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Health Services Virtual Organization (HSVO) NEP11 Final Report
Borealis
Ellaway, Rachel; Topps, David; Lachapelle, Kevin; Spence, John; Joy, Aislinn; Cooperstock, Jeremy; Spencer, Bruce; Brooks, Martin — 2024-01-11 The goal of the Health Services Virtual Organization (HSVO) project was to create a sustainable research platform for experimental development of shared ICT-based health services. This was based around the development of a focused collection of functioning services supporting patient treatment planning and team & individual preparedness in the operating room, emergency room, general practice clinics, and patients’ bedsides. A virtual organization was created to develop the platform. The partners were Lakehead University in Thunder Bay, the Northern Ontario School of Medicine in Sudbury and Thunder Bay, the Communications Research Centre and iDeal Consulting in Ottawa, McGill University in Montréal (the Centre for Intelligent Machines and the McGill Simulation Centre), the National Research Council in Fredericton and Innovations in Learning in California. Non-funded partners were added later including the University of Wisconsin-La Crosse and University College Cork (UCC) in Ireland. The platform was based on using Inocybe’s Argia (www.inocybe.ca; software formerly known as UCLP); and NRC’s SAVOIR; Service-oriented Architecture for a Virtual Organization's Infrastructure and Resources (formerly known as Eucalyptus). SAVOIR would connect and control multiple ‘edge devices’ at multiple locations across an articulated private network. The planned edge devices were: • OpenLabyrinth: this is an open source narrative game engine used for creating and running virtual patient cases. • Laerdal SimMan 3G: this is a commercial medical simulation mannequin platform consisting of a human model and a range of software tools for creating and executing training scenarios. • Remote Stereo Viewer (RSV) is a tool for visualizing 3D image datasets, the case of HSVO sourced from the Bassett Collection running from a server at CENIC in California. • VOLSEG is a tool for visualizing volumetric datasets, in the case of the HSVO project a volumetric visual and interactive rendering of the visible human dataset. • Camera array is a means to produce virtual camera views either live or from a stored dataset by capturing multiple video camera feeds observing the same scene from a grid perspective. • General web resources such as the Canadian Medical Association’s Clinical Practice Guidelines. The high level objectives were to: • Establish an articulated high speed and high capacity articulated private network (APN) between all of the project partners and then establish lightpath capabilities over this network. • Set up a number of existing edge devices and develop others (in particular a camera array) • Set up SAVOIR as the middleware hub and connect the edge devices through it via the APN so that they can be controlled from SAVOIR at multiple locations • Conduct trials and evaluations of the platform with medical learners
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Turk Talk - Hybrid NLP example
Borealis
Topps, David; Sharma, Nishan; Ellaway, Rachel; Cullen, Michelle; Cowan, Michele; Topps, Maureen; Corral, Janet; Armson, Heather; Popovic, Ana — 2021-01-13 Human-hybrid NLP.Using Turk Talk approach for Initial Dx and Final Dx. Example showing the Scenario Director's ability to redirect a User according to their free text input. This case can now be made public as a demo. In the 'About' node, we have added some additional instructional materials.
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Bridge Too Far
Borealis
Topps, David; Ellaway, Rachel — 2021-01-01 Triage and transport case. Premise: 21yo man dives off bridge, head injury, c/spine, drowning, difficult intubation. For use with Laerdal SimMan and Osirix video models.
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Agile Writing for Busy Clinical Educators
Borealis
Topps, David; Ellaway, Rachel; Corral, Janet — 2021-04-14 Academic writing is a team sport, requiring close collaboration. We explore the concept of Agile Writing in this context. We look at various approaches, writing tools, team constructs and also provide some real examples of this in action. This document is based on a live, ongoing manuscript that can continue to be edited collaboratively, and commented upon. You can find the live document here: https://docs.google.com/document/d/1SQcei209kzleu9Sy2hL1XXucIlgAmhtH2fLOiNw0WDQ/edit?usp=sharing
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Branching case creation
Borealis
Topps, David; Cullen, Michelle; Ellaway, Rachel — 2022-01-10 In our various materials on creating good learning designs in OLab, we have spoken much about branching narratives in case designs. The ability to create such branching designs is a powerful feature of OLab but not all authors make good use of this capability. The important principle that we try to convey is about decisions and consequences. Real life is not like a quiz: if you make the wrong choice, there is no little man who jumps out of the bushes with a wee red flag to tell you that you made the wrong choice. You have to live with the consequences of your decision. This is certainly not a hard concept to grasp. But it is harder to incorporate into your scenario design. So here are a few examples to consider when trying to adopt this approach: https://creativecommons.org/licenses/by-nc-sa/4.0/
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Using Directed Acyclic Graphs in OLab
Borealis
Topps, David; Wirun, Corey; Myhre, Doug; Hecker, Kent; Ellaway, Rachel — 2022-04-22 As a term, a ‘graph’ in mathematics is a shortening of ‘graphic formula’, essentially an image showing how a formula works visually rather than symbolically. The term ‘graphic’ comes from the Greek (via Latin ‘graphos’ meaning to write or draw). In English, words ending in -graphy reflect a sense of writing or otherwise representing something such that it involves representation for study. This is compared with -logy words which are to do with the study of something – biology is the study of life, biography is writing or representing one or more lives. Geology would be the study of rocks, geography is about representing or recording the earth. A graph then is a representation, an image, a recording, a visual abstraction.
