Knowledge engineering in the software development for remote development of decision-making competencies

Background. Development of medical competences is the aim of medical education. Technology of virtual patients has become the main learning tool for these skills as a safe (for real patient), standard digital model. Remote access allows expanding the use, and learning even in case of face-to-face contact limitations.

Aim. Public presentation of the development dynamics and practical results of knowledge engineering during software creation for the formation and assessment of medical decision-making competencies.

Methods. The materials for this research were expert knowledge of skillful clinicians  with  significant  scientific  and teaching experience. Individual and group knowledge engineering methods were used to extract and formalize expert knowledge: survey, brain storm, structured interview, critical review, Delphi method.

Results. Each completed case was considered as a set of textual and multimedia information describing the diagnostic and treatment process (DTP). This information was discretized and represented by a sequence of information nodes in linear trajectory — a model of DTP «as it was.» Subsequently, list of information nodes was determined where DTP trajectory could be changed after another decisions, and additional trajectories that are absent in reality were synthesized. Instead of linear model, the branched graph was created for each case — “how could it be” model that included a certain set of DTP trajectories. Criteria and a scale for evaluating the effectiveness of students’ decisions were formulated, a rating system of evaluation was developed, evidence-based reference materials were prepared for each case. The task specification for programmers was formulated on the basis of obtained results. Software package was developed and implemented for the development and assessment of decision-making competencies of trainees.

Conclusion. The experience of our multidisciplinary team has shown that the engineering of expert knowledge in weakly formalized domains is central to the development software for the development and evaluation of medical decision-making competencies.

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