Abstract Title
The 'activity' component as an educational principle:Implementation of virtual patients




9II Virtual Patients/Social networking


University Clinic of Münster - Clinic of Vascular and Endovascular Surgery
University Clinic of Münster - Institute for Student Affairs and Medical Education


The FAIR principles: 4 elements of effective learning

As one main strategy to enhance learning outcome the ´activity´ element was firstly described by R.M. Harden and J.M. Laidlaw in 2012.

Aim of this strategy is the engagement of the student in active rather than in passive learning situations.  It can be achieved by student-centred approaches as well as small group work and problem-based learning (PBL). Even within traditional lectures an activity element can be implemented through different strategies including small group discussions or audience response systems.

The key to activity is the challenge to think and reflect.

The activity element consists of:

  1. Small group teaching
  2. e-Learning technologies
  3. learner´s role in a clinical context
Summary of Results


Motivation, clarification and expectations

The ´activity´ tool within the cardiovascular seminars showed positive learning effects. Evaluation of the seminar was improved comparing 2010 and 2014. Evaluation was performed by students´ grading. Free comments showed an increase in acceptability of this tool.

The seminars prepare for the interdisciplinary course of angiology to achieve a mastery learning on staged diagnostic workup in PAD (peripheral artery disease) and performance of an arterial Doppler occlusive measurement.

Summary of Work

Cardiovascular seminars

Besides the feedback element, the activity component was increasingly implemented within the cardiovascular seminars.

Virtual patients were implemented in a web-based diagnostic simulation program, the Inmedea™ simulator (www.inmedea-simulator.net). Key symptoms, e.g. back pain or deception, lead to virtual scenarios including graphic, audio and video material.

The ´blended learning´ is performed within small groups (8-10 students) and one teacher/moderator/facilitator.

Activity is achieved by:

  1. the size of the group which makes interactive learning possible
  2. teacher as the moderator or facilitator in the background
  3. students´ adoption of responsibility on decision-making in a prepared clinical setting
  4. possibility to give and receive a timely and frequent feedback
  5. improve independent learning with further VPs (virtual patients)
  6. standard situations as an independent approach in formative assessment
Take-home Messages

Take Home Messages

  1. The key to activity is the challenge to think and reflect.
  2. Activity activates information and skills storage in the long-term memory.
  3. Activating methods contain simulation, small group work, prepared clinical setting, PBL and portfolios
  4. The active reflective process improves learning outcome and motivation
  5. Activity and feeback clarifies the goals of learning for the assessment



The activity component is an effective learning principle and has shown its relevance within the cardiovascular seminars.

Outcome-centred evaluations will be objective of further interventional studies.



  1. Harden, RM, Laidlaw, JM. Effective Continuing Education: The CRISIS Criteria. AMEE Guide No. 4, Med Educ 1992; 26: 408-422
  2. Laidlaw, JM, Harden, RM. Impact of technology on the education of health care professionals. Intl J Technol Assess 1987; 3: 67-82
  3. Harden, RM Laidlaw, JM. Understanding basic educational principles. In: Essential Skills for a Medical teacher: An Introduction to teaching and learning in medicine. 1st ed 2012, Churchill Livingstone Elsevier, Chapter 2.
  4. Edmunds, S, Brown, G. Effective Small Group Learning. AMEE Guide No. 48 2010Crosby, JR, Hesketh, EA. Developing the teaching instinct: 11: Small group learning. Med Teach 2004; 26: 16-19
  5. Berman, NB, Fall, LH, Chessman, AW, et al. A collaborative model for developing and maintaining virtual patients for medical education. Med Teach 2011; 33: 319-324
  6. Ellaway, R, Masters, K. e-Learning in Medical education. AMEE Guide No. 32, 2008
Summary of Results
Summary of Work
Take-home Messages
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