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Case Factors in Decision Making - ontology hypernormalization
Borealis
Topps, David; Wirun, Corey; Ellaway, Rachel — 2022-04-22 This is part of a project looking at the factors that clinicians might take into consideration when making clinical decisions. This is a complex and multifactorial process, which is sometimes performed in a step-wise algorithmic manner, but more commonly as a less well-defined heuristic process. In evaluating each therapeutic action or step, we will need to consider various factors as to whether the step was useful or not. Ideally, these factors should all be present and affected by each step in the case but this may not always be true.
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Norlien TIDE Project Report
Borealis
Topps, David; Ellaway, Rachel; Lee, Sonya; Mutch, Catlin; Morrison, Sandra — 2024-01-17 This report documents a case study of a national project in Canada to develop “a suite of e-learning tools on early brain and biological development and addictions for undergraduate medical education”. The project, commissioned by the Association of Faculties of Medicine of Canada (AFMC) and funded by the Norlien (now Palix) Foundation, consists of three groups of learning resources: ● An e-Textbook Primer ● 22 Virtual Patients – 9 in OpenLabyrinth, 13 in another platform ● 13 Podcasts These materials and additional details about the project can be found here: https://www.afmc.ca/web/en/projects-resources/addiction-elearning This project exemplifies a number of issues: ● VPs as part of a larger project ● Virtual patient cases that can be used anywhere and on any platform ● Virtual patient cases that are program and system agnostic (Canada’s healthcare system varies by province) ● Longevity ● Low maintenance This report outlines the problems faced and the solutions developed.
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DynIA: Dynamically Informed Allegories - final project report
Borealis
Topps, David; Taenzer, Paul; Armson, Heather; Mehta, Ashi; Mutch, Cathlin; Carr, Eloise; Ellaway, Rachel — 2024-02-28 An important strategy for improving population health is to use what we learn from medical research in our patient care. One approach to this is using the highest quality medical research to make recommendations and guide healthcare providers in deciding how to diagnose and treat their patients. These recommendations form the basis of healthcare tools that are called clinical practice guidelines. Theme four focused on strategies for increasing the uptake of clinical practice guidelines on low back pain and headache into community-based care. Theme four researchers collaborated with guideline developers in Alberta at the Institute of Health Economics and an organization called Towards Optimize Practice (TOP) that is sponsored by the Alberta Medical Association and the Alberta Ministry of Health (Alberta Health and Wellness). The research team first looked at what is already been known about uptake of guideline recommendations for chronic pain. This process involved going back to original research from around the world. Research librarians and scientists found 19 scientific papers that are relevant. Taken together, these studies indicated that the best approach to improving uptake of chronic pain guidelines into community care is to present them to care providers in special interactive educational settings where they are able to discuss the recommendations approaches with the educators. Theme four then went on to test this approach in the study of using an interactive educational workshop focused on the low back pain guideline. The study was conducted in collaboration with researchers from the University of Calgary and the University of Alberta. The workshop presenters were an expert team of physicians, physiotherapists, nurses and psychologists that traveled to the offices of the community healthcare providers. This study showed that the providers’ knowledge of low back pain increased after the workshop. When the medical records were examined, the researchers were unable to detect changes in how care was provided. This was a small study involving 24 providers. The researchers concluded that a larger study may confirm the increase in provider knowledge and detect changes in care. https://creativecommons.org/licenses/by-nc-sa/4.0/
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METRICS Model for Medical Education Scholarship
Borealis
Ellaway, Rachel; Topps, David — 2019-05-01 This is a framework or pattern, rather than a dataset. It relates to how elements or objects of scholarly value can be described. This has been useful in various contexts including academic reporting, performance reviews
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PiHPES Project: broadened perspectives on learning analytics
Borealis
Topps, David; Ellaway, Rachel — 2019-05-02 The Precision in Health Professions Education Scholarship (PiHPES) project is an exploration of the problems of trying to apply a big data approach to learning analytics to medical schools and health professional education.
