Challenges and Opportunities of Using Virtual Patients in XMOOCs

xMOOCs, a type of massive open on-line courses, are characterized by impressive enrollment rates and instructional design based on short video clips and self-assessment quizzes. Offering courses free of charge and prerequisites to large audiences is praised for democratization of knowledge but scorned for non-imaginative educational design. Virtual patients (VPs), known for their qualities in fostering active decision-making, are a natural choice to increase attractiveness and educational potential of health xMOOCs without substantial time requirements for supervision. Karolinska Institutet joined the edX consortium to participate in organizing xMOOCs. Behavioral Medicine was among the courses selected to initiate the collaboration. Due to a case-based character of the course it was convenient to extend it by two branched VPs. The MOOC started in Sept 2014, lasted over 5 weeks and had close to 20,000 enrollees. The VPs were delivered using the MedBiquitous-compliant Open Labyrinth system hosted on the VPH Share cloud-computing platform. Respectively 2458 and 1806 participants declared completing the VPs providing lot of positive feedback. An inspiring opportunity is what was learned from the close to 6,000 traces left in VPs by the participants. Considering the large variety of participants, with USA and India as the most often represented, it was also an interesting challenge how to take advantages and pay tribute to the cultural diversity while designing VPs.