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  • 1. Abdel Hai, R
    et al.
    Yassin, A
    Ahmad, MF
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Comparing an e-Learning Reproductive Health Module with Traditional Lectures at a Medical School in Egypt2010Ingår i:  , 2010Konferensbidrag (Övrigt vetenskapligt)
  • 2. Abdel Hai, R
    et al.
    Yassin, A
    Ahmad, MF
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Exploring Knowledge, Attitudes and Behaviors of Medical Students Towards Using Computer Technology in Learning2010Ingår i:  , 2010Konferensbidrag (Övrigt vetenskapligt)
  • 3. Abdelhai, Rehab
    et al.
    Yassin, Sahar
    Ahmad, Mohamad F.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    An e-learning reproductive health module to support improved student learning and interaction: a prospective interventional study at a medical school in Egypt2012Ingår i: BMC Medical Education, ISSN 1472-6920, Vol. 12, 11- s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The Public Health (PH) course at the medical college of Cairo University is based on traditional lectures. Large enrollment limits students' discussions and interactions with instructors. Aim: Evaluate students' learning outcomes as measured by improved knowledge acquisition and opinions of redesigning the Reproductive Health (RH) section of the PH course into e-learning and assessing e-course utilization. Methods: This prospective interventional study started with development of an e-learning course covering the RH section, with visual and interactive emphasis, to satisfy students' diverse learning styles. Two student groups participated in this study. The first group received traditional lecturing, while the second volunteered to enroll in the e-learning course, taking online course quizzes. Both groups answered knowledge and course evaluation questionnaires and were invited to group discussions. Additionally, the first group answered another questionnaire about reasons for non-participation. Results: Students participating in the e-learning course showed significantly better results, than those receiving traditional tutoring. Students who originally shunned the e-course expressed eagerness to access the course before the end of the academic year. Overall, students using the redesigned e-course reported better learning experiences. Conclusions: An online course with interactivities and interaction, can overcome many educational drawbacks of large enrolment classes, enhance student's learning and complement pit-falls of large enrollment traditional tutoring.

  • 4. Ahmad, Fouad
    et al.
    Ibrahim, Maha
    El-Esnawy, N
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    An e-Learning Faculty Development Course with Formative Assessment2010Ingår i: 16th Annual Sloan Consortium International Conference on Online Learning, 2010Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    An e-Learning faculty development course has been developed and taught in Egypt for the past five years. The course adopts Formative Assessment (FA) techniques to enhance participants' learning. The additional FA effort for collecting and analyzing data as well as adjusting teaching is worth investing to accommodate gaps in learning.

  • 5. Arborelius, Lotta
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Svensson, Anna-Karin
    Sygel, Kristina
    Kristiansson, Marianne
    A new interactive computer simulation system for violence risk assessment of mentally disordered violent offenders2013Ingår i: CBMH. Criminal behaviour and mental health, ISSN 0957-9664, E-ISSN 1471-2857, Vol. 23, nr 1, 30-40 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Assessment of risk of future violence has developed from reliance on static indicators towards a more dynamic approach. In the latter context, however, the offender is seldom confronted with real life situations. Aims The aim of this study is to evaluate a computer-based system Reactions on Display, which presents human interactions based on real-life situations for its effectiveness in distinguishing between potentially violent offenders with mental disorder and a healthy comparison group. Methods Male offenders with autism spectrum disorders or psychosis were recruited from specialist forensic psychiatric units in Sweden and healthy participants from the local communities. Each consenting participant was presented with film clips of a man in neutral and violent situations, which at critical moments stopped the story to ask him to predict the thoughts, feelings and actions of the actor. Results Offender patients, irrespective of diagnosis, detected fewer emotional reactions in the actor in the non-violent sequence compared with controls. When asked to choose one of four violent actions, the offender patients chose more violent actions than did the controls. They also reported fewer physical reactions in the actors when actors were being violent. There were also some examples of incongruent or deviant responses by some individual patients. Conclusions and implications for practice The use of interactive computer simulation techniques is not only generally acceptable to offender patients, but it also helps to differentiate their current response style to particular circumstances from that of healthy controls in a way that does not rely on their verbal abilities and may tap more effectively into their emotional reactions than standard verbal questions and answer approaches. This may pave the way for Reactions on Display providing a useful complement to traditional risk assessment, and a training route with respect to learning more empathic responding, thus having a role in aiding risk management.

  • 6.
    Bahati, Bernard
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Tedre, Matti
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Evode, Mukama
    Exploring feedback practices in formative assessment in Rwandan higher education: a multifaceted approach is needed2016Ingår i: International Journal of Teaching and Education, ISSN 1993-3916, Vol. IV, nr 2, 1-22 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Inspired by the current scholarship that indicates that, if used well, formative assessment and feedback can advance student’s learning, this paper explores the practices of feedback in formative assessment in Rwandan higher education, specifically at the University of Rwanda. The study used aqualitative approach with the aim of gaining lecturers’ and students’ perspectives on formative assessment and feedback; and exploring different ways formative assessment and feedback were practiced. Using data collected through interviews, student focus group discussions, and document analysis; the paper shows that formative assessment and feedback were understood in the context of binding prescription within the boundaries of limited description in academic regulations. Feedback was in most cases reduced to marks, and lecturers – who portrayed themselves as information providers, mastery checkers, and performance appraisers - were in full charge of all formative assessment efforts. The paper also shows that lack of clarity and feed forward instructionsin too-much-delayed lecturers’ written feedback led students to just receive feedback and not use it to enhance their performance. Building on this study’s findings and on the existing literature, the paper suggests three important moves whereby a collaborative research-based approach that will bring together different stakeholders will help to move away from a single-sided approach to a multifaceted approach in both perception and practice of formative assessment and feedback at the University of Rwanda.

