There is great interest in using computer-assisted instruction in medical education, but getting computer-assisted instruction materials used broadly is difficult to achieve. We describe a successful model for the development and maintenance of a specific type of computer-assisted instruction - virtual patients - in medical education. The collaborative model's seven key components are described and compared to other models of diffusion of innovation and curriculum development. The collaborative development model that began in one medical discipline is now extended to two additional disciplines, through partnerships with their respective clerkship director organizations. We believe that the ability to achieve broad use of virtual patients, and to transition the programs from successfully relying on grant funding to financially self-sustaining, resulted directly from the collaborative development and maintenance process. This process can be used in other learning environments and for the development of other types of computer-assisted instruction programs.
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The Computer-assisted Learning in Pediatrics Program (CLIPP) is an example of a successful virtual patient program developed using this collaborative development and maintenance model (Fall et al. 2005). The CLIPP project began development in 2000 with the goal of comprehensively covering the learning objectives of the Council on Medical Student Education in Pediatrics curriculum (Olson et al. 2000) with a series of virtual patient cases. The CLIPP project was supported with funding from US Government grants from 2000 to 2006. During the 2005–2006 academic year, approximately 11,500 individual students at more than 70 medical schools completed 150,000 CLIPP case sessions. This broad adoption and high level of use of a virtual patient program is unprecedented. Since the 2006 academic year, at which time grant funding was no longer available, CLIPP has been supported and maintained by a fee-based subscription model, administered through an independent, non-profit, educational institute. This model has proven successful, with the number of schools using CLIPP increasing considerably since the institution of subscription fees. Currently, CLIPP is in use in more than 110 medical schools in the USA and Canada, and is extensively integrated into their curricula. The typical student completes 20 CLIPP cases, and spends 15–20 h per clerkship working on the cases.
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