Formation and assessment of medical competencies on a virtual model of the treatment and diagnostic process in cardiology

Abstract

Background. It is the competence of making diagnostic and therapeutic decisions that is the most important in clinical practice. Digital model of treatment and diagnostic process (TDP) allows provide the remote formation of skills for decision-making.Aim: To provide the methodological support of remote formation of competences, to improve and assess the skills of medical decision-making in cardiology.Methods. Clinical and diagnostic information from different sources was the material for creating virtual models of TDP. Skilled cardiologists were involved to develop technical specification; knowledge engineering methods were used. Fifty virtual patients with linear structure and ten with branched structure were developed. Technical specification was implemented using Web technologies – Java Script (framework Vue.js), Twitter bootstrap, PostgreSQL.Results. In the first phase of this project only a Web-resource was created. All digital models of patients’ TDP were placed in a linear order without any interactivity. To assess the effectiveness of medical decisions in the second phase of the project, branched TDP model with interactivity was created. It covers all stages of medical decision-making: from the patient hospital admission to his discharge. Besides the real invariant treatment of the patient, the model includes “subjunctive” process variants – “how could it be if ...” Among the interactive blocks, experts considered those leading to a change in TDP trajectory. We named them as “trigger” blocks, where the decisions influence upon TDP outcome. To assess the effectiveness of decisionmaking by learners, the rating system has been developed. It makes it possible to calculate not only general, but also particular personal ratings for certain categories of medical and diagnostic decisions.Conclusion. This study suggests the methodology for remote formation and evaluation of doctor’s competencies, which is implemented in the format of virtual TDP models.