Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial

Plackett, Ruth; Kassianos, Angelos P.; Kambouri, Maria; Kay, Natasha; Mylan, Sophie; Hopwood, Jenny; Schartau, Patricia; Gray, Shani; Timmis, Jessica; Bennett, Sarah; Valerio, Chris; Rodrigues, Veena; Player, Emily; Hamilton, William; Raine, Rosalind; Duffy, Stephen J.; Sheringham, Jessica

doi:10.1186/s12909-020-02168-4

Cited by 30 publications

(30 citation statements)

References 40 publications

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“…A trial evaluated eCREST in 3 UK medical schools to test feasibility and acceptability and is described in detail elsewhere [33]. This trial found that eCREST appeared to influence students' data gathering but had less impact on flexibility in thinking about diagnoses.…”

Section: The Electronic Clinical Reasoning Educational Simulation Toolmentioning

confidence: 99%

“…Initially, a trial of eCREST was conducted to explore its potential effects on data gathering. The results of the trial's feasibility and effects on data gathering are reported elsewhere [33]. The methodological details of this study are also summarized in the sections below.…”

Section: Designmentioning

confidence: 99%

“…The trial took place at 3 UK medical schools, with full details reported elsewhere [33]. The concurrent qualitative study took place at one of the UK medical schools participating in the trial, with students who were not part of the trial.…”

Section: Settingmentioning

confidence: 99%

“…For the trial, 18.16% (264/1454 of all eligible) final year medical students were recruited and randomly assigned to an intervention or control group. A total of 148 students (78 in the intervention group and 70 in the control group) remained in the trial after 1 month [33]. For the qualitative study, 16 final year medical students were recruited through a peer-assisted learning scheme, where the students opted to undertake a project in medical education, via newsletters and snowball sampling.…”

Section: Participantsmentioning

confidence: 99%

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Using Virtual Patients to Explore the Clinical Reasoning Skills of Medical Students: Mixed Methods Study

Plackett¹,

Kassianos²,

Timmis³

et al. 2021

J Med Internet Res

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Background Improving clinical reasoning skills—the thought processes used by clinicians to formulate appropriate questions and diagnoses—is essential for reducing missed diagnostic opportunities. The electronic Clinical Reasoning Educational Simulation Tool (eCREST) was developed to improve the clinical reasoning of future physicians. A feasibility trial demonstrated acceptability and potential impacts; however, the processes by which students gathered data were unknown. Objective This study aims to identify the data gathering patterns of final year medical students while using eCREST and how eCREST influences the patterns. Methods A mixed methods design was used. A trial of eCREST across 3 UK medical schools (N=148) measured the potential effects of eCREST on data gathering. A qualitative think-aloud and semistructured interview study with 16 medical students from one medical school identified 3 data gathering strategies: Thorough, Focused, and Succinct. Some had no strategy. Reanalysis of the trial data identified the prevalence of data gathering patterns and compared patterns between the intervention and control groups. Patterns were identified based on 2 variables that were measured in a patient case 1 month after the intervention: the proportion of Essential information students identified and the proportion of irrelevant information gathered (Relevant). Those who scored in the top 3 quartiles for Essential but in the lowest quartile for Relevant displayed a Thorough pattern. Those who scored in the top 3 quartiles for Relevant but in the lowest quartile for Essential displayed a Succinct pattern. Those who scored in the top 3 quartiles on both variables displayed a Focused pattern. Those whose scores were in the lowest quartile on both variables displayed a Nonspecific pattern. Results The trial results indicated that students in the intervention group were more thorough than those in the control groups when gathering data. The qualitative data identified data gathering strategies and the mechanisms by which eCREST influenced data gathering. Students reported that eCREST promoted thoroughness by prompting them to continuously reflect and allowing them to practice managing uncertainty. However, some found eCREST to be less useful, and they randomly gathered information. Reanalysis of the trial data revealed that the intervention group was significantly more likely to display a Thorough data gathering pattern than controls (21/78, 27% vs 6/70, 9%) and less likely to display a Succinct pattern (13/78, 17% vs 20/70, 29%; χ23=9.9; P=.02). Other patterns were similar across groups. Conclusions Qualitative data suggested that students applied a range of data gathering strategies while using eCREST and that eCREST encouraged thoroughness by continuously prompting the students to reflect and manage their uncertainty. Trial data suggested that eCREST led students to demonstrate more Thorough data gathering patterns. Virtual patients that encourage thoroughness could help future physicians avoid missed diagnostic opportunities and enhance the delivery of clinical reasoning teaching.

