scholarly journals Virtual patient simulation: Promotion of clinical reasoning abilities of medical students

2012 ◽  
pp. 518-527
Keyword(s):  
Medical Students ◽  
Clinical Reasoning ◽  
Health Care Professionals ◽  
Patient Simulation ◽  
Clinical Endocrinology ◽  
Virtual Patient ◽  
Control Group ◽  
Reasoning Abilities ◽  
Academic Level ◽  
Simulation Group

Objectives: Virtual patient simulation (VPS) is used in the education of health care professionals. This method brings an opportunity for the learner to examine necessary diagnostic and therapeutic skills. The aim of this study was to assess the efficacy of VPS on clinical reasoning abilities of medical students and to evaluate their attitude towards VPS in clinical endocrinology course in a teacher centered educational environment. Methods: Fifty-one medical students in their 6th academic year were simply randomized in two groups, the simulation and the control. The students in the simulation group were provided by an application which presented them virtual case scenarios on diagnosis and management of thyroid nodules and osteomalacia. All the students sat for a diagnostic test at the beginning and at the end of the course. The test comprised a series of essay questions matched for their academic level and closely related to the case scenarios. They were also asked to complete a questionnaire to assess their attitude towards the application. Results: Participants in both groups did not have any statistical differences in scientific background in basic sciences (P=0.672) and prior clinical examinations (P=0.376). At completion of the course the mean score of the students in the simulation group improved significantly compared to the students in the control group by 3.5 vs. 1.0 points (P=0.001). The students found the application worthful and showed a positive attitude towards it. Conclusions: Virtual patient simulation improved clinical reasoning abilities of medical students in the context of a traditional teaching/learning environment.

scholarly journals Using peer role-playing to improve students’ clinical skills for musculoskeletal physical examinations

2020 ◽  
Author(s):  
Kazuyo Yamauchi ◽  
Yoko Hagiwara ◽  
Nahoko Iwakura ◽  
Saori Kubo ◽  
Azusa Sato ◽  
...  
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Clinical Reasoning ◽  
Clinical Skills ◽  
Role Play ◽  
Role Playing ◽  
Simulation Program ◽  
Control Group ◽  
Clinical Competency ◽  
Simulation Group

Abstract Background: The traditional curriculum for medical students in Japan does not include sufficient opportunity for the students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. So, the effective program requires to help medical students and residents improve these clinical skills about MSK. Our purpose was to assess using mini-CEX that these clinical skills of medical students have experienced peer role-playing simulation program.Methods: Participants were 90 women medical students who were completing their first orthopaedic clinical clerkship, were allocated into two groups. The simulation group encountered with role-play for MSK cases as low fidelity simulation, and a structured debriefing with the course supervisor including self- reflection at Day 1 (n = 64). The control group did not participate in the role-play due to clerkship schedule randomized (n = 26). We observed and assessed all participants’ performance at outpatient encounter using the mini clinical evaluation exercise (mini-CEX) when all participant encountered the first visit MSK outpatient at Day 2, and compared mini-CEX score between the simulation group and the control group. A statistical method was used Wilcoxon rank-sum test.Results: The Physical examination, the Clinical reasoning and Diagnosis, and the Overall clinical competency of the mini-CEX scores were significant differences in the simulation group higher than in the control group (p < .05, Physical examination: p = .014, Clinical Reasoning: p = .042, Overall: p = .016). These finding suggests the possibility that our medical students who have experienced peer role-playing simulation program improved the clinical skills of physical examination, the clinical reasoning and diagnosis, and the Overall clinical competency on the real-life MSK outpatient encounters.Conclusions: We successfully capture to assess using mini-CEX that these clinical skills improving of medical students who have experienced peer role-playing simulation program. A peer role-playing as a low-fidelity simulation will enable to polish the competency of medical students a musculoskeletal physical examination, and a clinical reasoning and diagnosis in a clinical setting, as a practical educational opportunity.