  • 7.
    Bergman, Maria Elena
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Barn- och ungdomsvetenskapliga institutionen.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Lärplattor och Appar i Förskolan har kommit för att stanna men för vadå?: En studie om appar med inriktning på matematik och språk i Upplandsbro och Vaxholms kommuner2015Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Studien är ett projekt som startade 2013 i Upplandsbro och Vaxholms kommuner. Studien handlade om lärplattor(surfplattor, iPads) i förskolan och hur pedagoger kan arbeta i grupper med introduktionen av apparinom kunskapsområden matematik och språkutveckling. Forskningen finansierades delvis av kommunerna.Syftet med projektet var att beskriva och förstå hur arbete med lärplattor kan förändra förutsättningar för lärandei förskolan.En första huvudfråga formulerades och löd: Hur påverkas barns intresse och kunskapsutveckling när de arbetarmed hjälp av lärplattor inom områdena matematik och språkutveckling i förskolan. Fokus ligger i hur devuxna organiserar och genomför arbetet med yngre barn i ovan nämnda områden. Fokus inte riktas mot enskildabarn, utan om hur pedagogerna ser på detta hjälpmedel.Studien använde sig av flera datainsamlingsmetoder, enkäter, forskningscirklar, intervjuer med barn och personalenfilmade sekvenser när lärplattan användes i några utvalda grupper. Den första enkäten var avsedd attgöra en lägesbeskrivning av de två valda temana innan lärplattor skulle användas. Frågorna i den första enkätenfokuserade på vilket sätt personalen arbetade med de två nämnda ämnesområden. Den andra enkäten togupp frågor kring apparnas innehåll och vad personalen trodde barnen hade lärt sig under den tid de arbetademed lärplattorna samt frågor kring kvalitetsarbetet. Grupperna som deltog i projektet var mycket heterogenaoch arbetade med lärplattor på olika sätt och det är därför svårt att uttala sig om huruvida och på vilket sättbarns lärande har påverkats.Resultatet av projektet visar att personalen och barnen har lärt sig att hantera IKT i den dagliga verksamhetenoch att en viss kunskapslyft kring språk och matematik har kunnat skönjas. Barnen har lärt sig att snabbthantera apparna, det har visat sig att barnens kollaborativa lärande ökade, att apparna har stimulerat barnsmatematiska och språkliga utveckling då barnen har lärt sig nya begrepp och nya färdigheter.Andra aspekter med beröring på lärande, t.ex. turtagning och kollaboration (dvs barnen hjälpte varandra attlösa de problem som de mötte i samband med användning av de olika apparna) kunde också påvisas. Vidareframgick det att såväl barn som personal som inte hade svenska som modersmål visade förbättringar i uttaletav det svenska språket genom imitation. Vad gäller små barn lärde sig touchtekniken, lägga pussel, härmaljud och även att hjälpa varandra. Anmärkningsvärt var att barn som hade behov av särskilt stöd och stimulanspåverkades positivt av lärplattans övningar, enligt personal från en avdelning talade ett barn med autismsyndromför första gången och en annan blev lugnare och mer koncentrerad av att se bilder och filmsamt lyssna på musik.Apparnas innehåll - trots många inslag av mekaniskt lärande (lärande utan reflektion) - visade positiva effekterpå hela verksamheten. Delar av personalen som var teknikpessimister ändrade uppfattning under projektetsgång och de som redan arbetade IKT-inriktat utvidgade användningen av apparna. Denna utvidgadeverksamhet stimulerade till matematik och språkövningar med inslag av kreativt material. Fördelarna medintroduktionen av lärplatta överträffade nackdelarna några exempel var; lättare att arbeta med Pedagogiskdokumentation, dokumentera verksamheten och gå tillbaks till olika händelser. Surfplattan var lätt att ta medsig i samband med utflykter, lättillgänglig, samarbete underlättades, barnen interagerade och den sociala kontaktenökade.Nackdelarna som kunde identifieras var att lärplattan inte kan erbjuda barnen tredimensionella upplevelser,det observerades ett bläddrande utan mål, det går inte att producera tal, imitation och enkla belöningar resulterari mekaniskt inlärning och överdrivet bläddrande kan hämna sociala relationer vilket blir en paradox dåbarnet samtidigt kunde öka sitt kollaborativa arbete.!2Vidare togs det upp som nackdel att ledningen på förskolorna inte gav pedagogerna tillräckligt med tid attdelta samt att den tekniska supporten inte alltid fanns tillhands. Underhållet av tekniken var inte optimal,personalen önskade få bättre villkor vad gäller den pedagogiska utmaningen med Pedagogisk Dokumentationoch tidsfaktorn är problem som ofta togs upp vid forskningscirklarna.Personalen som deltog arbetade med många organisatoriska problem visade entusiasm och intresse för attlära sig och tillsammans med barnen utforskade och upptäckte ämnesområdena på ett meningsfullt sätt.Sammantaget var kunskapen kring apparnas innehåll å ena sida mekaniskt och å andra sidan visade sig meningsfullt.Denna paradox handlar kanske mer om vad man vill att barnen skall lära och den intressekonfliktensom råder kring ”skolifiering” av förskolan. Vad och varför skall barnen lära sig matematik och språk i enslags undervisande form? På vilket sätt bör den kunskap barnen tillgodogör sig vara meningsfull?Kanske handlar dessa paradoxer om kvalitet i lärandet av matematik och språk anpassad till förskolans praktik.Att apparna är uppbyggda utifrån en kvantitativ och behavioristisk syn på kunskap med belöning, stimulusoch respons som har varit ovant i förskolans värld behöver inte i sig innebära en nackdel - det är upprepandesom har bidragit till att barnen har lärt att hantera apparna. Barnen lärde sig att hantera dessa två områdenoch med lärplattan som tekniskt verktyg gick lärande snabbt, effektivt, barnen samarbetade och interagerademed varandra.Frågor som skulle vara intressanta att lära sig mer om i framtida studier inkluderar: Är detta ett kvalitativtbättre lärande? Lär sig barnen bättre utan införande av lärplattan? Och vad är framtidens lärande för förskolebarn?Det behövs givetvis en annan typ av forskning över tid för att utröna hur och på vilket sätt dessa apparutvecklar barns lärande och i synnerhet småbarnslärandet.

  • 8. Botezatu, Mihaela
    et al.
    Hult, Håkan
    Kassaye Tessma, Mesfin
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Virtual patient simulation for learning and assessment: superior results in comparison with regular course exams2010Ingår i: Medical Teacher, ISSN 0142-159X, Vol. 32, nr 10, 845-850 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    

    Background: Our study aimed to observe the differences in assessment results between virtual patient simulation (VPS) and regular course exams in an Internal Medicine course for undergraduate medical students.

    Methods: Four cohorts of students (n = 216) used: a VPS or lectures for learning (terms 1 and 2); VPS and lectures or only lectures (term 3); and a paired set-up with both VPS and lectures (term 4). The assessment results, measured with both a VPS-based exam and a paper-based exam, were compared. A scoring rubric (0–6), developed and validated for the purpose of the trial, was applied to both types of assessment. Mean score differences of the results were compared for the four cohorts.

    Results: Both VPS and regular examination results were significantly higher in the VPS group compared to regular exam group (p < 0.001) in terms 1, 2 and 3. The paired mean difference in term 4 was 0.66 (95% confidence interval (CI) 0.50, 0.83; p < 0.001) for haematology and 0.57 (95% CI 0.45, 0.69; p < 0.001) for cardiology.

    Conclusion: Our findings suggest that using VPS both for learning and for assessment supports learning. VPS are better than traditional assessment methods when the virtual application is used for both learning and evaluation.

  • 9. Botezatu, Mihaela
    et al.
    Hult, Håkan
    Kassaye Tessma, Mesfin
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Virtual patient simulation: knowledge gain or knowledge loss?2010Ingår i: Medical Teacher, ISSN 0142-159X, Vol. 32, nr 7, 562-568 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Virtual patients (VPs), high-fidelity simulators and standardized patients are powerful educational interventions leading to effective learning and supporting knowledge retention.

    Aim: This study explored the variations in retention with VP versus regular learning activities.

    Method: We conducted a randomized controlled study on early and delayed assessment results of 49 students using VP for learning and examination of haematology and cardiology topics in an Internal Medicine course, by means of a 0–10 scoring rubric.

