Virtual Interactive Case-Based Education (VICE): A Conference for Deliberate Practice of Diagnostic Reasoning

MedEdPORTAL

Tyler J. Albert¹  Jeffrey W. Redinger²  Scott L. Hagan³  Thomas A. Newman⁴  Paul B. Cornia⁵  Jessica Woan⁶  Alexander A. Logan⁷  Mayuree Rao⁸ 

[1] Attending Physician, VA Puget Sound Health Care System;Medical Director, Seattle VA Primary Care Clinic, VA Puget Sound Health Care System;Section Head for Hospital Medicine, VA Puget Sound Health Care System;Acting Assistant Professor, Department of Medicine, University of Washington;Associate Professor, Department of Medicine, University of Washington;Clinical Instructor, Department of Medicine, University of Washington;Clinical Instructor, Division of Hospital Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco;Fellow, Department of Medicine, VA Puget Sound Health Care System and University of Washington;

关键词: Clinical Reasoning/Diagnostic Reasoning;    Deliberate Practice;    Diagnostic Schema;    Problem Representations;    Cognitive Biases;    Clinical Competence;   

DOI  :  10.15766/mep_2374-8265.11159

来源: DOAJ

【 摘 要 】

Introduction Current approaches to teaching diagnostic reasoning minimally address the need for deliberate practice. We developed an educational conference for internal medicine residents to practice diagnostic reasoning and examine how biases affect their differential diagnoses through cognitive autopsies. Methods We formatted the Virtual Interactive Case-Based Education (VICE) conference as a clinical problem-solving exercise, in which a facilitator presents a case to a single discussant selected from the audience. We delivered VICE on an internet-based conferencing platform with screen-sharing capability over approximately 30 minutes. To maximize learners’ psychological safety, we employed an active facilitation model that normalized uncertainty and prioritized the diagnostic process over arriving at the correct diagnosis. Results Resident attitudes toward VICE were assessed by utilizing a postconference survey and gathering descriptive data for 11 sessions. Ninety-seven percent of respondents (n = 35) felt that VICE was a novel and valuable addition to their curriculum. Qualitative data suggested that positive features of the conference included the opportunity to practice diagnostic reasoning, the single-discussant format, and the supportive learning environment. Discussants reported that holding the conference in person would have negatively impacted their experience. Discussion Internal medicine residents universally valued the opportunity to engage in deliberate practice of case-based reasoning in a psychologically safe environment during the VICE conference. The virtual nature of the conference contributed significantly to discussants’ positive experience. This resource includes all materials necessary to implement VICE, as well as an instructional video on facilitation.

【 授权许可】

Unknown