scholarly journals Virtual patients in the acquisition of clinical reasoning skills: does presentation mode matter? A quasi-randomized controlled trial

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Fabian Schubach ◽  
Matthias Goos ◽  
Götz Fabry ◽  
Werner Vach ◽  
Martin Boeker
Keyword(s):  
Randomized Controlled Trial ◽  
Clinical Reasoning ◽  
Controlled Trial ◽  
Presentation Mode ◽  
Virtual Patients ◽  
Randomized Controlled ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills

scholarly journals Can clinical case discussions foster clinical reasoning skills in undergraduate medical education? A randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e025973 ◽  
Author(s):  
Marc Weidenbusch ◽  
Benedikt Lenzer ◽  
Maximilian Sailer ◽  
Christian Strobel ◽  
Raphael Kunisch ◽  
...  
Keyword(s):  
Learning Outcomes ◽  
Clinical Reasoning ◽  
Clinical Case ◽  
Controlled Trial ◽  
Case Discussions ◽  
Reasoning Skills ◽  
Randomised Controlled ◽  
Clinical Reasoning Skills ◽  
Subjective Learning ◽  
Case Based

ObjectiveFostering clinical reasoning is a mainstay of medical education. Based on the clinicopathological conferences, we propose a case-based peer teaching approach called clinical case discussions (CCDs) to promote the respective skills in medical students. This study compares the effectiveness of different CCD formats with varying degrees of social interaction in fostering clinical reasoning.Design, setting, participantsA single-centre randomised controlled trial with a parallel design was conducted at a German university. Study participants (N=106) were stratified and tested regarding their clinical reasoning skills right after CCD participation and 2 weeks later.InterventionParticipants worked within a live discussion group (Live-CCD), a group watching recordings of the live discussions (Video-CCD) or a group working with printed cases (Paper-Cases). The presentation of case information followed an admission-discussion-summary sequence.Primary and secondary outcome measuresClinical reasoning skills were measured with a knowledge application test addressing the students’ conceptual, strategic and conditional knowledge. Additionally, subjective learning outcomes were assessed.ResultsWith respect to learning outcomes, the Live-CCD group displayed the best results, followed by Video-CCD and Paper-Cases, F(2,87)=27.07, p<0.001, partial η2=0.384. No difference was found between Live-CCD and Video-CCD groups in the delayed post-test; however, both outperformed the Paper-Cases group, F(2,87)=30.91, p<0.001, partial η2=0.415. Regarding subjective learning outcomes, the Live-CCD received significantly better ratings than the other formats, F(2,85)=13.16, p<0.001, partial η2=0.236.ConclusionsThis study demonstrates that the CCD approach is an effective and sustainable clinical reasoning teaching resource for medical students. Subjective learning outcomes underline the importance of learner (inter)activity in the acquisition of clinical reasoning skills in the context of case-based learning. Higher efficacy of more interactive formats can be attributed to positive effects of collaborative learning. Future research should investigate how the Live-CCD format can further be improved and how video-based CCDs can be enhanced through instructional support.

scholarly journals Online patient simulation training to improve clinical reasoning: A feasibility randomised controlled trial

2020 ◽  
Author(s):  
Ruth Plackett ◽  
Angelos P Kassianos ◽  
Maria Kambouri ◽  
Natasha Kay ◽  
Sophie Mylan ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Clinical Reasoning ◽  
Controlled Trial ◽  
Intervention Group ◽  
Diagnostic Errors ◽  
Control Group ◽  
Feasibility Randomised Controlled Trial ◽  
Reasoning Skills ◽  
Randomised Controlled ◽  
Clinical Reasoning Skills

Abstract Background: Online patient simulations (OPS) are a novel method for teaching clinical reasoning skills to students and could contribute to reducing diagnostic errors. However, little is known about how best to implement and evaluate OPS in medical curricula. The aim of this study was to assess the feasibility, acceptability and potential effects of eCREST — the electronic Clinical Reasoning Educational Simulation Tool.Methods: A feasibility randomised controlled trial was conducted with final year undergraduate students from three UK medical schools in academic year 2016/2017 (cohort one) and 2017/2018 (cohort two). Student volunteers were recruited in cohort one via email and on teaching days, and in cohort two eCREST was also integrated into a relevant module in the curriculum. The intervention group received three patient cases and the control group received teaching as usual; allocation ratio was 1:1. Researchers were blind to allocation. Clinical reasoning skills were measured using a survey after one week and a patient case after one month.Results: Across schools, 264 students participated (18.2% of all eligible). Cohort two had greater uptake (183/833, 22%) than cohort one (81/621, 13%). After one week, 99/137 (72%) of the intervention and 86/127 (68%) of the control group remained in the study. eCREST improved students’ ability to gather essential information from patients over controls (OR =1.4; 95% CI 1.1-1.7, n =148). Of the intervention group, most (84/98, 82%) agreed eCREST helped them to learn clinical reasoning skills.Conclusions: eCREST was highly acceptable and improved data gathering skills that could reduce diagnostic errors. Uptake was low but improved when integrated into course delivery. A summative trial is needed to estimate effectiveness.

