Virtual patients design and its effect on clinical reasoning and student experience: a protocol for a randomised factorial multi-centre study

BMC Medical Education

David Davies²  Nick Parsons¹  Jane Kidd²  Maggie E Allen³  James Bateman³ 

[1] Department of Statistics, Warwick Medical School, Coventry, CV4 7AL, UK;Education and Development Research Team, Warwick Medical School, Coventry CV4 7AL, UK;University Hospitals Coventry and Warwickshire, NHS Trust, Lakin Road, Coventry CV2 2DX, UK

关键词: Rheumatology;    Musculoskeletal;    Undergraduate;    Education;    Elearning;    Clinical reasoning;    Virtual patients;   

Others  :  1153534
DOI  :  10.1186/1472-6920-12-62

 received in 2012-05-28, accepted in 2012-07-04,  发布年份 2012

【 摘 要 】

Background

Virtual Patients (VPs) are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent) and structured clinical reasoning feedback (present or absent).

Methods/Design

This is a multi-centre randomised 2x2 factorial design study evaluating two independent variables of VP design, branching (present or absent), and structured clinical reasoning feedback (present or absent).The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded.

In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for both primary outcomes.

Discussion

This trial will provide robust evidence to support the effectiveness of different designs of virtual patients, based on student performance and evaluation. The cases and all learning materials will be open access and available on a Creative Commons Attribution-Share-Alike license.

【 授权许可】

   
2012 Bateman et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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