Teaching Virtually revolutionised With Internet Project

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Sussex researchers are piloting a new project which could pave the way for a revolution in the training of doctors and health professionals - and the worldwide web is at the helm.

The pioneering venture, dubbed PATSy (Patient Assessment Training System), is a multimedia package which can accept case-based data from virtually any health-related field. It will train students and further the knowledge of researchers and practising clinicians using an unprecedented system of audio-clips, video-clips and interactive tests. It could be used by pathologists, psychiatrists, neuropsychologists - or indeed any health professional who needs to carry out tests on patients to arrive at a diagnosis.

The system is currently proving its potential for revolutionising current teaching practices. It is already an integral part of the speech therapy course at Queen Margaret's College in Edinburgh, and has sparked off interest at York, Newcastle and Sheffield Universities.

Spearheading the project is Dr Richard Cox, a cognitive scientist in COGS. He believes PATSy will become a central tool in universities and medical schools across the country - not just for speech therapy, but for a range of other disciplines too. The programme gives any student who deals with patients a confidence boost, as they can practise dealing with clinical situations many times before they have to encounter a real patient. But it also counteracts the ad hoc basis on which students currently acquire clinical skills training.

It is possible, for example, for speech therapy students to complete a course having only ever encountered a fraction of the conditions which they might confront in their career. With this programme, they can gain virtual experience of a wide range of disorders.

They are able to 'administer' up to 40 tests on the patients in order to reach a diagnosis.

With the speech therapy database, a student can log-on to the site, using a special password, and select a patient from an organised menu of cases. A videoclip is then displayed of the patient speaking with a consultant. The clip is crucial, as Richard points out: "The astute observer can detect patterns of language use, as well as clues from motor movements. Also, it ensures that they see the patient they are dealing with as a real person rather than a disembodied voice." A test can then be 'administered' on the patient by the logged-on student. On the TROG test, for example, the patient listens to a stimulus and points to the corresponding picture. An arrow on the screen reveals which pictures the patient has chosen, and the student can make a record of their success rate. Other tests include the patient's own spoken response to tests, which the student is able to hear and take note of. The students can then make a diagnosis, as they would be able to in a clinical situation.

Richard emphasises that the teaching tool benefits tutors as well as students. The sequence of tests is logged, which means students can be assessed on which tests they have chosen and in what order: "They can print their log off and take it to tutorials for assessments. This presents an unprecedented opportunity for tutors to gain an explicit insight into students' diagnostic reasoning," he says. It will also be an invaluable resource for researchers who want to discover further details about cases they might read about in journals. Indeed, Richard believes that inclusion on PATSy could eventually become an adjunct to normal ways of academic publishing. And crucially, "PATSy can also help trained clinicians who feel they've got a bit rusty, and who want to get some experience with rare cases," he says.

New cases and new disciplines can be added to the database all the time, making it a dynamic, growing resource. Psychiatrists could virtually scrutinise symptoms of rare disorders, clinical psychologists could scour on-line patients for Alzheimer's Disease, and pathologists could determine the root causes of rare diseases. In the near future, PATSy could be an integral part of every health-related case-based discipline.