 90s CALs Episodic strings
of pearls - open choice of actions and
interactions within prescribed stages -
WebSP Branching choose your own adventure -
decisions and consequences - OpenLabyrinth Virtual
worlds SecondLife
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• Procedural, Educational, Narrative
• classic HEIDR path history, examine,
  investigate, diagnose treat
• individual Hx, Ex , DDx , Ix , Dx , Rx episodes
• decision trees structured (guidelines,
  protocols)
• free-form (mazes and puzzles)
• 24 - parallel story lines
• catharsis fixing a problem from the past
• the problem colleague
• detective - what really happened? what went
  wrong/right?
• expose/explore knowledgebase
• assess vs teach

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Game Patterns

• Win
• Improve
• Compete
• Strategize
• Rules and boundaries
• Levels
• Realworld paradigms, clichés and metaphors
• Solve (puzzle)
• Different roles/perspectives
• FPS, NPCs, string of pearls

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Metrics Patterns

• Reaching end point(s)
• Time taken
• Number of steps taken, steps/areas visited or
  avoided, sequence of steps
• Patient model survival, pulse, BP
• Professional model DDx, Rx
• Other counters (keys, strength, chance factors)
• Confidence of decision
• Aggregate/function of some or all of the above

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OL metrics (time and sequence)
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OL metrics (counters and sequence)
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Analysing Pattern

• Authoring
• Structural analyses graph theory, cyclometric
  flow, interaction density,
• Semantic analyses content, cognitive load
• Execution analyses path coherence, metrics
• Professional analyses relation to guidelines,
  personal expert validation, domain reflection
• !Game theory not games of chance or competition
• !Bayesian networks causal probabilities derived
  from previous patterns of execution

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Applications of Pattern

• Common thematic activity across a number of NOSM
  education informatics research projects
• Authoring templates, wizards, libraries
• Modeling behavior (formative)
• Modeling behavior (summative)
• Validation
• Auditing and validating practice and underlying
  models
• Procedural, cultural and cognitive dimensions of
  practice

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ePBL in virtual worlds
Nossum
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Four Experiments and a Funeral

• Virtuous cycle of VP development
• Design pattern analysis and application
• Lateral correlation and validation
• Towards a network-based science of games,
  instruction and learning
• End of learning activity innocence?

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Thank you