Web-Based Immersive Virtual Patient Simulators: Positive Effect on Clinical Reasoning in Medical Education

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

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A Resident-Driven Mobile Evaluation System Can Be Used to Augment Traditional Surgery Rotation Evaluations

The American Surgeon ◽

10.1177/00031348211011130 ◽

2021 ◽

pp. 000313482110111

Author(s):

Kurun Partap S Oberoi ◽

Akia D Caine ◽

Jacob Schwartzman ◽

Sayeeda Rab ◽

Amber L Turner ◽

...

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

General Surgery ◽

Residency Program ◽

Evaluation System ◽

Clinical Rotation ◽

Web Based ◽

General Surgery Residency ◽

Surgery Residency Program ◽

To Receive

Background The Accreditation Council for Graduate Medical Education requires residents to receive milestone-based evaluations in key areas. Shortcomings of the traditional evaluation system (TES) are a low completion rate and delay in completion. We hypothesized that adoption of a mobile evaluation system (MES) would increase the number of evaluations completed and improve their timeliness. Methods Traditional evaluations for a general surgery residency program were converted into a web-based form via a widely available, free, and secure application and implemented in August 2017. After 8 months, MES data were analyzed and compared to that of our TES. Results 122 mobile evaluations were completed; 20% were solicited by residents. Introduction of the MES resulted in an increased number of evaluations per resident ( P = .0028) and proportion of faculty completing evaluations ( P = .0220). Timeliness also improved, with 71% of evaluations being completed during one’s clinical rotation. Conclusions A resident-driven MES is an inexpensive and effective method to augment traditional end-of-rotation evaluations.

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The (future) doctor will see you now: Piloting a longitudinal virtual patient in medical education, simulating general practice

Medical Teacher ◽

10.1080/0142159x.2020.1853689 ◽

2020 ◽

pp. 1-5

Author(s):

Thomas Dale MacLaine ◽

Cornelia Juengst ◽

David Harris ◽

Catherine Fenn ◽

Helen Gabathuler ◽

...

Keyword(s):

Medical Education ◽

General Practice ◽

Virtual Patient ◽

The Future ◽

Future Doctor

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Clinical reasoning and medical education: Scoping Review

Educación Médica ◽

10.1016/j.edumed.2020.11.015 ◽

2021 ◽

Author(s):

Giovanni García-Castro ◽

Francisco Javier Ruiz-Ortega

Keyword(s):

Medical Education ◽

Clinical Reasoning ◽

Scoping Review

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What Ifs and Multi-directional symptoms PBL cases: two simple and functional adjuncts to problem-based learning materials

International Journal of Innovation in Science and Mathematics Education ◽

10.30722/ijisme.27.08.005 ◽

2019 ◽

Vol 27 (8) ◽

Author(s):

Jeff Schwartz

Keyword(s):

Medical Education ◽

Clinical Reasoning ◽

Problem Based Learning ◽

New Materials ◽

Learning Materials ◽

Case Based Learning ◽

Patient Presentation ◽

Case Based ◽

Management Issues

Although problem-based learning (PBL) is widely used in medical education for its many virtues, a number of deficiencies exist. As means of enhancing the experience of PBL for students, two relatively simple adjuncts to PBL are presented. What Ifs are short hypothetical scenarios, appended to the end of a PBL case, that require students to revisit elements of the PBL case just completed and apply their newly acquired knowledge to clinical reasoning in an altered scenario or to explore anew another dimension of the PBL case. Multi-directional symptoms PBL cases are cases where a common presenting symptom, rather than a specific pathology, is the focus of the PBL case and, following a core narrative of the initial patient presentation, a series of independent continuation narratives with appropriate histories, examination findings and investigation results, lead students to divergent diagnoses and management issues. In addition to keeping the PBL process fresh by rotating new materials regularly, these adjuncts extend the PBL process in the direction of case-based learning.

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Design-Based Research: Definition, Characteristics, Application and Challenges

Journal of Education in Black Sea Region ◽

10.31578/jebs.v5i1.185 ◽

2019 ◽

Vol 5 (1) ◽

pp. 26-35

Author(s):

Hamed Vaezi ◽

Hossein Karimi Moonaghi ◽

Reyhaneh Golbaf

Keyword(s):