scholarly journals Using peer role-playing to improve students’ clinical skills for musculoskeletal physical examinations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kazuyo Yamauchi ◽  
Yoko Hagiwara ◽  
Nahoko Iwakura ◽  
Saori Kubo ◽  
Azusa Sato ◽  
...  
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Clinical Reasoning ◽  
Clinical Skills ◽  
Role Play ◽  
Role Playing ◽  
Control Group ◽  
Simulation Group ◽  
Physical Examinations ◽  
Simulation Programme

Abstract Background The traditional curriculum for medical students in Japan does not include sufficient opportunities for students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. Therefore, an effective programme is required to help medical students and residents improve their clinical skills in MSK. This paper aims to assess the clinical skills of medical students who have participated in a peer role-playing simulation programme using a mini clinical evaluation exercise (mini-CEX). Methods Participants were 90 female medical students who were completing their first orthopaedic clinical clerkship. They were divided into two groups. The simulation group participated in a role-play focussed on MSK cases as low-fidelity simulation, a structured debriefing with the course supervisor, and a self-reflection on Day 1 (n = 64). The control group did not participate in the role-play due to randomised clerkship schedules (n = 26). On Day 2 of the intervention, we observed and assessed all participants’ performances during MSK outpatient encounters using the mini-CEX. We compared the mini-CEX score between the simulation group and the control group; the Wilcoxon rank-sum test was used for statistical analysis. Results The mini-CEX scores for physical examination, clinical reasoning and diagnosis, and overall clinical competency were significantly higher in the simulation group than in the control group (p < .05, physical examination: p = .014, clinical reasoning: p = .042, overall: p = .016). These findings suggest that medical students who partake in a peer role-playing simulation programme could experience improved clinical skills for physical examination, clinical reasoning and diagnosis, and overall clinical competency in real-life MSK outpatient encounters. Conclusions Through a mini-CEX assessment, our findings indicate that medical students who participated in our peer role-playing simulation programme have improved clinical skills. Peer role-playing as a low-fidelity simulation and practical educational opportunity will enable educators to polish the competency of medical students in musculoskeletal physical examinations and clinical reasoning and diagnosis in a clinical setting.

scholarly journals Evaluating the effectiveness of a single-day simulation-based program in psychiatry for medical students: a controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia Younes ◽  
Anne Laure Delaunay ◽  
M. Roger ◽  
Pierre Serra ◽  
France Hirot ◽  
...  
Keyword(s):  
Medical Students ◽  
Factor Structure ◽  
Internal Consistency ◽  
Controlled Study ◽  
Simulated Patients ◽  
Control Group ◽  
Retest Reliability ◽  
Knowledge And Attitudes ◽  
Simulation Group ◽  
Test Retest Reliability

Abstract Background Training in psychiatry requires specific knowledge, attitudes, and skills that are obtainable by simulation, of which the use is only recent and still needs further development. Evidence is accumulating on its effectiveness but requires further validation for medical students. We aimed to evaluate the effectiveness of a single-day optional teaching program in psychiatry by simulation for medical students and validate a scale measuring Confidence in Psychiatric Clinical Skills (CPCQ), as part of the assessment. Methods This was a controlled study in a French University that compared (using paired-sample Student t-tests) knowledge and attitudes (university grades and CPCQ scores) before, just after teaching with simulated patients, and 2 months later. Satisfaction with the program (including the quality of the debriefing) was also investigated. The CPCQ scale was validated by assessing the factor structure, internal consistency, and test-retest reliability. Finally, a comparison was run with a control group who received the usual psychiatric instruction using covariance analyses. Results Twenty-four medical students were included in the simulation group and 76 in the control group. Just after the simulation, knowledge and attitudes increased significantly in the simulation group. Satisfaction with the training and debriefing was very high. The CPCQ scale showed good psychometric properties: a single-factor structure, acceptable internal consistency (α = 0.73 [0.65–0.85]), and good test-retest reliability (ICC = 0.71 [0.35–0.88]). Two months after the simulation, knowledge and attitudes were significantly higher in the simulation group than the control group, despite a lack of difference in knowledge before the simulation. Conclusions Adding a simulation program in psychiatry to the usual teaching improved the knowledge and confidence of medical students. The CPCQ scale could be used for the evaluation of educational programs.

