Adaptation of an international virtual patient collection to the COVID-19 pandemic

Hege, Inga; Sudacka, Małgorzata; Kononowicz, Andrzej A.; Nonnenmann, Julia; Banholzer, Julia; Schelling, Jörg; Adler, Martin W.; Espinoza, Bernarda; Garrido, Marie Astrid; Radon, Katja

doi:10.3205/zma001385

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…Due to limitations in bedside teaching, many learners and teachers are looking for alternatives or other approaches to supporting their established Fig. 2 A vicious circle blocking implementation of clinical reasoning in curricula educational methods [23]. We call for protected time for faculty members to develop their teaching techniques.…”

Section: Discussionmentioning

confidence: 99%

Why is it so difficult to implement a longitudinal clinical reasoning curriculum? A multicenter interview study on the barriers perceived by European health professions educators

Sudacka

Adler²,

Durning

et al. 2021

BMC Med Educ

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Background Effective clinical reasoning is a core competency of health professionals that is necessary to assure patients’ safety. Unfortunately, adoption of longitudinal clinical reasoning curricula is still infrequent. This study explores the barriers that hinder the explicit teaching of clinical reasoning from a new international perspective. Methods The context of this study was a European project whose aim is to develop a longitudinal clinical reasoning curriculum. We collected data in semi-structured interviews with responders from several European countries who represent various health professions and have different backgrounds, roles and experience. We performed a qualitative content analysis of the gathered data and constructed a coding frame using a combined deductive/inductive approach. The identified themes were validated by parallel coding and in group discussions among project members. Results A total of 29 respondents from five European countries participated in the interviews; the majority of them represent medicine and nursing sciences. We grouped the identified barriers into eight general themes: Time, Culture, Motivation, Clinical Reasoning as a Concept, Teaching, Assessment, Infrastructure and Others. Subthemes included issues with discussing errors and providing feedback, awareness of clinical reasoning teaching methods, and tensions between the groups of professionals involved. Conclusions This study provides an in-depth analysis of the barriers that hinder the teaching of explicit clinical reasoning. The opinions are presented from the perspective of several European higher education institutions. The identified barriers are complex and should be treated holistically due to the many interconnections between the identified barriers. Progress in implementation is hampered by the presence of reciprocal causal chains that aggravate this situation. Further research could investigate the perceptual differences between health professions regarding the barriers to clinical reasoning. The collected insights on the complexity and diversity of these barriers will help when rolling out a long-term agenda for overcoming the factors that inhibit the implementation of clinical reasoning curricula.

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Section: Discussionmentioning

confidence: 99%

Why is it so difficult to implement a longitudinal clinical reasoning curriculum? A multicenter interview study on the barriers perceived by European health professions educators

Sudacka

Adler²,

Durning

et al. 2021

BMC Med Educ

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“…Virtual patients (VPs) are "interactive computer simulation[s] of real-life clinical scenarios for the purpose of medical training, education, or assessment" [1]. Their importance has been increasing over the years [2], especially since the beginning of the COVID-19 pandemic [3]. VPs provide a safe environment in which learners can work at their own 2 of 15 pace and learn from errors without harming a patient [4].…”

Section: Introductionmentioning

confidence: 99%

Planning a Collection of Virtual Patients to Train Clinical Reasoning: A Blueprint Representative of the European Population

Mayer

Domingues

Hege

et al. 2022

IJERPH

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Background: Virtual patients (VPs) are a suitable method for students to train their clinical reasoning abilities. We describe a process of developing a blueprint for a diverse and realistic VP collection (prior to VP creation) that facilitates deliberate practice of clinical reasoning and meets educational requirements of medical schools. Methods: An international and interdisciplinary partnership of five European countries developed a blueprint for a collection of 200 VPs in four steps: (1) Defining the criteria (e.g., key symptoms, age, sex) and categorizing them into disease-, patient-, encounter- and learner-related, (2) Identifying data sources for assessing the representativeness of the collection, (3) Populating the blueprint, and (4) Refining and reaching consensus. Results: The blueprint is publicly available and covers 29 key symptoms and 176 final diagnoses including the most prevalent medical conditions in Europe. Moreover, our analyses showed that the blueprint appears to be representative of the European population. Conclusions: The development of the blueprint required a stepwise approach, which can be replicated for the creation of other VP or case collections. We consider the blueprint an appropriate starting point for the actual creation of the VPs, but constant updating and refining is needed.

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Using a virtual patient system to improve medical students’ confidence in clinical diagnosis: a controlled study

Lee,

Lau

et al. 2024

JARHE

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PurposeThis study aimed to evaluate the effectiveness of using a virtual patient (VP) software program in increasing clinical reasoning skills confidence among medical students.Design/methodology/approachA quasi-experimental design was used to compare the outcomes of students’ confidence levels on clinical reasoning between problem-based learning (PBL) and VP program with 122 pre-clinical Year 2 medical students. History taking, physical examination, clinical investigations and diagnosis was investigated using four PBL cases in the oncology block. Pre- and post-differences in mean confidence scores between the arms were compared, as well as mean difference by type of case and skill category.FindingsA total of 122/156 (78.2%) students participated; n = 55 were from 7 VP groups and n = 67 were from 13 control arm groups. For the primary outcome, the VP arm showed a statistically significant increase in confidence measures among 11/16 (4 cases × 4 skills) categories, compared to 4/16 for the control arm. The proportion of the students who indicated an improved confidence was statistically significant for the cervical cancer case for physical examination (60.0% improved in VP vs 12.5% in control), investigation (60.0% VP vs 18.8% control) and diagnosis (60.0% in VP vs 25.0% in control). Finally, analysis by case showed an increment in overall mean scores from the start to end of the case within the VP arm while the pattern was erratic in the control arm cases.Originality/valueThe study results showed that incorporating the VP into PBL was more effective in increasing students’ clinical reasoning confidence levels compared to the usual PBL. As the study utilized existing PBL cases, it demonstrates how medical schools can incorporate digital VP tools into pre-clinical years before students' transition to learning from actual patients in the clinical years.

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Adaptation of an international virtual patient collection to the COVID-19 pandemic

Cited by 4 publications

References 3 publications

Why is it so difficult to implement a longitudinal clinical reasoning curriculum? A multicenter interview study on the barriers perceived by European health professions educators

Why is it so difficult to implement a longitudinal clinical reasoning curriculum? A multicenter interview study on the barriers perceived by European health professions educators

Planning a Collection of Virtual Patients to Train Clinical Reasoning: A Blueprint Representative of the European Population

Using a virtual patient system to improve medical students’ confidence in clinical diagnosis: a controlled study

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