    Results: The mean difference for early assessment with VP (study – control mean score) was 1.43 (95% confidence interval (CI) 0.96, 1.91; p < 0.001) for haematology and 1.34 (95% CI 0.93, 1.76; p < 0.001) for cardiology. In regular exams, the mean score difference was 2.21 (95% CI 1.3, 3.1; p < 0.001) and 1.52 (95% CI 0.76, 2.28; p < 0.001), respectively. With delayed assessments, the difference in mean score for Web-SP was 1.48 (95% CI 1.09, 1.86; p < 0.001), haematology and 1.16 (95% CI 0.74, 1.58; p < 0.001), cardiology; for regular exams the figures were 1.96 (95% CI 0.93, 2.98; p < 0.001) and 1.74 (95% CI 0.89, 2.58; p < 0.001). The effect size ranged from 0.5 to 0.8.

    Conclusion: Our results indicate better retention with VP than with traditional learning methods.

  • 10. Botezatu, Mihaela
    et al.
    Hult, Håkan
    Tessma, Mesfin
    Dahlgren, Lars Owe
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Virtual Patient Simulation: what do students make of it?: A focus group study2010Ingår i: BMC Medical Education, ISSN 1472-6920, Vol. 10, nr 91Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The learners' perspectives on Virtual Patient Simulation systems (VPS) are quintessential to their successful development and implementation. Focus group interviews were conducted in order to explore the opinions of medical students on the educational use of a VPS, the Web-based Simulation of Patients application (Web-SP).

    Methods

    Two focus group interviews-each with 8 undergraduate students who had used Web-SP cases for learning and/or assessment as part of their Internal Medicine curriculum in 2007-were performed at the Faculty of Medicine of Universidad el Bosque (Bogota), in January 2008. The interviews were conducted in Spanish, transcribed by the main researcher and translated into English. The resulting transcripts were independently coded by two authors, who also performed the content analysis. Each coder analyzed the data separately, arriving to categories and themes, whose final form was reached after a consensus discussion.

    Results

    Eighteen categories were identified and clustered into five main themes: learning, teaching, assessment, authenticity and implementation. In agreement with the literature, clinical reasoning development is envisaged by students to be the main scope of VPS use; transferable skills, retention enhancement and the importance of making mistakes are other categories circumscribed to this theme. VPS should enjoy a broad use across clinical specialties and support learning of topics not seen during clinical rotations; they are thought to have a regulatory effect at individual level, helping the students to plan their learning. The participants believe that assessment with VPS should be relevant for their future clinical practice; it is deemed to be qualitatively different from regular exams and to increase student motivation. The VPS design and content, the localization of the socio-cultural context, the realism of the cases, as well as the presence and quality of feedback are intrinsic features contributing to VPS authenticity.

    Conclusions

    Five main themes were found to be associated with successful VPS use in medical curriculum: Learning, Teaching, Assessment, Authenticity and Implementation. Medical students perceive Virtual Patients as important learning and assessment tools, fostering clinical reasoning, in preparation for the future clinical practice as young doctors. However, a number of issues regarding VPS design, authenticity and implementation need to be fulfilled, in order to reach the potential educational goals of such applications.

  • 11. Botezatu, Mihaela
    et al.
    Hult, Håkan
    Tessma, Mesfin
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    As time goes by: stakeholder opinions on the implementation and use of a virtual patient simulation system2010Ingår i: Medical Teacher, ISSN 0142-159X (print), 1466-187X (electronic), Vol. 32, nr 11, e509-516 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Stakeholder opinions on the implementation of a particular virtual patient application might prove important for decision-making and implementation efforts in general. This study aimed to capitalize on experiences originated from two postimplementation settings of Web-based Simulation of Patients (Web-SP). Method: We conducted a cross-sectional survey of stakeholder opinions (39 students, teachers, course directors, and university leaders) on the implementation and use of Web-SP in Colombia and Sweden, using a mixed method approach. Results: The respondents did not show equal preference in rating the ranking of the order of importance included in the variables (Friedman’s Chi square: 26.5 to 115.1, df=6, p <0.001, Kendall’s coefficient of concordance ranging from 0.11 to 0.50). The answers provided as free comments supported the statistical findings on the importance of end-user customization, need for authenticity in software design, and use of virtual patient simulations in a curricular context, for clinical reasoning development. Conclusions: Virtual Patient design should allow extensive editing, support case authenticity and enhance clinical reasoning abilities, in an effort for ensuring accountability and sustainable development of the field.

  • 12. Courteille, O
    et al.
    Ekblad, S
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Mollica, R
    Pantziaras, I
    Virtual Patients for training Patient Encounter in transcultural psychiatry: Enhancing learning outcomes in the affective domai2010Konferensbidrag (Övrigt vetenskapligt)
  • 13. Courteille, Olivier
    et al.
    Felländer-Tsai, Li
    Hedman, Leif
    Kjellin, Ann
    Enochsson, Lars
    Lindgren, G
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Mixed Virtual Reality Simulation - Taking endoscopic simulation one step further2011Ingår i: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 163, 144-146 s.Artikel i tidskrift (Refereegranskat)
  • 14. Edelbring, S
    et al.
    Zary, N
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Dahlgren, Lars Owe
    The influence of case follow-up intensity on how students perceive virtual patient methodology2010Ingår i: eLearning Symposium Final Programme & Abstract Book.pdf:  , 2010Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: A need for a structured approach for student guidance has been identified in using media presented patient cases (de Leng et al., 2007). Furthermore integration aspects seem to influence what importance and value students find in virtual patients (VPs) in relation to course content and their study situation (Hege et al., 2007). One important course integration aspect is how students’ VP case work is followed up.

    Summary of work: We investigated students’ perceptions of VPs in a clinical course using a questionnaire (n=161, response rate: 65%). The course was delivered with variations in case follow-up strategy: none, medium and high intensity of follow-ups. Intensity was defined after degree of processing requirements of students at a follow-up seminar. Differences in students’ perceptions of VPs was analysed regarding this variation.

    Summary of results: Students’ questionnaire responses will be presented regarding their perceptions of the value of VPs in the course. Items include relation to the examination, future professional practice, understanding of subject matter, learning facts about symptom and diagnosis and training of diagnosing skills.

    Conclusions: Preliminary analysis shows that level of intensity of follow-up activities in the course influence the value that students ascribe to VPs.

    Take-home message: Careful planning of case follow-up increase the value of using VPs in courses.

