Auditorium Presentation (

 

A Method of Reviewing Student Clinical Skills on Computer-Based Patient Simulations Embedded in a Clinical Clerkship Experience

 

Joel Gordon, MD, Scott Elliott

University of Iowa, College of Medicine

 

Abstract:

The overall goal of the presentation is to assist the audience in understanding the benefits of computer-based patient simulations and how simulations are integrated within a medical curriculum for both instructional and assessment purposes. 

 

Computer-based technology has become a part of curriculum innovation and change at University of Iowa College of Medicine for several reasons.  These include: 1) shortened patient hospitals stays, resulting in smaller range of illnesses for students to encounter; 2) decreases in teacher-student contact time resulting in the need for alternative instructional methods; 3) the need for more efficient assessment methods of clinical reasoning and diagnostic skills; 4) an increased emphasis on self-directed learning.

 

Through the advent of computer-based simulations, many of the aforementioned situations are being addressed.  The use of simulations has: 1) allowed the provision of “virtual” patients for “just-in-time” training; 2) increased self-paced, self-directed learning; 3) provided a global experience of working with a core group of illnesses, regardless of the patient population during the time of a students clinical experience; 4) broadened students educational experiences through computerized clinical scenarios that reinforce principles presented in both basic and clinical sciences.  Simulations have also allowed educators to select problems that will challenge students given their knowledge and experience, therefore delivering a clinical problem at an educationally relevant time.

 

Computer-based patient simulations have been implemented successfully in the 3rd year Ambulatory Nephrology portion of the Internal Medicine Clerkship at Iowa.  General internal and renal medicine cases are reviewed and delivered via simulation software.  Data reflecting simulation usage is collected and provides the information necessary to review student performance.  

 

For the purpose of the presentation, several factors of student performance are evaluated.  First to be evaluated is a student’s clinical performance during a simulation.  This information is obtained via clinical competency assessment software that has been specifically designed for this purpose.  The flexibility of the software allows customization of the “key” features of assessment components.  This affords adaptability to any clinical rating approach existing in institutions today.   In each phase of the clinical encounter (history, physical exam, diagnostic studies, diagnosis, treatment, follow-up), the software will record, analyze, and score positive, negative, and neutral actions made by a student.  The system compares and analyzes student results according to the instructor’s criteria in order to calculate performance.  An easy-to-view interface is provided for administrators / faculty to quickly scan results.

 

Just as important is the learner’s evaluation of the patient simulations.  Throughout the course of these simulations, students provide feedback on both a standardized Likert and open-ended evaluation forms.  These have been used in a formative fashion over three years, allowing software developers to respond to student’s concerns.  Ongoing qualitative and quantitative analysis of these responses will be used to gauge the students’ perception of the software’s effectiveness as a learning tool.

 

Benefit in Attending Session:

From an instructional perspective, implementing simulated patient cases has increased self-paced, self-directed learning while providing broad experiences of working with a core group of illnesses, regardless of the patient population during the time of a students’ clinical experience.  These experiences help ensure students receive necessary training to meet minimal requirements.  From a performance review perspective, simulations provide the advantage of quickly identifying areas of a student’s clinical competency (strengths and weaknesses).  Faculty can quickly review performance and provide meaningful and helpful feedback to students.  

 

 

PRIMARY AUTHOR'S INFORMATION

Scott Elliott

University of Iowa

College of Medicine

1-204 MEB

Iowa City, Iowa 52242

Telephone Number: 319-335-8918

Fax Number: 319-335-8904

E-mail Address: scott-elliott@uiowa.edu

 

CO-AUTHORS' INFORMATION

Joel Gordon, MD

University of Iowa

Department of Internal Medicine

Iowa City, Iowa 52242

Telephone Number(s): 319-356-3972

E-mail Address(es): joel-gordon@uiowa.edu