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 students 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
instructors 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 learners
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 students
concerns. Ongoing qualitative and
quantitative analysis of these responses will be used to gauge the students
perception of the softwares 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 students 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