  • 15. Edelbring, Samuel
    et al.
    Broström, Olle
    Henriksson, Peter
    Vassiliou, Daphne
    Spaak, Jonas
    Dahlgren, Lars Owe
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Zary, Nabil
    Integrating virtual patients into courses: follow-up seminars and perceived benefit2012Ingår i: Medical Education, ISSN 0308-0110, E-ISSN 1365-2923, Vol. 46, nr 4, 417-425 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    CONTEXT The use of virtual patients (VPs) suggests promising effects on student learning. However, currently empirical data on how best to use VPs in practice are scarce. More knowledge is needed regarding aspects of integrating VPs into a course, of which student acceptance is one key issue. Several authors call for looking beyond technology to see VPs in relation to the course context. The follow-up seminar is proposed as an important aspect of integration that warrants investigation. METHODS A cross-sectional explanatory study was performed in a clinical clerkship introduction course at four teaching hospitals affiliated to the same medical faculty. The VP-related activities were planned collaboratively by teachers from all four settings. However, each setting employed a different strategy to follow up the activity in the course. Sixteen questionnaire items were grouped into three scales pertaining to: perceived benefit of VPs; wish for more guidance on using VPs, and wish for assessment and feedback on VPs. Scale scores were compared across the four settings, which were ranked according to the level of intensity of students' processing of cases during VP follow- up activities. RESULTS The perceived benefit of VPs and their usage were higher in the two intense-use settings compared with the moderate-and lowintensity settings. The wish for more guidance was high in the low-and one of the highintensity settings. Students in all settings displayed little interest in more assessment and feedback regarding VPs. CONCLUSIONS High case processing intensity was related to positive perceptions of the benefit of VPs. However, the low interest in more assessment and feedback on the use of VPs indicates the need to clearly communicate the added value of the follow-up seminar. The findings suggest that a more intense follow-up pays off in terms of the benefit perceived by students. This study illustrates the need to consider VPs from the perspective of a holistic

  • 16.
    Ekanayake, Hiran B.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap. University of Skövde, Sweden; University of Colombo School of Computing, Sri Lanka.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Backlund, Per
    Ziemke, Tom
    Ramberg, Robert
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Hewagamage, Kamalanath P.
    Affective Realism of Animated Films in the Development of Simulation-Based Tutoring Systems2013Ingår i: International Journal of Distance Education Technologies, ISSN 1539-3100, E-ISSN 1539-3119, Vol. 11, nr 2, 96-109 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This paper presents a study focused on comparing real actors based scenarios and animated characters based scenarios with respect to their similarity in evoking psychophysiological activity for certain events by measuring galvanic skin response (GSR). In the experiment, one group (n=11) watched the real actors’ film whereas another group (n=7) watched the animated film, which had the same story and dialogue as the real actors’ film. The results have shown that there is no significant difference in the skin conductance response (SCR) scores between the two groups; however, responses significantly differ when SCR amplitudes are taken into account. Moreover, Pearson’s correlation reported as high as over 80% correlation between the two groups’ SCRs for certain time intervals. The authors believe that this finding is of general importance for the domain of simulation-based tutoring systems in development of and decisions regarding use of animated characters based scenarios.

  • 17. Ekblad, Solvig
    et al.
    Mollica, Richard F.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Pantziaras, Ioannis
    Lavelle, James
    Educational potential of a virtual patient system for caring for traumatized patients in primary care2013Ingår i: BMC Medical Education, ISSN 1472-6920, Vol. 13, 110- s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Virtual Patients (VPs) have been used in undergraduate healthcare education for many years. This project is focused on using VPs for training professionals to care for highly vulnerable patient populations. The aim of the study was to evaluate if Refugee Trauma VPs was perceived as an effective and engaging learning tool by primary care professionals (PCPs) in a Primary Health Care Centre (PHC). Methods: A VP system was designed to create realistic and engaging VP cases for Refugee Trauma for training refugee patient interview, use of established trauma and mental health instruments as well as to give feedback to the learners. The patient interview section was based on video clips with a Bosnian actor with a trauma story and mental health problems. The video clips were recorded in Bosnian language to further increase the realism, but also subtitled in English. The system was evaluated by 11 volunteering primary health clinicians at the Lynn Community Health Centre, Lynn, Massachusetts, USA. The participants were invited to provide insights/feedback about the system's usefulness and educational value. A mixed methodological approach was used, generating both quantitative and qualitative data. Results: Self-reported dimensions of clinical care, pre and post questionnaire questions on the PCPs clinical worldview, motivation to use the VP, and IT Proficiency. Construct items used in these questionnaires had previously demonstrated high face and construct validity. The participants ranked the mental status examination more positively after the simulation exercise compared to before the simulation. Follow up interviews supported the results. Conclusions: Even though virtual clinical encounters are quite a new paradigm in PHC, the participants in the present study considered our VP case to be a relevant and promising educational tool. Next phase of our project will be a RCT study including comparison with specially prepared paper-cases and determinative input on improving clinical diagnosis and treatment of the traumatized refugee patient.

  • 18.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    A historical view of case simulation methods for healthcare education and its significance for Psychiatry - what will the next step be?2012Konferensbidrag (Övrigt vetenskapligt)
  • 19.
    Fors, Uno
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Courteille, O
    Learner Acceptance of Using Virtual Patient Encounters to Train Foreign Healthcare Professionals in Swedish2014Ingår i: International Journal of Virtual and Personal Learning Environments, ISSN 1947-8518, E-ISSN 1947-8526, Vol. 5, nr 3, 18-32 s.Artikel i tidskrift (Refereegranskat)
  • 20.
    Fors, Uno
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Forsberg, E.
    Gunning, W. T.
    Can virtual patients be used to assess clinical reasoning? The effect of different grading metrics2012Konferensbidrag (Övrigt vetenskapligt)
  • 21.
    Fors, Uno G. H.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Gunning, William T.
    The Impact of Different Scoring Rubrics for Grading Virtual Patient-based Exams2014Ingår i: Journal of educational computing research (Print), ISSN 0735-6331, E-ISSN 1541-4140, Vol. 50, nr 1, 97-119 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Virtual patient cases (VPs) are used for healthcare education and assessment. Most VP systems track user interactions to be used for assessment. Few studies have investigated how virtual exam cases should be scored and graded. We have applied eight different scoring models on a data set from 154 students. Issues studied included the impact of penalizing guessing, requiring a correct diagnose, different grading levels, and the effect of using weighted diagnose metrics. Controlling the random-guessing approach is necessary and can be accomplished by a rubric that measures a relative efficiency of the learner's inquiries and the total number of inquiries. Using a straight percentage score versus a curved exam score had a major impact on grades. Significant differences were found when using different metrics as only one of the eight rubric models resulted in a Gaussian distribution. Course directors need to analyze expected learning outcomes from a course to determine a scoring metric to assess those particular needs; the grading rubric must also control for guessing.

  • 22.
    Fors, Uno G. H.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Gunning, William T.
    The Impact of Different Scoring Rubrics for Grading Virtual Patient-based Exams2014Ingår i: Journal of educational computing research (Print), ISSN 0735-6331, E-ISSN 1541-4140, Vol. 50, nr 1, 97-119 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Virtual patient cases (VPs) are used for healthcare education and assessment. Most VP systems track user interactions to be used for assessment. Few studies have investigated how virtual exam cases should be scored and graded. We have applied eight different scoring models on a data set from 154 students. Issues studied included the impact of penalizing guessing, requiring a correct diagnose, different grading levels, and the effect of using weighted diagnose metrics. Controlling the random-guessing approach is necessary and can be accomplished by a rubric that measures a relative efficiency of the learner's inquiries and the total number of inquiries. Using a straight percentage score versus a curved exam score had a major impact on grades. Significant differences were found when using different metrics as only one of the eight rubric models resulted in a Gaussian distribution. Course directors need to analyze expected learning outcomes from a course to determine a scoring metric to assess those particular needs; the grading rubric must also control for guessing.

