Introduction. Integration of multimedia results of diagnostic examinations into the information model of diagnostic and treatment process makes it possible to teach medical decision-making taking into account all available information about the patient.Aim. The purpose of this work was to use multimedia results of instrumental examination methods to form and verify the level of effective diagnostic decision-making.Material and Methods. A significant array of multimedia information arising in the course of treatment and diagnostic process was derived from databases of diagnostic units and was important for medical decision-making. The model was supplemented with clinically and demographically relevant studies of other patients when necessary. The multimedia components were integrated into the virtual simulations with two different trajectories of information presentation to the trainees depending on the purpose of further use.Results. At the first stage of the project, the multimedia components were integrated into linear models of completed cases to demonstrate medical decisions to the trainees. The multimedia components were presented as the fragments of magnetic resonance imaging (MRI) data, echocardiography and vascular ultrasound recordings, scanned electrocardiograms (ECG), angiography results, X-ray images, tomograms, and results of other visualization methods of patient examination. Each multimedia file was accompanied by a textual conclusion made by a relevant specialist. At the second stage, the multimedia components were integrated into the models with a branched trajectory of information presentation. The course of disease and the patient’s condition could change depending on the decisions made, which means that there are alternative scenarios of the therapeutic and diagnostic process unlike the real invariant treatment of the patient. This possibility is especially important for the formation of medical decision-making competencies in safe conditions of simulation. To elaborate clinical diagnostic tasks, the authors developed a rating system quantifying the effectiveness of the decisions.Discussion. Building physician competencies in the educational process through repeated decision-making under changing conditions is crucially important for the health and lives of patients and can be effectively implemented using simulation technologies. Web access to this content is strategically important for the use of virtual patients with multimedia diagnostic results to practice decision-making skills in clinical disciplines.

The widespread introduction of virtual computer simulations (VCS) in the educational process is limited by the tools’ market for their development. The created software shell consists of three functionally different modules: creating and editing video conferencing; use of videoconferencing; monitoring of the educational process. The developed software shell has remote access and can become the main tool for the repository of virtual computer simulations. Currently, videoconferencing in the field of cardiology has been created as a potential digital base for practical clinical studies and accreditation.

Implementation of virtual patients allows avoiding risks for patient safety, using the standardized clinical situations repeatedly, and providing remote access to information. In order to create virtual patients, the project team comprised of specialists competent in the diverse subject areas. Every virtual patient is a structural model for a diagnostic and treatment process of a real patient augmented with textual and multimedia information. A sample comprising of 50 archival clinical charts of patients with typical cardiovascular diseases and rare pathology variants was formed. Textual information from medical records is supplemented with the multimedia results of instrumental and laboratory studies. Created data and knowledge base of virtual patients was designated for a demonstration of complete cardiovascular cases to the trainees in linear trajectory with an option of Web-access. The virtual patient repository will become a factual basis for problem-based distance learning of medical students and physicians.

Implementation of virtual patients allows avoiding risks for patient safety, using the standardized clinical situations repeatedly, and providing remote access to information. In order to create virtual patients, the project team comprised of specialists competent in the diverse subject areas. Every virtual patient is a structural model for a diagnostic and treatment process of a real patient augmented with textual and multimedia information. A sample comprising of 50 archival clinical charts of patients with typical cardiovascular diseases and rare pathology variants was formed. Textual information from medical records is supplemented with the multimedia results of instrumental and laboratory studies. Created data and knowledge base of virtual patients was designated for a demonstration of complete cardiovascular cases to the trainees in linear trajectory with an option of Web-access. The virtual patient repository will become a factual basis for problem-based distance learning of medical students and physicians.

