Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial

BMC Medical Education

Angelos P. Kassianos¹  Jessica Timmis¹  Natasha Kay¹  Jessica Sheringham¹  Shani Gray¹  Ruth Plackett¹  Rosalind Raine¹  Chris Valerio²  Sophie Mylan²  Sarah Bennett²  Maria Kambouri³  Willie Hamilton⁴  Emily Player⁵  Veena Rodrigues⁵  Patricia Schartau⁶  Jenny Hopwood⁷  Stephen Duffy⁸ 

[1] Department of Applied Health Research, University College London;Department of Global Health and Development, London School of Hygiene and Tropical Medicine;Institute of Education, UCL;Institute of Health Service Research, University of Exeter;Norwich Medical School, UEA;Primary Care and Population Health Department, UCL;UCL Medical School, UCL;Wolfson Institute of Preventive Medicine, QMUL;

关键词: Clinical reasoning;    Simulation;    Virtual patient;    Online learning;    Medical students;    Medical education;   

DOI  :  10.1186/s12909-020-02168-4

来源: DOAJ

【 摘 要 】

Abstract Background Online patient simulations (OPS) are a novel method for teaching clinical reasoning skills to students and could contribute to reducing diagnostic errors. However, little is known about how best to implement and evaluate OPS in medical curricula. The aim of this study was to assess the feasibility, acceptability and potential effects of eCREST — the electronic Clinical Reasoning Educational Simulation Tool. Methods A feasibility randomised controlled trial was conducted with final year undergraduate students from three UK medical schools in academic year 2016/2017 (cohort one) and 2017/2018 (cohort two). Student volunteers were recruited in cohort one via email and on teaching days, and in cohort two eCREST was also integrated into a relevant module in the curriculum. The intervention group received three patient cases and the control group received teaching as usual; allocation ratio was 1:1. Researchers were blind to allocation. Clinical reasoning skills were measured using a survey after 1 week and a patient case after 1 month. Results Across schools, 264 students participated (18.2% of all eligible). Cohort two had greater uptake (183/833, 22%) than cohort one (81/621, 13%). After 1 week, 99/137 (72%) of the intervention and 86/127 (68%) of the control group remained in the study. eCREST improved students’ ability to gather essential information from patients over controls (OR = 1.4; 95% CI 1.1–1.7, n = 148). Of the intervention group, most (80/98, 82%) agreed eCREST helped them to learn clinical reasoning skills. Conclusions eCREST was highly acceptable and improved data gathering skills that could reduce diagnostic errors. Uptake was low but improved when integrated into course delivery. A summative trial is needed to estimate effectiveness.

【 授权许可】

Unknown