SimPharm v2.0: A patient-simulation based clinical pharmacology teaching tool

Introduction. For students studying pharmacy, there is a leap between class room learning and dealing with real patients in a dynamic clinical environment. We propose to bridge this gap through a game based, role-playing, software tool in which the student takes the role of a clinical pharmacist in a simulated hospital environment which allows interaction with virtual patients. The interactions and approach is based on the general approach of game theory. The student is free to interactively learn by exploration, making decisions and experiencing consequences without real life sequelae. The student can monitor the symptoms of the patient, order investigations, ask the patient and medical team questions and modify, add, retain or remove drug treatments. The performance of the student can be assessed after the time course of a clinical case episode has finished. A key challenge is that the simulation of drug action, physiology and disease processes in a virtual patient needs to be sufficiently realistic that it provides an immersive and potentially valid clinical experience given a vast combination of drugs, pathologies and patient variability.

Aim. To develop a game in the form of an electronic teaching tool for clinical pharmacology which realistically simulates human physiology, pathophysiology and the effect of drug treatments in virtual patients.

Methods. Mathematical models have been developed to simulate a set of human physiomes (e.g. cardiovascular, respiratory, endocrine). The physiomes contain the necessary physiology, pathophysiology and drug targets to emulate an immersive clinical response. Drugs are portrayed using standardised PKPD properties across a variety of pathologies and drug treatments. Symptom tables map abnormal physiological values to adjectives or verbs for each symptom. With these mappings, medical notes (and answers to questions) can be automatically constructed using natural language processing techniques and presented to the student. An accompanying case building/data entry program is being developed to allow pharmacometricians to parameterize systems with pharmacometric data, design pathological events and create symptom tables and to allow clinical case developers to specify clinical scenarios, such as write patient histories and schedule pathological events.
Results: A simulation platform is in the process of development. It currently incorporates cardiovascular, respiratory and haemoglobin sub-systems models that can be used to generate pathologies such as heart failure and myocardial infarction in addition to the effects of beta-blockers, diuretics and ACE inhibitors. A case will be used to illustrate the system.

Discussion: A demo version of SimPharm is being developed.