Aim. To create a methodological base for distance learning of cardiology healthcare professionals — multimedia clinical diagnostic tasks.Material and methods. The interdisciplinary team used text and multimedia formats for clinical diagnostic data. Web technologies provided remote access to information located on the server.Results. The report presents the experience of the practical implementation of multimedia clinical diagnostic tasks in cardiology, including the augmented reality. The variability of presenting information to students is implemented in the multimedia clinical diagnostic tasks, which is integrated with the rating system for evaluating decisions. The solution paths are determined by the actions of the students in the trigger interactive blocks and is evaluated by the rating system. Personal rating is a numerical value that integrally characterizes the decisionmaking competence of students. The conversion of the quantitative rating into the conventional form (‘pass/fail’, ‘excellent’, ‘good’, ‘passing grade’) will be provided after the trial period of the software.Conclusion. The created Web service and computer simulations can become a methodological basis for the distance learning in cardiology. This technology can be in demand in the continuing medical education.

Aim . To formulate the methodology for developing the interactive virtual computer simulations with a rating assessment of trainees’ decisions and the capability of remote access. Material and Methods. The methods of knowledge engineering were used to extract and formalize expert knowledge about the structure, significance, and relevance of clinical diagnostic information. The materials for creating virtual computer simulations were based on texts from the archival medical records, laboratory data, and multimedia results of instrumental methods of study. A three-tier network architecture was applied to provide the capabilities of remote access. It was organizationally represented by three components: a client layer, a business logic layer, and a data layer. Data transfer was provided by the Web protocols while microservices represented the infrastructure. Results . The information was formalized and structured after expert analysis and identification of significant diagnostic and prognostic data. The process included defining the domain model, identifying the aggregates and connections between them, and designing software and user interfaces. Possible solutions for trainees are now presented in the form of interactive reference lists. The artifacts of the user’s work are saved in the storage represented by the module for working with the server file system and the object-relational database management system. Each task module contains static and interactive blocks of information. The purpose of static blocks is to provide trainees with the necessary information for making clinical and diagnostic decisions. The interactive blocks allow selecting one or more solutions from the list. The content and sequence of further information presentation are determined by the trainees’ answers to the questions of an interactive block. Trainees’ decision-making competencies are evaluated using the rating system. The final personal rating is calculated as a multiplication of all coefficients related to the trainees’ decisions. This approach integrates a rating system with the trajectory chosen by the trainee for task completion. Conclusions . The distance learning technologies, developed for clinical disciplines in this study, are quite new and innovative. The repository of virtual computer simulations is under development to improve the methodological support of remote clinical training.

Aim. To formulate the methodology for developing the interactive virtual computer simulations with a rating assessment of trainees’ decisions and the capability of remote access.Material and Methods. The methods of knowledge engineering were used to extract and formalize expert knowledge about the structure, significance, and relevance of clinical diagnostic information. The materials for creating virtual computer simulations were based on texts from the archival medical records, laboratory data, and multimedia results of instrumental methods of study. A three-tier network architecture was applied to provide the capabilities of remote access. It was organizationally represented by three components: a client layer, a business logic layer, and a data layer. Data transfer was provided by the Web protocols while microservices represented the infrastructure.Results. The information was formalized and structured after expert analysis and identification of significant diagnostic and prognostic data. The process included defining the domain model, identifying the aggregates and connections between them, and designing software and user interfaces. Possible solutions for trainees are now presented in the form of interactive reference lists. The artifacts of the user’s work are saved in the storage represented by the module for working with the server file system and the object-relational database management system. Each task module contains static and interactive blocks of information. The purpose of static blocks is to provide trainees with the necessary information for making clinical and diagnostic decisions. The interactive blocks allow selecting one or more solutions from the list. The content and sequence of further information presentation are determined by the trainees’ answers to the questions of an interactive block. Trainees’ decision-making competencies are evaluated using the rating system. The final personal rating is calculated as a multiplication of all coefficients related to the trainees’ decisions. This approach integrates a rating system with the trajectory chosen by the trainee for task completion.Conclusions. The distance learning technologies, developed for clinical disciplines in this study, are quite new and innovative. The repository of virtual computer simulations is under development to improve the methodological support of remote clinical training.

