Completed project

The goal of the ISP project is to try to develop and study the use of realistic simulated patient cases (Virtual Patients) to furnish students and teachers with typical clinical problems, to present a more vivid example of patients-based problems than those presently available in paper-based simulations and to make students more confident in their abilities to solve clinical problems.

Studies in medicine are best performed with the aid of patients. Access to patients though, is limited and patients have to be protected. Case bases studies can, however, be accomplished in other ways as with actors and computer based patients. The ISP system includes a natural language driven illness history function, interactive physical exams as well as a very detailed lab and imaging section. ISP was started in 1990 with the ambition to offer vivid descriptions of patients with communication in "natural" language".

Function of the ISP system

A number of different simulated cases with important and typical diseases are produced. These typical cases could be used in clinical as well as preclinical education. As an offspring of the project, some of the cases mightalso be tried out for examinations, as a complement to paper-based patient problems. The idea is that the computer simulations will permit a much more thorough evaluation of the students' abilities than is possible with a traditional examination. The simulations consist of six main parts:

Medical History

Here, the students can interact with the simulated patient on the screen with an interface resembling natural language. The user types the question using free text and the system responds by playing a corresponding video sequence, in which the simulated patient (virtual actor) gives the answer. For the inexperienced user, also a menu system with preformed questions is available. Almost any medically relevant question can be used and the simulated patient can react with some "emotions", including fear, anger and irritation. A very large number of video sequences are available, which might be combined in real time by the system.

Physical Examination

In this part, the students interact with the simulated patient (displayed using photographs) and they can perform any common examination like inspection, auscultation, palpation, percussion and so forth. All examination results are given in a realistic manner. For example, all heart and respiratory sounds are recorded from real patients. This part is very detailed and contains several hundred responses.

Laboratory Tests

Different laboratory investigations, from the chemical or microbiological lab, the physiological department, from the X-ray department etc. may be ordered here. This part includes several hundred X-ray, CT and MR images and more than 1000 other lab tests, including reference values where applicable.


Here the user can submit their suggestion of correct diagnosis for the case, including a short motivation.


In this module, are the students told how they performed in solving the clinical problem - what anamnestic concepts they used and what they missed, what examinations they did and what they missed and finally what examinations that were harmful, expensive and/or unnecessary.





Our research on Virtual Cases

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