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Koelewijn G, Hennus MP, Kort HSM, Frenkel J, van Houwelingen T. Games to support teaching clinical reasoning in health professions education: a scoping review. MEDICAL EDUCATION ONLINE 2024; 29:2316971. [PMID: 38394053 PMCID: PMC10896137 DOI: 10.1080/10872981.2024.2316971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Given the complexity of teaching clinical reasoning to (future) healthcare professionals, the utilization of serious games has become popular for supporting clinical reasoning education. This scoping review outlines games designed to support teaching clinical reasoning in health professions education, with a specific emphasis on their alignment with the 8-step clinical reasoning cycle and the reflective practice framework, fundamental for effective learning. METHODS A scoping review using systematic searches across seven databases (PubMed, CINAHL, ERIC, PsycINFO, Scopus, Web of Science, and Embase) was conducted. Game characteristics, technical requirements, and incorporation of clinical reasoning cycle steps were analyzed. Additional game information was obtained from the authors. RESULTS Nineteen unique games emerged, primarily simulation and escape room genres. Most games incorporated the following clinical reasoning steps: patient consideration (step 1), cue collection (step 2), intervention (step 6), and outcome evaluation (step 7). Processing information (step 3) and understanding the patient's problem (step 4) were less prevalent, while goal setting (step 5) and reflection (step 8) were least integrated. CONCLUSION All serious games reviewed show potential for improving clinical reasoning skills, but thoughtful alignment with learning objectives and contextual factors is vital. While this study aids health professions educators in understanding how games may support teaching of clinical reasoning, further research is needed to optimize their effective use in education. Notably, most games lack explicit incorporation of all clinical reasoning cycle steps, especially reflection, limiting its role in reflective practice. Hence, we recommend prioritizing a systematic clinical reasoning model with explicit reflective steps when using serious games for teaching clinical reasoning.
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Affiliation(s)
- Gilbert Koelewijn
- Research Group Technology for Healthcare Innovations, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, the Netherlands
- Department of Pediatrics, Wilhelmina Children’s Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marije P. Hennus
- Department of Pediatrics, Wilhelmina Children’s Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Helianthe S. M. Kort
- Research Group Technology for Healthcare Innovations, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, the Netherlands
- Building Healthy Environments for Future Users Group, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Joost Frenkel
- Department of Pediatrics, Wilhelmina Children’s Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
| | - Thijs van Houwelingen
- Research Group Technology for Healthcare Innovations, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, the Netherlands
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Benayon M, Latchupatula L, Mansoor M, Kocaqi E, Azim A, Sibbald M. Mock Wards: Incorporating a Theoretical Framework to Create a Blended Virtual and In-Person Clinical Reasoning Education Platform. Cureus 2024; 16:e64954. [PMID: 39040615 PMCID: PMC11260654 DOI: 10.7759/cureus.64954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2024] [Indexed: 07/24/2024] Open
Abstract
Introduction The coronavirus 2019 pandemic highlighted virtual learning (VL) as a promising tool for medical education, yet its effectiveness in teaching clinical reasoning (CR) remains underexplored. Past studies have suggested VL can effectively prepare students for clinical settings. Informed by the Milestones of Observable Behaviours for CR (MOBCR) and whole-case theoretical frameworks, the Mock Wards (MW) program was created using a novel blended in-person learning (IPL) and VL platform. MW consisted of case-based small-group formats for medical students interested in learning approaches and differentials to commonly encountered presenting symptoms and diagnoses in internal medicine. This study sought to use MW's blended design to qualitatively analyze CR development and compare its utility between VL and IPL. Methods Qualitative analysis was conducted using in-depth semi-structured interviews with first-year pre-clerkship medical students (n = 8) who completed the MW program and participated in the study. The interview guide was informed by the MOBCR framework. Interview transcripts were analyzed using a directed qualitative content analysis approach. Translational coding and HyperRESEARCHTM (Researchware, Inc., Randolph, MA) software-generated mind maps guided the theme development. Results Three overarching themes were constructed: (1) tailoring pedagogical frameworks to learning modalities, (2) learning through interactivity, and (3) balancing accessibility with learner engagement. Participants emphasized that teaching CR skills is modality-specific and not fully interchangeable, with IPL being superior in facilitating social cohesion, non-verbal communication, and feedback. In contrast, VL required structured approaches and relied more on verbal communication and pre-made digital materials. IPL also enhanced interactivity, peer relationships, and spontaneous communication, whereas VL faced challenges such as social awkwardness and technological constraints hindering effective collaboration. VL provided superior accessibility to facilitate distributed learning and management of concurrent academic obligations. Conclusion The MW-blended platform highlights the importance of focusing on modality-tailored pedagogies, emphasizing group interactability, and balancing VL accessibility against decreased engagement within the IPL environment when teaching CR skills. Blended education models may benefit from a scaffolding approach, using IPL as a prerequisite to VL to improve CR development and alignment within a learner's zone of proximal development.