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OpenLabyrinth v3.1.1 source code
Borealis
Topps, David; Ellaway, Rachel; Corral, Janet — 2019-05-02 OpenLabyrinth is a software platform for creating, distributing and evaluating virtual scenarios. v3.1.1 is one of the more stable versions, and an easy install on a wide variety of LAMP servers.
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Decision Analysis Methods in OpenLabyrinth
Borealis
Ellaway, Rachel; Topps, David — 2019-10-10 Evaluation of decisions made when learners are navigating an OpenLabyrinth virtual patient case presents some challenges because of possible complex, branching nature of such cases. The complexity presents great richness in describing and tracking realistic decision opportunities but necessitates different approaches in assessing whether the learner made good choices. This paper explores some aspects of graph theory and path analysis, and presents some perspectives on calculating the probabilities that the pathway chosen was a good one. Standard setting approaches may be required to provide a benchmark against which to measure.
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QuRE and Process Mining
Borealis
Topps, David; Fisher, Bruce; Wirun, Corey; Moores, David; Wong, Annabelle; Ellaway, Rachel — 2019-10-26 With over 3 million referrals and consultations between specialists and primary care providers in Alberta each year, the Quality Referral Evolution (QuRE) has rich scope for improving the quality of communications in the requisition/reporting processes. Using a series of educational interventions such as workshops and reminder cards, the QuRE team has been widely recognized and adopted outside the province. But the consultation process is a complex and fragile set of multiple steps. This technical report describes how activity metrics derived from the electronic medical record (EMR) and captured in an intermediary Learning Record Store (LRS) can provide a powerful mechanism to interface between the clinical and educational activities in the workplace. However, while some simple metrics and reporting can be derived from the LRS directly, there is more to be gained by bringing process mining tools into play.
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BEAMER: Better Extraction of Activity Metrics from Electronic (medical) Records
Borealis
Wirun, Corey; Topps, David; Ellaway, Rachel — 2019-10-27 Design document for an open-source, open-standard web-service that supports extraction and translation of Change Tracking (CT) data from the enterprise-level database engine that supports an electronic medical record (or similar health information system), and makes it available for consumption by a secure Learning Record Store (LRS).
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OpenLabyrinth v3.4.1 source code
Borealis
Topps, David; Ellaway, Rachel; Rud, Sergey — 2019-05-02 OpenLabyrinth is a software platform for creating, distributing and evaluating virtual scenarios.
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OER integration for PiHPES
Borealis
Topps, David; Wirun, Corey; Ellaway, Rachel — 2019-05-13 During our explorations of the factors surrounding the integration of education systems in PiHPES (https://dataverse.scholarsportal.info/dataverse/pihpes), it became clear that there is a need to consider how to integrate an Open Educational Repository (OER) into our efforts. The rationale for this is more clearly delineated in Getting Value from OERs. (1) This document is a Technical Report on the specifications, data formats, protocols and standards that need to be considered in such an effort.
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Digital Professionalism workshop
Borealis
Topps, David; Ellaway, Rachel — 2021-01-21 Hi welcome to our workshop on Digital Professionalism. This has been created for learners at the University of Calgary but you are welcome to use it too. Some of these materials will relate to some resources that we have placed in an OpenLabyrinth virtual scenario here. This scenario is not at all linear – there are various areas you can explore in any order. It is a wee bit easy to get lost, hence the pointers on navigation below. There will also be some short YouTube segments — we recommend you watch the first two.
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PINE: Walk a Mile in My Shoes
Borealis
Topps, David; Ellaway, Rachel — 2021-04-14 13yo female comes back from basketball practice complaining of pain in her right foot. Explores team communications, virtual roles. Premise: This is about communications with a team environment. FHT stuff. Based on a simple ankle injury. Need to decide what key points you want to convey. Main things are: 1. Avoid the common help seeking paths of ER and walkin clinics -- there are other options. 2. Communication between professionals -- which are the most appropriate methods 3. Perspectives of seeing issues from another person
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Heterogeneous graphs and Graph Neural Networks
Borealis
Topps, David; Wirun, Corey; Ellaway, Rachel — 2022-04-22 In exploring some of the concepts around Directed Acyclic Graphs and OLab in the assessment of clinical decision making, we have been juggling the ideas around layered and interconnected DAGs. Some of these explorations led us to the concept of heterogeneous graphs

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