Medical Education ◽

Practical Knowledge ◽

Educational Innovation ◽

Sources Of Information ◽

Multiple Sources ◽

Short Term ◽

Web Based ◽

Design Based Research ◽

Definition Of ◽

New Research

In recent years medical education has developed dramatically, but lecturers often cite the existence of a gap between theoretical and practical knowledge. In the first decade of the present century, new research methodology named “design-based research (DBR)” was developed, which most experts and journals refer to as a fundamental way to make changes in the quality and applicability of studies and educational research as well as to enhance and improve the practice of instruction. The aim of the present study was introducing design-based research and its concepts, features, applications, and challenges. A narrative review was conducted in 2018. For this purpose, authorized English academic database including Web of Science, Science Direct, Google Scholar, international database and library in medical research filed with keywords including “design-based research, definition of DBR, DBR applications, medical education, and DBR challenges” without date limitation until 2018.11.21 were screened. Overall, 68 articles were selected and after careful reading, 21 article with related subjects were selected for material extraction. The conclusion was made that DBR that combines empirical research with design-based theories could be considered as an effective method for understanding quality, time and the cause of the phenomenon of educational innovation in practice. Usually DBR is formed by initial evaluation of a problem that occurs in a particular context, and this assessment continues throughout design and implementation. One of the characteristics of DBR is the guiding team, which includes researchers, professionals, designers, managers, teachers, trainers and others whose expertise and knowledge may in some way help. The application of DBR in web-based training programs is quite evident. The probability of non-returns in short-term projects is one of the main challenges of DBR. Medical education has developed dramatically in recent years, but it has made little progress in promoting innovative research methodologies. DBR can be used as a bridge between theories and practice and provide the basis for close communication between researchers, designers, and participants. By applying sophisticated methods and multiple sources of information, the success rate of an intervention in a particular environment is assessed, which ultimately leads to improved theories.

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Electronic Medical Education Effect on Learner Application of Health Care Knowledge in Iran

Advances in Research ◽

10.9734/air/2019/v18i630106 ◽

2019 ◽

pp. 1-5

Author(s):

Shima Tabatabai

Keyword(s):

Health Care ◽

Medical Education ◽

Clinical Reasoning ◽

Controlled Trial ◽

Basic Knowledge ◽

Medical Education Program ◽

Significant Difference ◽

E Learning ◽

Level Of Knowledge ◽

Scientific Meetings

Background: Like most of countries, medical education in Iran consists of undergraduate, postgraduate, and continuing medical education (CME). The use of Internet technologies, have been integrated into all three level of medical education. The effect of Electronic medical education on application of health care knowledge in compare with traditional medical education could show the effectiveness of program. Aims: The aim of this study is to examine the effect of E-Learning on application level of knowledge &clinical reasoning issues as compared to lecture-based learning in a medical education program. Study Design and Methodology: This randomized controlled trial was conducted in scientific meetings for 68 Physicians. Knowledge assessment tests were performed before and immediately after E-Learning and lecture-based educational session. Results: A significant improvement at the application level of knowledge & clinical reasoning was found in both groups (P < 0.01). There was no significant difference between the E-Learning & traditional educational approaches. Course completers had significant improvements in application level of health care knowledge. Conclusion: The effect of E-Learning in medical education and on learner basic knowledge, application of health care knowledge in response to clinical vignettes is comparable to a lecture-based approach. Therefore, E-Learning can be effective in all levels of Medical Education, and it will enable Physicians to have a self-directed learning with choosing the place and time of their lifelong learning process.

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Rushing Roulette – how do learners perform routine tasks under time pressure?

10.7287/peerj.preprints.1859v1 ◽

2016 ◽

Author(s):

David Topps ◽

Ana Popovic ◽

Teejay Horne ◽

Jean M Rawling ◽

Maureen Topps

Keyword(s):

Clinical Reasoning ◽

Time Pressure ◽

Predictive Analytics ◽

Virtual Patient ◽

Decision Points ◽

Coaching Methods ◽

Routine Tasks ◽

Learner Activity ◽

Competing Priorities ◽

Situational Judgement

Introduction: Remediating, or preferably, predicting which residents will have difficulty before they need remediating, is a challenging task. Most of us perform better when pumped for an exam. But how do we respond when under routine pressures? Do weaker learners adapt differently, despite coaching? Methods: Using an adaptation of virtual patient software, we explored how learners cope with handling repetitive yet time-sensitive routine tasks. We emulated the performance of routine tasks within a virtual electronic medical record (EMR) environment, tracking individual learner activity and decision pathways, time to act (with and without enforced pressure from programmed time-outs) and their adaptation trajectories over time with coaching. Learners were assessed using Situational Judgement and modified Script Concordance Testing, with reproducible and granular time constraints introduced into the clinical reasoning process. Results: Our case designs introduce a number of competing elements: time pressures, competing priorities and instructions, resource availability and unpredictable outcomes. Learner behaviour is assessed using a variety of metrics including time-stamped decision points, decision pathways and internal counter scores. Clinical reasoning pathways, as compared to a reference peer panel, are in turn compared with and without the time pressures. Conclusions: Predictive analytics have made great promises in diagnosing problems for learners in difficulty but are complex and expensive to deploy widely. Our simpler, rapidly reproducible approach may provide a more practical solution.

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