  • 23.
    Fors, Uno G. H.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Skoglund, Åsa
    A pilot study of virtual cases in law education2013Ingår i: European Journal of Law and Technology, ISSN 2042-115X, Vol. 4, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to investigate the possibility to create and use virtual law cases/virtual clients for training Contract Law for undergraduate students. The study also investigated the attitudes of the learners of using such cases.

    A previously wide-spread case system for healthcare education, Web-SP, was adapted to be used for legal cases. One case was developed by a senior legal expert and teacher, which was subsequently used by 52 students in a course on contract law during a seminar. A questionnaire was used to gather students' opinions on the use of the virtual cases.

    Most students were positive to the use of virtual law cases to practice their legal decision making. Almost all learners believed that the virtual cases were realistic and engaging and that they also found the interactive Web-SP cases to be good for their learning.

    Future studies need to look into concrete learning outcomes as well as the potential of using virtual law cases for exams.

  • 24.
    Forsberg, Elenita
    et al.
    Halmstad Univ, Sch Social & Hlth Sci, Halmstad, Sweden .
    Georg, Carina
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Nursing, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad Univ, Sch Social & Hlth Sci, Halmstad, Sweden .
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Virtual patients for assessment of clinical reasoning in nursing – a pilot study2011Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 31, nr 8, 757-762 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In different nursing programmes, one important learning outcome is clinical reasoning (CR) skills. However, to date, there is limited number of methods available for assessment of CR skills; especially for distance-based courses. This study investigates students' opinions about the feasibility of using Virtual Patients (VPs) for assessing CR in nursing education. VPs were introduced as an assessment tool in three different nursing courses at two universities, comprising 77 students in total. Students' overall acceptance of this assessment tool, including its applicability to the practise of nursing and the potential of VP-based assessment as a learning experience, were investigated using questionnaires. Course directors used the Web-SP system to assess students' interactions with VPs and their answers regarding diagnoses, caring procedures and their justifications. Students' found the VP cases to be realistic and engaging, and indicate a high level of acceptance for this assessment method. In addition, the students' indicated that VPs were good for practising their clinical skills, although some would prefer that the VP system be less "medical" and asked for more focus on nursing. Although most students supplied correct diagnoses and made adequate clinical decisions, there was a wide range in their ability to explain their clinical reasoning processes.

  • 25. Forsberg, Elenita
    et al.
    Ziegert, Kristina
    Hult, Håkan
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Assessing progression of clinical reasoning through virtual patients: An exploratory study2016Ingår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 16, nr 1, 97-103 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To avoid test-driven learning, there have been discussions regarding the use of more formative assessments in health care education to promote students' deep learning. Feedback is important in formative assessment, but many students ignore it; therefore, interventions should be introduced which stimulate them to reflect on the new knowledge. The aim for this study was to explore if Virtual Patient (VP)-based formative assessments, in connection with self-evaluations, had an impact on postgraduate pediatric nursing students' development of clinical reasoning abilities. Students' self-evaluations served as the basis for measuring progress. Data was analysed using deductive content analysis. The findings showed a clear progression of the clinical reasoning ability of the students. After the first assessment, the students described feelings of uncertainty and that their knowledge gaps were exposed. At the mid-course assessment the awareness of improved clinical reasoning was obvious and the students were more certain of knowing how to solve the VP cases. In the final assessment, self-efficacy was expressed. VP -based assessments, in connection with self-evaluations, early in the education resulted in a gain of students' own identification of the concept of clinical reasoning, awareness of what to focus on during clinical practice and visualised expected clinical competence.

  • 26. Forsberg, Elenita
    et al.
    Ziegert, Kristina
    Hult, Håkan
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Clinical reasoning in nursing, a think-aloud study using virtual patients - A base for an innovative assessment2014Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, nr 4, 538-542 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In health-care education, it is important to assess the competencies that are essential for the professional role. To develop clinical reasoning skills is crucial for nursing practice and therefore an important learning outcome in nursing education programmes. Virtual patients (VPs) are interactive computer simulations of real-life clinical scenarios and have been suggested for use not only for learning, but also for assessment of clinical reasoning. The aim of this study was to investigate how experienced paediatric nurses reason regarding complex VP cases and how they make clinical decisions. The study was also aimed to give information about possible issues that should be assessed in clinical reasoning exams for post-graduate students in diploma specialist paediatric nursing education.

    The information from this study is believed to be of high value when developing scoring and grading models for a VP-based examination for the specialist diploma in paediatric nursing education.

    Using the think-aloud method, data were collected from 30 RNs working in Swedish paediatric departments, and child or school health-care centres. Content analysis was used to analyse the data.

    The results indicate that experienced nurses try to consolidate their hypotheses by seeing a pattern and judging the value of signs, symptoms, physical examinations, laboratory tests and radiology. They show high specific competence but earlier experience of similar cases was also of importance for the decision making. The nurses thought it was an innovative assessment focusing on clinical reasoning and clinical decision making. They thought it was an enjoyable way to be assessed and that all three main issues could be assessed using VPs.

    In conclusion, VPs seem to be a possible model for assessing the clinical reasoning process and clinical decision making, but how to score and grade such exams needs further research.

  • 27. Forsberg, Elenita
    et al.
    Ziegert, Kristina
    Hult, Håkan
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Evaluation of a novel scoring and grading model for vp-based exams in postgraduate nurse education2015Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, nr 12, 1246-1251 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    For Virtual Patient-based exams, several scoring and grading methods have been proposed, but none have yet been validated. The aim of this study was to evaluate a new scoring and grading model for VP-based exams in postgraduate paediatric nurse education. The same student group of 19 students performed a VP-based exam in three consecutive courses. When using the scoring and grading assessment model, which contains a deduction system for unnecessary or unwanted actions, a progression was found in the three courses: 53% of the students passed the first exam, 63% the second and 84% passed the final exam. The most common reason for deduction of points was due to students asking too many interview questions or ordering too many laboratory tests. The results showed that the new scoring model made it possible to judge the students' clinical reasoning process as well as their progress.

  • 28. Forsberg, Elenita
    et al.
    Ziegert, Kristina
    Hult, Håkan
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Using VPs for assessment of clinical competence in postgraduate Paediatric Nurse Education2012Ingår i:  , 2012Konferensbidrag (Övrigt vetenskapligt)
  • 29. Gunning, William T.
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    A Comparison of Facilitator and Second Year Medical Student Attitudes and Perceptions of a Virtual Patient Environment and Student Case Approaches, Development of Learning Issues and Development2013Ingår i: Colouring Outside the Lines: Conference Abstracts 2013, Dundee, UK: MedEdWorld , 2013, 549- s.Konferensbidrag (Refereegranskat)
  • 30. Gunning, William T.
    et al.
    Fors, Uno G. H.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Virtual Patients for assessment of medical student ability to integrate clinical and laboratory data to develop differential diagnoses: Comparison of results of exams with/without time constraints2012Ingår i: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 34, nr 4, E222-E228 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: We have evaluated medical student ability in a problem-based learning course using a Virtual Patient (VP)-based exam with variable parameters for assessment purposes. Methods: A class of 155 second year medical students was assessed using a VP exam with unlimited access during a 1-week period; 2 years later, the identical exam was administered to 175 students with a 3-h time limit. Results: Students taking the exam without time constraints utilized approximately twice as much time than students with the time limit. Without the pressure of a time-limit, students utilized half as many inquiries of the patient history, physical, and lab/imaging tests than were used by students having a time constraint, indicating that the time limited students used a "shotgun approach'' to try to collect as many "required'' inquiries as possible. Most students (91%) taking the untimed exam were able to correctly diagnose the exam case but only 31% of the time limited students correctly diagnosed the VP exam case, despite their higher number of inquiries. Conclusions: Our results demonstrate that an identical VP exam, administered with variables to compare untimed versus time-limited conditions, resulted in an unraveling of student's ability to integrate the data discovered during the process of progressive disclosure.