Aim. To develop the methodological ware for distance cardiologists’ postgraduate education by virtual patients’ simulations. The article describes the first stage of the project to create a database of virtual patients. It includes the integration of text and multimedia clinical and diagnostic information about patients and software for its presentation. A virtual patient is considered as an informational model of the diagnostic and treatment processes. Material and methods. To create a database of virtual patients, a description of completed clinical cases in specially designed patterns was used. To provide distance access to information about virtual patients, the JavaScript was used. Results. When forming the database of virtual patients, two categories of case histories were used — the most common cases and rare disease variants. From archival case histories and examination data, information has been selected that plays a significant role in the diagnosis and treatment. It was decided to present the information in the form of separate portions-visits. Each visit includes the results of tests and specialty consultations necessary to make a decision on further treatment. In the template developed by doctors and analysts, patient information is broken down into blocks that included complaints; anamnesis; physical examination; provisional diagnosis; diagnostic and treatment plan; tests’ results; administrations; final diagnosis; clinical report. These blocks served as the basis for the development of relational database tables. To visualize information about the virtual patient, prototypes of screen forms were implemented. Information about different visits was placed on different marks, and the user is able to see previously available information. Conclusion. After testing, this software will be used in education to demonstrate complete clinical cases to students. In addition, by each virtual case, tasks that require students to make medical decisions can be formed. The technology of virtual patients can be used both for postgraduates (doctors) and medical students.

Aim. To develop the methodological ware for distance cardiologists’ postgraduate education by virtual patients’ simulations. The article describes the first stage of the project to create a database of virtual patients. It includes the integration of text and multimedia clinical and diagnostic information about patients and software for its presentation. A virtual patient is considered as an informational model of the diagnostic and treatment processes.Material and methods. To create a database of virtual patients, a description of completed clinical cases in specially designed patterns was used. To provide distance access to information about virtual patients, the JavaScript was used. Results. When forming the database of virtual patients, two categories of case histories were used — the most common cases and rare disease variants. From archival case histories and examination data, information has been selected that plays a significant role in the diagnosis and treatment. It was decided to present the information in the form of separate portions-visits. Each visit includes the results of tests and specialty consultations necessary to make a decision on further treatment. In the template developed by doctors and analysts, patient information is broken down into blocks that included complaints; anamnesis; physical examination; provisional diagnosis; diagnostic and treatment plan; tests’ results; administrations; final diagnosis; clinical report. These blocks served as the basis for the development of relational database tables. To visualize information about the virtual patient, prototypes of screen forms were implemented. Information about different visits was placed on different marks, and the user is able to see previously available information.Conclusion.After testing, this software will be used in education to demonstrate complete clinical cases to students. In addition, by each virtual case, tasks that require students to make medical decisions can be formed. The technology of virtual patients can be used both for postgraduates (doctors) and medical students.

Aim. To develop an information basis for the formation and implementation of multimedia models for the diagnosis and treatment of depersonalized cases of cardiovascular diseases (virtual patients).Material and methods. The materials of the study were completed case histories and multimedia results of investigation of fifty patients who underwent hospital treatment. After an expert assessment of the completed clinical case, it was posted on the server. To provide remote access to content, web development technologies were used.Results. An information model of the medical process in text and multimedia formats has been formed. The virtual patient interface has been implemented in the form of marks appearing as new patient information is received, affecting the decision making. The structure of text and multimedia information on marks of various types is given. The implemented version of virtual patient technology provides web access to the demonstration of depersonalized medical process.Conclusion. During the project progress, a repository of virtual patients is created as a multimedia model for the diagnosis and treatment of cardiovascular pathology provided by web access. The repository will be used to enhance the diagnostic and treatment competencies of doctors through the demonstration and detailed analysis of completed disease cases. Virtual patients can become methodological basis for postgraduate education of doctors in the continuing medical education system.