scholarly journals Assessing clinical reasoning abilities of medical students using clinical performance examination

2016 ◽  
Vol 28 (1) ◽  
pp. 35-47 ◽  
Author(s):  
Sunju Im ◽  
Do-Kyong Kim ◽  
Hyun-Hee Kong ◽  
Hye-Rin Roh ◽  
Young-Rim Oh ◽  
...  
Keyword(s):  
Medical Students ◽  
Clinical Reasoning ◽  
Clinical Performance ◽  
Reasoning Abilities ◽  
Performance Examination

scholarly journals Virtual patient simulation in breaking bad news training for medical students

2020 ◽  
Vol 103 (7) ◽  
pp. 1435-1438
Author(s):  
Valerie Carrard ◽  
Céline Bourquin ◽  
Sandy Orsini ◽  
Marianne Schmid Mast ◽  
Alexandre Berney
Keyword(s):  
Medical Students ◽  
Patient Simulation ◽  
Virtual Patient ◽  
Bad News ◽  
Breaking Bad News ◽  
Breaking Bad

scholarly journals The Effectiveness of Using Virtual Patient Educational Tools to Improve Medical Students’ Clinical Reasoning Skills: A Systematic

2021 ◽  
Author(s):  
Ruth Plackett ◽  
Angelos P. Kassianos ◽  
Sophie Mylan ◽  
Maria Kambouri ◽  
Rosalind Raine ◽  
...  
Keyword(s):  
Medical Students ◽  
Problem Solving ◽  
Clinical Reasoning ◽  
Meta Analysis ◽  
Data Gathering ◽  
Virtual Patient ◽  
Undergraduate Medical Students ◽  
Educational Tools ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills

Abstract Background Use of virtual patient educational tools could fill the current gap in the teaching of clinical reasoning skills. However, there is a limited understanding of their effectiveness. The aim of this study was to synthesise the evidence to understand the effectiveness of virtual patient tools aimed at improving undergraduate medical students’ clinical reasoning skills. Methods We searched MEDLINE, EMBASE, CINAHL, ERIC, Scopus, Web of Science and PsycINFO from 1990 to October 2020, to identify all experimental articles testing the effectiveness of virtual patient educational tools on medical students’ clinical reasoning skills. Quality of the articles was assessed using an adapted form of the MERSQI and the Newcastle-Ottawa Scale. A narrative synthesis summarised intervention features, how virtual patient tools were evaluated and reported effectiveness. Results The search revealed 7,290 articles, with 20 articles meeting the inclusion criteria. Average study quality was moderate (M=7.1, SD=2.5), with around a third not reporting any measurement of validity or reliability for their clinical reasoning outcome measure (7/20, 35%). Eleven articles found a positive effect of virtual patient tools on reasoning (11/20, 55%). Seven (7/20, 35%) reported no significant effect or mixed effects and two found a significantly negative effect (2/20, 10%). Several domains of clinical reasoning were evaluated. Data gathering, ideas about diagnosis and patient management were more often found to improve after virtual patient use (27/46 analyses, 59%) than knowledge, flexibility in thinking, problem-solving, and critical thinking (4/10 analyses, 40%). Conclusions Using virtual patient tools could effectively complement current teaching especially if opportunities for face-to-face teaching or other methods are limited, as there was some evidence that virtual patient educational tools can improve undergraduate medical students’ clinical reasoning skills. Evaluations that measured more case specific clinical reasoning domains, such as data gathering, showed more consistent improvement than general measures like problem-solving. Case specific measures might be more sensitive to change given the context dependent nature of clinical reasoning. Consistent use of validated clinical reasoning measures is needed to enable a meta-analysis to estimate effectiveness.