  • 31. Jepsen, Rikke Malene H. G.
    et al.
    Grønnebæk Tolsgaard, Martin
    Birkvad Rasmussen, Maria
    Kayser, Lars
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Ringsted, Charlotte
    Preparing for practice using a self-directed approach to learning from virtual patients: A randomised trial of the effect on clinical performance2013Ingår i: Colouring Outside the Lines: Conference Abstracts 2013, Dundee, UK: MedEdWorld , 2013, 358- s.Konferensbidrag (Refereegranskat)
  • 32.
    Kanter, Theo
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Rahmani, Rahim
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Immersive Networking — A Framework for Virtual Environments with Augmented Reality in Human Decision-Making2016Ingår i: International Journal of Multimedia and Ubiquitous Engineering, ISSN 1975-0080, Vol. 11, nr 6, 43-60 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this publication we present Immersive Networking as a novel framework for connecting people and places and things in virtual environments with augmented reality to be used in eg. Virtual training environments. The research is mandated by technology advances in internetworking underpinned by 5G networks and Internet-of-Things. These advances present new possibilities and challenges to integrate people, places and things in virtual environments. Existing frameworks such as MPEG-V possess representational capabilities but have insufficient support for integrating entities from the real world via heterogeneous infrastructure. MPEG-V for instance makes no statements about distributed control. Seamless experiences in virtual environment require self-organization of connectivity between people, places and things via heterogeneous 5G and Internet-of-Things infrastructures. A second important aspect of the quality of our experience is the immediacy of responses. Both aspects of seamless and self-organizing connections between entities require that we push control to the end-devices co-located with the entities themselves. These end-devices may incorporate sensing gateways and interaction devices, which include both local and non-local information from the virtual environment in the interaction. Thus delegation of control to end-devices requires means for the organizing or relations and clustering by relevance. This capability is particularly important as the projected number of devices and sensors to be connected via the Internet-of-Things is projected to be in the order of 50 billion by 2020. Immersive Networking supported by MediaSense constitutes a scalable self-organizing means for connecting people and places and things in virtual environments with augmented reality. MediaSense moves control to the edge enabling immediacy in experiences based on seamless self-organization through clustering of entities in relations organized by relevance. We conclude by validating our approach in several scenarios evaluating the relevance and application in human decision-making..

  • 33.
    Käck, Annika
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Roll-Pettersson, Lise
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Alai-Rosales, Shahla S.
    Høium, Kari
    Männikkö Barbutiu, Sirkku
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Fors, Uno G. H.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Intercultural Blended Design Considerations: a Case Study of a Nordic-Baltic Course in Autism Intervention2014Ingår i: European Journal of Open, Distance and E-Learning, ISSN 1027-5207, Vol. 17, nr 1, 93-107 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Specialized educational programs previously unavailable to many students are now accessible to students spread throughout the world. In particular, this globalization presents new opportunities and challenges for universities educating professionals in the field of autism treatment. The aim of the present case study is to analyse the experiences of students who participated in an intercultural graduate level blended learning course in applied behaviour analysis with an autism focus. Students were enrolled in universities in four Nordic-Baltic countries. Country based focus group interviews and surveys were used to explore student’s experiences and perceptions. Results indicate that access to expertise and interacting with other cultures were noted to positively affect learning experience. Risk for cultural divide due to discrepancies in technology, differing pedagogical traditions, and understanding of English were also reported. Implications regarding the potential risks and benefits inherent in intercultural blended learning courses are discussed and suggestions are offered for enhancing the success of such courses.

  • 34.
    Linikko, Jari
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Westling Allodi, Mara
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Simulation of working with an individual education plan for a virtual pupil2012Konferensbidrag (Övrigt vetenskapligt)
  • 35. Lund, Bodil
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Sejersen, Ronny
    Sällnäs, EvaLotta
    Rosén, Annika
    Student perception of two different simulation techniques in oral and maxillofacial surgery undergraduate training2011Ingår i: BMC Medical Education, ISSN 1472-6920, Vol. 11, 82- s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Yearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery. Methods: Forty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP) Simulation system (Web-SP) and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire. Results: The response rate was 91.5% (43/47). The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised. Conclusions: The two tested simulation methods were well accepted and most students agreed that the future curriculum would benefit from permanent inclusion of these exercises, especially when used in combination. The results also stress the importance of teaching technical skills and clinical reasoning in concert.

  • 36. Muntean, Valentin
    et al.
    Calinici, Tudor
    Tigan, Stefan
    Fors, Uno G. H.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Language, culture and international exchange of virtual patients2013Ingår i: BMC Medical Education, ISSN 1472-6920, Vol. 13, 21- s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Language and cultural differences could be a limiting factor for the international exchange of Virtual Patients (VPs), especially for small countries and languages of limited circulation. Our research evaluated whether it would be feasible to develop a VP based educational program in our Romanian institution, with cases in English and developed in a non-Romanian setting. Method: The participants in the research comprised 4th year Romanian medical students from the Faculty of Medicine in Cluj-Napoca, Romania, with previous training exclusively in Romanian, good English proficiency and no experience with VPs. The students worked on eight VPs in two identical versions, Romanian and English. The first group (2010) of 136 students worked with four VPs developed in Cluj and the second group (2011) of 144 students with four VPs originally developed at an US University. Every student was randomly assigned two different VPs, one in Romanian and another in English. Student activity throughout the case, the diagnosis, therapeutic plan and diagnosis justification were recorded. We also compared student performance on the two VPs versions, Romanian and English and the student performance on the two sets of cases, originally developed in Romania, respectively USA. Results: We found no significant differences between the students' performance on the Romanian vs. English version of VPs. Regarding the students' performance on the two sets of cases, in those originally developed in Romania, respectively in the USA, we found a number of statistically significant differences in the students' activity through the cases. There were no statistically significant differences in the students' ability to reach the correct diagnosis and therapeutic plan. Conclusion: The development of our program with VPs in English would be feasible, cost-effective and in accordance with the globalization of medical education.