scholarly journals Improving Pediatric Basic Life Support Performance Through Blended Learning With Web-Based Virtual Patients: Randomized Controlled Trial

2015 ◽  
Vol 17 (7) ◽  
pp. e162 ◽  
Author(s):  
Ronny Lehmann ◽  
Christiane Thiessen ◽  
Barbara Frick ◽  
Hans Martin Bosse ◽  
Christoph Nikendei ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Blended Learning ◽  
Basic Life Support ◽  
Life Support ◽  
Controlled Trial ◽  
Virtual Patients ◽  
Web Based ◽  
Randomized Controlled

scholarly journals Teaching clinical reasoning to undergraduate medical students by illness script method: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mana Moghadami ◽  
Mitra Amini ◽  
Mohsen Moghadami ◽  
Bhavin Dalal ◽  
Bernard Charlin
Keyword(s):  
Medical Students ◽  
Clinical Reasoning ◽  
Controlled Trial ◽  
Intervention Group ◽  
Signs And Symptoms ◽  
Control Group ◽  
Illness Script ◽  
Fourth Year Medical Students ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills

Abstract Background The illness script method employs a theoretical outline (e.g., epidemiology, pathophysiology, signs and symptoms, diagnostic tests, interventions) to clarify how clinicians organized medical knowledge for clinical reasoning in the diagnosis domain. We hypothesized that an educational intervention based on the illness script method would improve medical students’ clinical reasoning skills in the diagnosis domain. Methods This study is a randomized controlled trial involving 100 fourth-year medical students in Shiraz Medical School, Iran. Fifty students were randomized to the intervention group, who were taught clinical reasoning skills based on the illness script method for three diseases during one clinical scenario. Another 50 students were randomized to the control group, who were taught the clinical presentation based on signs and symptoms of the same three diseases as the intervention group. The outcomes of interest were learner satisfaction with the intervention and posttest scores on both an internally developed knowledge test and a Script Concordance Test (SCT). Results Of the hundred participating fourth-year medical students, 47 (47%) were male, and 53 (53%) were female. On the knowledge test, there was no difference in pretest scores between the intervention and control group, which suggested a similar baseline knowledge in both groups; however, posttest scores in the intervention group were (15.74 ± 2.47 out of 20) statistically significantly higher than the control group (14.38 ± 2.59 out of 20, P = 0.009). On the SCT, the mean score for the intervention group (6.12 ± 1.95 out of 10) was significantly higher than the control group (4.54 ± 1.56 out of 10; P = 0.0001). Learner satisfaction data indicated that the intervention was well-received by students. Conclusion Teaching with the illness script method was an effective way to improve students’ clinical reasoning skills in the diagnosis domain suggested by posttest and SCT scores for specific clinical scenarios. Whether this approach translates to improved generalized clinical reasoning skills in real clinical settings merits further study.

Treatment Fidelity Procedures for an Aphasia Intervention Within a Randomized Controlled Trial: Design, Feasibility, and Results

2020 ◽  
Vol 29 (1S) ◽  
pp. 412-424
Author(s):  
Elissa L. Conlon ◽  
Emily J. Braun ◽  
Edna M. Babbitt ◽  
Leora R. Cherney
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Treatment Protocol ◽  
Treatment Fidelity ◽  
Protocol Adherence ◽  
Study Condition ◽  
Randomized Controlled ◽  
Aphasia Therapy ◽  
Percent Accuracy ◽  
Over Time

Purpose This study reports on the treatment fidelity procedures implemented during a 5-year randomized controlled trial comparing intensive and distributed comprehensive aphasia therapy. Specifically, the results of 1 treatment, verb network strengthening treatment (VNeST), are examined. Method Eight participants were recruited for each of 7 consecutive cohorts for a total of 56 participants. Participants completed 60 hr of aphasia therapy, including 15 hr of VNeST. Two experienced speech-language pathologists delivered the treatment. To promote treatment fidelity, the study team developed a detailed manual of procedures and fidelity checklists, completed role plays to standardize treatment administration, and video-recorded all treatment sessions for review. To assess protocol adherence during treatment delivery, trained research assistants not involved in the treatment reviewed video recordings of a subset of randomly selected VNeST treatment sessions and completed the fidelity checklists. This process was completed for 32 participants representing 2 early cohorts and 2 later cohorts, which allowed for measurement of protocol adherence over time. Percent accuracy of protocol adherence was calculated across clinicians, cohorts, and study condition (intensive vs. distributed therapy). Results The fidelity procedures were sufficient to promote and verify a high level of adherence to the treatment protocol across clinicians, cohorts, and study condition. Conclusion Treatment fidelity strategies and monitoring are feasible when incorporated into the study design. Treatment fidelity monitoring should be completed at regular intervals during the course of a study to ensure that high levels of protocol adherence are maintained over time and across conditions.

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