scholarly journals Scaffolding clinical reasoning of medical students with virtual patients: effects on diagnostic accuracy, efficiency, and errors

Diagnosis ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 137-149 ◽  
Author(s):  
Leah T. Braun ◽  
Katharina F. Borrmann ◽  
Christian Lottspeich ◽  
Daniel A. Heinrich ◽  
Jan Kiesewetter ◽  
...  
Keyword(s):  
Medical Students ◽  
Diagnostic Accuracy ◽  
Clinical Reasoning ◽  
Diagnostic Errors ◽  
Initial Assessment ◽  
Control Group ◽  
Diagnostic Efficiency ◽  
Virtual Patients ◽  
Or Efficiency ◽  
Electronic Learning Environment

Abstract Background Understanding clinical reasoning is a major challenge in medical education research. Little is known about the influence of scaffolding and feedback on the clinical reasoning of medical students. The aim of this study was to measure the effects of problem representation (cognitive representation of a clinical case) and structured scaffolding for reflection with or without feedback on the diagnostic efficiency and characterization of diagnostic errors of medical students. Methods One hundred and forty-eight advanced medical students were randomly assigned to one of five groups (2 × 2 design with a control group). They worked on 15 virtual clinical cases (five learning cases, five initial assessment cases, and five delayed assessment cases) in an electronic learning environment. After each case, they stated their presumed diagnosis and explained their diagnostic conclusion. Diagnostic accuracy, efficiency, and error distribution were analyzed. Results The diagnostic accuracy (number of correctly solved cases) and efficiency (solved cases/total time) did not differ significantly between any of the groups in the two different assessment phases [mean = 2.2–3.3 (standard deviation [SD] = 0.79–1.31), p = 0.08/0.27 and mean = 0.07–0.12 (SD = 0.04–0.08), p = 0.16/0.32, respectively]. The most important causes for diagnostic errors were a lack of diagnostic skills (20%), a lack of knowledge (18%), and premature closure (17%). Conclusions Neither structured reflections nor representation scaffolding improved diagnostic accuracy or efficiency of medical students compared to a control group when working with virtual patients.

scholarly journals The Utility of Virtual Patient Simulations for Clinical Reasoning Education

2020 ◽  
Vol 17 (15) ◽  
pp. 5325 ◽  
Author(s):  
Takashi Watari ◽  
Yasuharu Tokuda ◽  
Meiko Owada ◽  
Kazumichi Onigata
Keyword(s):  
Medical Students ◽  
Clinical Reasoning ◽  
Virtual Patient ◽  
P Value ◽  
Lecture Hall ◽  
Patient Simulations ◽  
Clinical Scenarios ◽  
Post Test ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills

Virtual Patient Simulations (VPSs) have been cited as a novel learning strategy, but there is little evidence that VPSs yield improvements in clinical reasoning skills and medical knowledge. This study aimed to clarify the effectiveness of VPSs for improving clinical reasoning skills among medical students, and to compare improvements in knowledge or clinical reasoning skills relevant to specific clinical scenarios. We enrolled 210 fourth-year medical students in March 2017 and March 2018 to participate in a real-time pre-post experimental design conducted in a large lecture hall by using a clicker. A VPS program (®Body Interact, Portugal) was implemented for one two-hour class session using the same methodology during both years. A pre–post 20-item multiple-choice questionnaire (10 knowledge and 10 clinical reasoning items) was used to evaluate learning outcomes. A total of 169 students completed the program. Participants showed significant increases in average total post-test scores, both on knowledge items (pre-test: median = 5, mean = 4.78, 95% CI (4.55–5.01); post-test: median = 5, mean = 5.12, 95% CI (4.90–5.43); p-value = 0.003) and clinical reasoning items (pre-test: median = 5, mean = 5.3 95%, CI (4.98–5.58); post-test: median = 8, mean = 7.81, 95% CI (7.57–8.05); p-value < 0.001). Thus, VPS programs could help medical students improve their clinical decision-making skills without lecturer supervision.

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