  • 37. Mårtensson, Pär
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Wallin, Sven-Bertil
    Zander, Udo
    Nilsson, Gunnar H.
    Evaluating research: A multidisciplinary approach to assessing research practice and quality2016Ingår i: Research Policy, ISSN 0048-7333, E-ISSN 1873-7625, Vol. 45, nr 3, 593-603 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There are few widely acknowledged quality standards for research practice, and few definitions of what constitutes good research. The overall aim was therefore to describe what constitutes research, and then to use this description to develop a model of research practice and to define concepts related to its quality. The primary objective was to explore such a model and to create a multidisciplinary understanding of the generic dimensions of the quality of research practice. Eight concept modelling working seminars were conducted. A graphic representation of concepts and their relationships was developed to bridge the gap between different disciplines. A concept model of research as a phenomenon was created, which included a total of 18 defined concepts and their relationships. In a second phase four main areas were distilled, describing research practice in a multidisciplinary context: Credible, Contributory, Communicable, and Conforming. Each of these was further specified in a concept hierarchy together with a defined terminology. A comprehensive quality model including 32 concepts, based on the four main areas, was developed for describing quality issues of research practice, where the model of research as a phenomenon was used to define the quality concepts. The quality model may be used for further development of elements, weights and operationalizations related to the quality of research practice in different academic fields. (C) 2015 The Authors. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  • 38. Nilsson, Mikael
    et al.
    Östergren, Jan
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Rickenlund, Anette
    Jorfeldt, Lennart
    Caidahl, Kenneth
    Bolinder, Gunilla
    Does individual learning styles influence the choice to use a web-based ECG learning programme in a blended learning setting?2012Ingår i: BMC Medical Education, ISSN 1472-6920, Vol. 12, 5- s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The compressed curriculum in modern knowledge-intensive medicine demands useful tools to achieve approved learning aims in a limited space of time. Web-based learning can be used in different ways to enhance learning. Little is however known regarding its optimal utilisation. Our aim was to investigate if the individual learning styles of medical students influence the choice to use a web-based ECG learning programme in a blended learning setting. Methods: The programme, with three types of modules (learning content, self-assessment questions and interactive ECG interpretation training), was offered on a voluntary basis during a face to face ECG learning course for undergraduate medical students. The Index of Learning Styles (ILS) and a general questionnaire including questions about computer and Internet usage, preferred future speciality and prior experience of E-learning were used to explore different factors related to the choice of using the programme or not. Results: 93 (76%) out of 123 students answered the ILS instrument and 91 the general questionnaire. 55 students (59%) were defined as users of the web-based ECG-interpretation programme. Cronbach's alpha was analysed with coefficients above 0.7 in all of the four dimensions of ILS. There were no significant differences with regard to learning styles, as assessed by ILS, between the user and non-user groups; Active/Reflective; Visual/Verbal; Sensing/Intuitive; and Sequential/Global (p = 0.56-0.96). Neither did gender, prior experience of E-learning or preference for future speciality differ between groups. Conclusion: Among medical students, neither learning styles according to ILS, nor a number of other characteristics seem to influence the choice to use a web-based ECG programme. This finding was consistent also when the usage of the different modules in the programme were considered. Thus, the findings suggest that web-based learning may attract a broad variety of medical students.

  • 39.
    Nouri, Jalal
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Åkerfeldt, Anna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Barn- och ungdomsvetenskapliga institutionen.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Selander, Staffan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Assessing Collaborative Problem Solving Skills in Technology-Enhanced Learning Environments - The PISA Framework and Modes of Communication2017Ingår i: International Journal:  Emerging Technologies in Learning, ISSN 1868-8799, E-ISSN 1863-0383, Vol. 12, nr 4, 163-174 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    As been highlighted by many, for instance by PISA, Collaborative Problem Solving (CPS) is a critical and necessary 21st century skill across educational settings. While many initiatives have been launched to investigate the nature of these skills, fewer are the attempts to understand how they should be assessed. However, in 2015, the PISA organization presented a framework for assessing CPS skills. This paper reports on an exploratory study investigating the predictive validity of the PISA assessment framework and if and how modes of communication influence the assessment of 24 students' collaborative problem solving activities when using a computer-based assessment task system. The findings presented demonstrate that the PISA CPS assessment framework have a weak predictive validity, does not count for quality or productivity in communication, and that the mode of communication indeed influence CPS processes and in turn what is possible to assess.

  • 40. Pantziaras, I.
    et al.
    Courteille, O.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Ekblad, S.
    Virtual Patients in Transcultural Psychiatric Training: The Role of Virtual Feedback – a pilot study2012Ingår i:  , 2012Konferensbidrag (Refereegranskat)
  • 41. Pantziaras, Ioannis
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Ekblad, Solveig
    Virtual Mrs K: the learners’ expectations and attitudes towards a virtual patient system in transcultural psychiatry2014Ingår i: Journal of Contemporary Medical Education, Vol. 2, nr 2, 109-115 s.Artikel i tidskrift (Refereegranskat)
  • 42. Pantziaras, Ioannis
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Ekblad, Solvig
    Innovative Training with Virtual Patients in Transcultural Psychiatry: The Impact on Resident Psychiatrists' Confidence2015Ingår i: PLoS ONE, ISSN 1932-6203, Vol. 10, nr 3, e0119754Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Virtual patients are now widely accepted as efficient and safe training tools in medical education, but very little is known about their implementation in psychiatry, especially in transcultural clinical care of traumatized refugee patients. Objective This study aimed at assessing the impact of training with a virtual patient on confidence in providing clinical care for traumatized refugee patients. Methods The authors developed an educational tool based on virtual patient methodology portraying the case of Mrs. K, a traumatized refugee woman with symptoms of PTSD and depression. A group (N=32) of resident psychiatrists tested the system and their confidence in different aspects of providing clinical care for this patient group was evaluated pre- and posttest by using a validated confidence questionnaire. Cronbach's a was calculated for all clusters. Changes between pre- and post-test were compared by using the matched-pair t-test, binomial distribution for exact significance test and a calculation of effect sizes (Cohen's d). Results A statistically significant improvement was exhibited in overall confidence (mean.: 0.34; p < 0.0001; d: 0.89) as well as in four more specific domains of clinical care, with the area of identifying and evaluating trauma-related diagnoses and disability showing the most prominent improvement (mean Delta: 0.47; p < 0.0001; d: 1.00). Conclusions This VP-system can lead to physicians' improvement of confidence in providing transcultural clinical care for traumatized refugee patients. Further research is required to investigate improvement in actual performance and cognitive outcomes with several VPs and in a long-term effect perspective.

  • 43. Pantziaras, Ioannis
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Ekblad, Solvig
    Training with Virtual Patients in Transcultural Psychiatry: do the learners actually learn?2015Ingår i: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 17, nr 2, e46Artikel i tidskrift (Refereegranskat)
  • 44. Panziaras, Ioannis
    et al.
    Courteille, Olivier
    Mollica, Richard
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Ekblad, Solvig
    A pilot study of user acceptance and educational potentials of virtual patients in transcultural psychiatry2012Ingår i: International Journal of Medical Education, ISSN 2042-6372, Vol. 3, 132-140 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The purpose of this pilot study was to evaluate user acceptance, educational potentials and face and con-struct validity of a dedicated Virtual Patient system for refugee trauma cases, designed to enhance clinical, interper-sonal, social and cultural competence.

    Methods: We developed a Virtual Patient system portraying a female refugee – mediated by a still image and pre-recorded voice – that was evaluated by an invited group of physicians (n=9) working as residents in Psychiatry (n=8) and General Medicine (n=1). The participants were invited to provide insights/feedback about the system’s usefulness and its educational value.

