The use of a virtual patient case in an OSCE-based exam – A pilot study

Abstract

Background: This study focuses on a skills test based clinical assessment where 118 fourth-year medical students at the four teaching hospitals of Karolinska Institutet participated in the same 12-module OSCE. The goal of one of the twelve examination modules was to assess the students' skills and ability to solve a virtual patient (VP) case (the ISP system), which included medical history taking, lab tests, physical examinations and suggestion of a preliminary diagnosis. Aims: The primary aim of this study was to evaluate the potential of a VP as a possible tool for assessment of clinical reasoning and problem solving ability among medical students. The feeling of realism of the VP and its possible affective impact on the student's confidence were also investigated. Method: We observed and analysed students' reactions, engagement and performance (activity log files) during their interactive sessions with the simulation. An individual human assistant was provided along with the computer simulation and the videotaped interaction student/assistant was then analysed in detail and related to the students' outcomes. Results:The results indicate possible advantages of using ISP-like systems for assessment. The VP was for instance able to reliably differentiate between students' performances but some weaknesses were also identified, like a confounding influence on students' outcomes by the assistants used. Significant differences, affecting the results, were found between the students in their degree of affective response towards the system as well as the perceived usefulness of assistance. Conclusion: Students need to be trained beforehand in mastering the assessment tool. Rating compliance needs to be targeted before VP-based systems like ISP can be used in exams and if such systems would be used in high-stake exams, the use of human assistants should be limited and scoring rubrics validated (and preferably automated).

Virtual Patients for assessment of medical student ability to integrate clinical and laboratory data to develop differential diagnoses: Comparison of results of exams with/without time constraints

“…Previous studies utilizing VPs for student ability assessment emphasized this essential condition (Courteille et al 2008;Waldmann et al 2008). …”

“…The use of VPs for assessment is a more recent application and has been described as a possible way to assess clinical reasoning and/or clinical decision-making abilities among students (Courteille et al 2008;Waldmann et al 2008;Gesundheit et al 2009;Round et al 2009;Botezatu et al 2010a, b;Forsberg et al 2010 (Brooks et al 2003) has emphasized that average raw scores of students tested under both timed and untimed conditions vary less than one raw score point. A more recent publication (Lee & Chen 2011) relates that most educational assessments are designed to measure knowledge ( power tests), are usually administered with time constraints, and before the application of computer-based assessment, it was extremely difficult to evaluate cognitive ability.…”

Promotion of Self-directed Learning Using Virtual Patient Cases

“…22 Patient simulation via virtual patient software has been used throughout higher education by multiple disciplines. [23][24][25][26][27][28][29][30] The design, development, implementation, and assessment of a novel approach to integrate the skills and attitudes of SDL into an advanced therapeutics course within a pharmacy curriculum using virtual patient software is described. This teaching strategy combines educational technology with principles of social learning in order to supplant lecture and support learners in exercising autonomy related to the learning endeavor.…”

Use Of Virtual Reality In The Education Of Health Workers

“…(2008) tarafından Karolinska Enstitüsü'nde tıp öğrencilerinin problem çözme ve klinik karar verme becerilerini değerlendirmek amacıyla sanal hastaların kullanıldığı pilot çalışmada, öğrencilerin büyük çoğunluğu gelecekteki sınavlarında da bu yöntemin kullanılmasını istedikleri görülmüştür. [39] Katılımcıların aynı ziksel ve coğra mekanda bulunmalarını gerektirmeyen sanal gerçeklik ortamı, gerçek zamanlı simülasyon için fırsat ve işbirliği sağlar. [17] Herhangi bir eğitim kurumu sanal sını arı saatlerce kullanabilir ve dünyanın dört bir yanından katılan öğrenciler davetli konuşmacıları dinlemeye davet edilebilirler.…”