How to come to deliberate practice with virtual patients for clinical reasoning?

8/14/2019 How to come to deliberate practice with virtual patients for clinical reasoning?

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Faculty of Health, Medicine and Life Sciences

School of Health Professions Education

Prof. dr. Albert Scherpbier

How to come to deliberate practice withvirtual patients for clinical reasoning?Bas de Leng, Jeroen Donkers, Soeren Huwendiek, Andrzej

Kononowicz

Krakow, June 5th, 2009


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VPs for clinical reasoning

The virtual patients are

based on a real cases wherepremature closure hadoccurred.

Video of physicalexamination together with

sounds of results. No feedback on performance

during work-up of case.

Built in CAMPUS, a crossplatform and web-based

program developed atHeidelberg University

Feature to rank diagnoses inthe DD.
http://mediview.unimaas.nl/e-vip/asx/13yrs-norm-ausc-hrt.asx


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Educational scenario: integration

All residentssimultaneously workedout the same virtualpatient.

Three times during thework-out a time outwas scheduled in whichthe residents discussedtheir diagnosticreasoning.

The logged actions ofthe residents and theirnotes were point ofdeparture.


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Feedback tool Feedback tool developed at Maastricht University compiled

and fed back the logged actions of the individual residents.


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Questionnaire on VPs

1. Authenticity

2. Professional approach

3. Coaching4. Learning effect

5. Overall judgment

Students questionnaire to evaluate their experiences with virtualpatients. It contains twelve 5-point Likert Scale statements onthe issues:


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Recidents perceptions of VP

the impossibility tophrase your ownquestions during thehistory taking

the absence of a real

observation of a sickpatient to get animpression of theseriousness of thesituation, and

that cases are

contrived foreducationalpurposes, makingusers feel that therehas to be a catch.

Issues that jeopardize the authenticity of VPs:


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Questionnaire on Educational Scenarios

1. Teaching presence

2. Cognitive presence

3. Social presence4. Learning effect

5. Overall judgment

Students questionnaire to evaluate their experiences with theintegration of virtual patients. It contains twenty 5-point LikertScale statements on the issues


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Recidents perceptions of scenario

The small groupdiscussions stimulatedargumentation aboutclinical reasoning, andgave residents animpression of clinicalreasoning of their

peers. During the group

discussions theresidents felt secureenough to openlydiscuss theirshortcomings.


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Conclusions Both residents and clinical supervisor of a medical specialist

training perceived a session combining individual virtualpatient workup with time out moments of small groupdiscussions as a valuable learning activity for clinicalreasoning.

The clinical supervisor found the presented teachingapproach feasible for the medical specialist training at the

workplace.

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How to come to deliberate practice with virtual patients for clinical reasoning?