    Results: Scores across our sample were high regarding the Virtual Patient system’s realistic nature (median value: 5 on a 7-point scale) as well as the Virtual Patient’s ability to mirror the course of a real clinical investigation (median value: 6 on a 7-point scale). The system was said to provide a good environment for safe training of clinical and com-municative skills. The system’s face and construct validity were also demonstrated. Proposed future improvements will include the implementation of detailed feedback from a Virtual Advisor and/or the Virtual Patient him/herself, the use of video-simulated patients and the ability to formulate clinical questions in free text.

    Conclusions: This dedicated Virtual Patient system was well received by the participants. They appraised it as having a good potential for training in relationship to the clinical encounter and the management of traumatized refugees.

  • 45. Rosén, A
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Zary, Nabil
    Sejersen, R
    Lund, B
    A systematic approach to improve oral and maxillofacial surgery education2011Ingår i: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 15, nr 4, 223-230 s.Artikel i tidskrift (Refereegranskat)
  • 46. Rosén, A
    et al.
    Fors, Uno
    Virtual Patient Lab, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Zary, Nabil
    Sejersen, R
    Lund, B
    A systematic approach to improve oral and maxillofacial surgery education2010Ingår i: European Journal of Dental Education, Vol. 15, nr 4, 223-230 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To improve teaching quality and student satisfaction, a new curriculum in Oral Surgery was implemented at Karolinska Institutet in 2007. This paper describes the curriculum change as well as the results regarding quality, satisfaction, cost-effectiveness and workload for teachers and staff. To design the new curriculum, all members of the teaching staff participated in a series of group discussions where problems with the previous curriculum were identified and ideas on how to improve the curriculum were discussed. Cost-effectiveness was evaluated by comparing the number of teaching sessions between the new and the old curriculum. A questionnaire was used to investigate the staffs’ perceived change in workload and teaching quality. The students’ satisfaction and attitudes to learning was screened for by on-line questionnaires. The large amount of passive observational teaching was considered as the main problem with the old curriculum. Half of these sessions were replaced by either clinical seminars or demonstrations performed in an interactive form. Students rated the new curriculum as a clear improvement. Analyses of time and cost-effectiveness showed a decrease in teaching sessions by almost 50%. Generally, the teachers were more positive towards the changes compared to the non-teaching staff. The students rated the new type of learning activities relatively high, whilst the traditional observational teaching was seen as less satisfactory. They preferred to learn in a practical way and few indicated analytic or emotional preferences. The majority of the students reported a good alignment between the new course curriculum and the final exam.

  • 47. Rosén, Annika
    et al.
    Eliassi, Sadia
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Sallnäs, Eva-Lotta
    Sejersen, Ronny
    Lund, Bodil
    A computerised third molar surgery simulator – results of supervision by different professionals2014Ingår i: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 18, nr 2, 86-90 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the study was to investigate which supervisory approach afforded the most efficient learning method for undergraduate students in oral and maxillofacial surgery (OMS) using a computerised third molar surgery simulator.

    Fifth year dental students participated voluntarily in a randomised experimental study using the simulator. The amount of time required and the number of trials used by each student were evaluated as a measure of skills development. Students had the opportunity to practise the procedure until no further visible improvements were achieved. The study assessed four different types of supervision to guide the students. The first group was where they were supported by a teacher/specialist in OMS, the second by a teaching assistant, the third group practised without any supervision and the fourth received help from a simulator technician/engineer. A protocol describing assessment criteria was designed for this purpose, and a questionnaire was completed by all participating students after the study.

    The average number of attempts required to virtually remove a third molar tooth in the simulator was 1.44 times for the group supervised by an OMS teacher; 1.5 times for those supervised by a teaching assistant; 2.8 times for those who had no supervision; and 3.6 times when support was provided only by a simulator technician. The results showed that the most efficient experience of the students was when they were helped by an OMS teacher or a teaching assistant. In a time and cost-effective perspective, supervision by a teaching assistant for a third molar surgery simulator would be the optimal choice.

  • 48.
    Saqr, Mohammed
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap. Qassim University, Kingdom of Saudi Arabia.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Tedre, Matti
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    How learning analytics can early predict under-achieving students in a blended medical education course2017Ingår i: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 39, nr 7, 757-767 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Learning analytics (LA) is an emerging discipline that aims at analyzing students' online data in order to improve the learning process and optimize learning environments. It has yet un-explored potential in the field of medical education, which can be particularly helpful in the early prediction and identification of under-achieving students. The aim of this study was to identify quantitative markers collected from students' online activities that may correlate with students' final performance and to investigate the possibility of predicting the potential risk of a student failing or dropping out of a course.Methods: This study included 133 students enrolled in a blended medical course where they were free to use the learning management system at their will. We extracted their online activity data using database queries and Moodle plugins. Data included logins, views, forums, time, formative assessment, and communications at different points of time. Five engagement indicators were also calculated which would reflect self-regulation and engagement. Students who scored below 5% over the passing mark were considered to be potentially at risk of under-achieving.Results: At the end of the course, we were able to predict the final grade with 63.5% accuracy, and identify 53.9% of at-risk students. Using a binary logistic model improved prediction to 80.8%. Using data recorded until the mid-course, prediction accuracy was 42.3%. The most important predictors were factors reflecting engagement of the students and the consistency of using the online resources.Conclusions: The analysis of students' online activities in a blended medical education course by means of LA techniques can help early predict underachieving students, and can be used as an early warning sign for timely intervention.

  • 49. Solvig, Ekblad
    et al.
    Fors, Uno G. H.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    André, Andreas
    Salminen, Helena
    Medical Training in Transition: Interprofessional and Intercultural Training Enhanced by E-learning Tools for Primary Healthcare Education: A Review2013Ingår i: International Medical Journal, ISSN 1341-2051, Vol. 20, nr 6Artikel, forskningsöversikt (Refereegranskat)
  • 50. Sunnqvist, Charlotta
    et al.
    Karlsson, Karin
    Lindell, Lisbeth
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Virtual patient simulation in psychiatric care - A pilot study of digital support for collaborate learning2016Ingår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 17, 30-35 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Psychiatric and mental health nursing is built on a trusted nurse and patient relationship. Therefore communication and clinical reasoning are two important issues. Our experiences as teachers in psychiatric educational programmes are that the students feel anxiety and fear before they start their clinical practices in psychiatry. Therefore there is a need for bridging over the fear. Technology enhanced learning might support such activities so we used Virtual patients (VPs), an interactive computer simulations of real-life clinical scenarios. The aim of this study was to investigate 4th term nursing students' opinions on the use of Virtual Patients for assessment in a Mental Health and Ill-health course module. We asked 24 volunteering students to practise with five different VP cases during almost 10 weeks before the exam. The participants were gathered together for participating in a written and an oral evaluation. The students were positive to the use of VPs in psychiatry and were very positive to use VPs in their continued nursing education. It seems that Virtual Patients can be an activity producing pedagogic model promoting students' independent knowledge development, critical thinking, reflection and problem solving ability for nurse students in psychiatric care.

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