How to tell a patient’s story? Influence of the case narrative design on the clinical reasoning process in virtual patients

Hege, Inga; Dietl, Anita; Kiesewetter, Jan; Schelling, Jörg; Kiesewetter, Isabel

doi:10.1080/0142159x.2018.1441985

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Subjectively, the usability was even slightly higher. Usability in our study was comparable to that in usability tests routinely performed with the Casus system for individual learners [31,32]. This provides initial evidence that the additional technical aspects of the collaboration tool did not decrease the usability of Casus.…”

Section: Principal Findingssupporting

confidence: 76%

Implementing Remote Collaboration in a Virtual Patient Platform: Usability Study

Kiesewetter¹,

Hege²,

Sailer³

et al. 2022

JMIR Med Educ

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Background Learning with virtual patients is highly popular for fostering clinical reasoning in medical education. However, little learning with virtual patients is done collaboratively, despite the potential learning benefits of collaborative versus individual learning. Objective This paper describes the implementation of student collaboration in a virtual patient platform. Our aim was to allow pairs of students to communicate remotely with each other during virtual patient learning sessions. We hypothesized that we could provide a collaborative tool that did not impair the usability of the system compared to individual learning and that this would lead to better diagnostic accuracy for the pairs of students. Methods Implementing the collaboration tool had five steps: (1) searching for a suitable software library, (2) implementing the application programming interface, (3) performing technical adaptations to ensure high-quality connections for the users, (4) designing and developing the user interface, and (5) testing the usability of the tool in 270 virtual patient sessions. We compared dyad to individual diagnostic accuracy and usability with the 10-item System Usability Scale. Results We recruited 137 students who worked on 6 virtual patients. Out of 270 virtual patient sessions per group (45 dyads times 6 virtual patients, and 47 students working individually times 6 virtual patients minus 2 randomly selected deleted sessions) the students made successful diagnoses in 143/270 sessions (53%, SD 26%) when working alone and 192/270 sessions (71%, SD 20%) when collaborating (P=.04, η2=0.12). A usability questionnaire given to the students who used the collaboration tool showed a usability score of 82.16 (SD 1.31), representing a B+ grade. Conclusions The collaboration tool provides a generic approach for collaboration that can be used with most virtual patient systems. The collaboration tool helped students diagnose virtual patients and had good overall usability. More broadly, the collaboration tool will provide an array of new possibilities for researchers and medical educators alike to design courses for collaborative learning with virtual patients.

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Section: Principal Findingssupporting

confidence: 76%

Implementing Remote Collaboration in a Virtual Patient Platform: Usability Study

Kiesewetter¹,

Hege²,

Sailer³

et al. 2022

JMIR Med Educ

Self Cite

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“…Some studies in our review involved patients with real experience of the medical problems they portrayed, but scripted their role, supposedly with the aim of standardising students’ learning experience [23]. A potential benefit of doing this might be to provide students with a “safe” environment in which to make mistakes [47]. Whilst this may be a valid approach to use in early years of student training, scripted, “virtual” or “simulated” patients can be perceived as formulaic by medical students, failing to prepare them well for dealing with issues beyond the clinical presentation, such as unemployment, disability, or other life circumstances [48].…”

Section: Discussionmentioning

confidence: 99%

Technology-delivered undergraduate medical education involving patients and carers: A rapid systematic review

Lawes-Wickwar

Lovat

Alao

et al. 2021

Preprint

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Background: Involving patients and carers in medical education centralises their voice in healthcare and supports students to develop key professional and person-centred skills. Medical schools are increasingly using technology to deliver educational activities. No review currently exists to establish the variety of technologies and their uses in undergraduate medical education when patients and/or carers are involved. Methods: Ovid MEDLINE, Ovid EMBASE and medRxiv were searched in October 2020 and reference lists of key articles were hand searched. Eligible studies reported technology-assisted education, in any setting, involving authentic patients and/or carers. Studies in foreign languages, or describing actors or non-authentic patients were excluded. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Levels of patient involvement were assessed using Towle et al (2010) taxonomy. Results: Twenty studies were included. The majority involved patients and/or carers via pre-recorded videos or online scenarios, with no student-interaction. Four studies evaluated remote consultations using telehealth technology, involving real-time interactions with authentic patients. Technology-supported teaching sessions involving patients and/or carers were found to be acceptable to students, educationally valuable (to students and educators), and enhanced student engagement, patient-centred attitudes, knowledge of specific patient groups, and communication and clinical skills. Two studies describing real-time remote interactions with authentic patients indicated potential barriers for students (reduced ability to build relationship with patients and examine them), educators (reduced ability to build rapport with students) and patients (issues with using or accessing telehealth). Conclusions: No studies directly measured the perspective of patients or carers involved in technology-delivered medical education. Future research should establish barriers and facilitators to patients and carers taking up a role in medical students education when technology is used, and evaluate PPI activities at Levels 3 and above as described by Towle et al taxonomy.

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“…31, p.1 The SUS includes 10 questions assessed on a 5-point Likert scale from strongly agree to strongly disagree (see box 2). The scale has been assessed for validity and reliability37 and used in previous research with VCs 38…”

Section: Methods and Analysismentioning

confidence: 99%

Supporting workforce practice change: protocol for a pilot study of a motivational interviewing virtual client software tool for health professionals

et al. 2020

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IntroductionMotivating behavioural change during client consultations is of crucial importance across all health professions to address the growing burden of chronic conditions. Yet health professionals often lack the skills and confidence to use evidence-based counselling interventions to support clients’ behavioural change and mobilise clients’ resources and self-efficacy for change to address their long-term needs.AimsThis pre–post pilot study will develop a motivational interviewing (MI) virtual client training tool for health professionals and test the effectiveness of the educational content and usability of the virtual client interaction.Methods and analysisPostgraduate students across a range of health disciplines will be recruited. Data assessing attitudes towards preventive healthcare will be collected using a modified version of the Preventive Medicine Attitudes and Activities Questionnaire. Conversations with the virtual client will be analysed using the Motivational Interviewing Treatment Integrity code to assess changes in MI skills. The System Usability Scale will be used to assess the usability of the virtual client training tool.Ethics and disseminationThis protocol was approved by the Flinders University Social and Behavioural Research Ethics Committee in May 2019. The results of the pilot study will inform the development of an avatar-based mobile application consisting of MI teaching and interactions with a generic virtual client that can be easily adapted to multiple scenarios.

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How to tell a patient’s story? Influence of the case narrative design on the clinical reasoning process in virtual patients

Cited by 5 publications

References 13 publications

Implementing Remote Collaboration in a Virtual Patient Platform: Usability Study

Implementing Remote Collaboration in a Virtual Patient Platform: Usability Study

Technology-delivered undergraduate medical education involving patients and carers: A rapid systematic review

Supporting workforce practice change: protocol for a pilot study of a motivational interviewing virtual client software tool for health professionals

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