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Section: The Electronic Clinical Reasoning Educational Simulation Toolmentioning

confidence: 99%

Section: Designmentioning

confidence: 99%

Section: Settingmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

See 2 more Smart Citations

Using Virtual Patients to Explore the Clinical Reasoning Skills of Medical Students: Mixed Methods Study

Plackett¹,

Kassianos²,

Timmis³

et al. 2021

J Med Internet Res

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“…Варіантом цього може служити застосування інтерактивних форм навчання, які формують в того, хто навчається, важливі компетенції -знання, навички, вміння, прагнення до саморозвитку. Інтерактивні методи найбільш відповідають особистісно-орієнтованому підходу, оскільки вони передбачають спільне навчання (навчання у співпраці), причому і студент, і викладач є суб'єктами навчального процесу [5,6,7]. В нашій практиці при вивченні внутрішньої медицини використовуються наступні методи інтерактивного навчання [8].…”

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The Characteristics of Using Interactive, High-Technology Information and Distance Learning Methods for Study the Discipline “Internal Medicine” in Blended Learning Conditions

Taktashov¹,

Hrona²,

Homozova³

et al. 2020

Ukr. ž. med. bìol. sportu

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The current state of the system of higher medical education is grounded on many factors including the growing volume of specialized information and the need to expand the level of students’ independent work as well as the conditions of certain restrictions independent of the educational system associated with quarantine measures, etc. This situation predetermines the model of blended learning and the search for both new and improvement of traditional methods and approaches for achieving a high-quality educational process, the purpose of which is to train a highly qualified future internship doctor. Relevant introduction of innovative methods along with the classic teaching “at the patient's bedside” both independently and together with the teacher is one of the motivating components for the student to master the discipline “Internal medicine”. There may be the following variants of interactive forms of learning: role play, work in small groups, case method, lesson-conference, creative tasks: thematic crosswords, quizzes; interactive video courses; methodology in the form “brainstorming”, “discussion”; research work), using different computer multimedia training programs, the department's website, electronic textbooks, online conferences, webinars and other high-tech tools. Of course, the model of distance learning introduced by higher education recently cannot replace traditional education, where the basic skills are formed in the field of practical improvement of the patient’s examination and treatment, but it can supplement it in the context of blended learning. In case of being properly applied and as a part of blended learning this model can really improve the interaction between a teacher and a student while preparing for the classroom lesson and during the student's independent work. In this case, the importance of independent theoretical training for a practical lesson becomes crucial with the growth of the motivational component in the conditions of organized interaction and control of academic performance making it possible to increase the volume of practical work with patients in the classroom. Conclusion. Using traditional, interactive and high-tech methods that complement each other in blended learning, the application of an integrated approach helps to improve the quality and effectiveness of education, expands the ability to form the experience of the student's creative and innovative activities which ultimately affects the future doctor’s competence

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Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review

et al. 2023

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Higher education for health care professionals faces numerous challenges. It is important to develop and apply methods supporting education, especially the practical skills. This scoping review aimed to explore the activities and learning outcomes of digital technology in practical skills teaching and learning in higher education for the social and health professions. Scoping review recommendations and the PRISMA-ScR checklist were applied. Randomized controlled trials published between 2016 and 2021 involving students in higher education who were taking courses in the social sciences and health care and reported interventions with digital technology activities and practices in practical teaching and learning were included. The CINAHL Plus, PubMed, Scopus, ERIC, and Sociological Abstracts/Social Services Abstracts databases were searched. Teaching methods were blended, e-learning or other online-based, and digital simulation-based activities. Teaching and learning environments, methods, resources, and activity characteristics varied, making a summary difficult. Interventions were developed in a face-to-face format prior to digitalization. The outcomes were measured at the knowledge level, not at the performance level. One-third of the studies showed a significant improvement in practical skills in the intervention group in comparison to the control conditions. The use of digital technology in the learning and teaching process have potential to develop of students' skills, knowledge, motivation, and attitudes. The pedagogy of technology use is decisive. The development of new digital methods for teaching and learning practical skills requires the engagement of students and teachers, in addition the researchers.

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Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial

Cited by 30 publications

References 40 publications

Using Virtual Patients to Explore the Clinical Reasoning Skills of Medical Students: Mixed Methods Study

Using Virtual Patients to Explore the Clinical Reasoning Skills of Medical Students: Mixed Methods Study

The Characteristics of Using Interactive, High-Technology Information and Distance Learning Methods for Study the Discipline “Internal Medicine” in Blended Learning Conditions

Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review

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