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Affiliation(s)
- Myles Benayon
- Internal Medicine, McMaster University, Hamilton, CAN
| | | | | | - Etri Kocaqi
- Internal Medicine, McMaster University, Hamilton, CAN
| | - Arden Azim
- Internal Medicine, McMaster University, Hamilton, CAN
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Araújo B, Gomes SF, Ribeiro L. Critical thinking pedagogical practices in medical education: a systematic review. Front Med (Lausanne) 2024; 11:1358444. [PMID: 38947238 PMCID: PMC11211358 DOI: 10.3389/fmed.2024.1358444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/20/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction The development of critical thinking (CT) has been a universal goal in higher education. A systematic review of the literature was conducted to evaluate the effectiveness of currently used pedagogical practices to foster CT/ clinical reasoning (CR)/ clinical judgment (CJ) skills and/or dispositions in undergraduate medical students. Methods PubMed, Web of Science and Scopus databases were searched from January 2010 to April 2021 with a predefined Boolean expression. Results Of the 3221 articles originally identified, 33 articles were included by using PICOS methodology. From these, 21 (64%) reported CR pedagogical practices and 12 (36%) CT pedagogical practices. Discussion Overall, pedagogical practices such as cognitive/visual representation, simulation, literature exposure, test-enhancing and team-based learning, clinical case discussion, error-based learning, game-based learning seem to enhance CT/CR skills and/or dispositions. Further research is required to identify the optimal timing, duration and modality of pedagogical interventions for effectively foster CT/CR in medical education.
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Affiliation(s)
- Beatriz Araújo
- Department of Public Health and Forensic Sciences, and Medical Education, Medical Education Unit, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Sandra F. Gomes
- Department of Public Health and Forensic Sciences, and Medical Education, Medical Education Unit, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Laura Ribeiro
- Department of Public Health and Forensic Sciences, and Medical Education, Medical Education Unit, Faculty of Medicine of the University of Porto, Porto, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Razaghpoor A, Taheri-Ezbarami Z, Jafaraghaee F, Maroufizadeh S, Falakdami A. The effect of serious game and problem-based learning on nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. J Pediatr Nurs 2024; 76:e1-e8. [PMID: 38443211 DOI: 10.1016/j.pedn.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Comparing the effect of serious game and problem-based learning on nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. DESIGN AND METHODS In this quasi-experimental study, 76 undergraduate nursing students were enrolled through a convenience sampling method, and were allocated to one of the three groups of serious game, problem-based learning, and control through the block randomization method. Data were collected using a valid and reliable 3-part researcher-made tool, completed before and two weeks after the intervention. Statistical analysis was performed using paired t-test, analysis of covariance, and Bonferroni post hoc test. A significance level of <0.05 was considered. RESULTS After the intervention, mean scores of both knowledge and clinical decision-making skill increased significantly in both intervention groups (p < 0.05). Mean post-test scores of both knowledge and clinical decision-making skill in the serious game group, and only clinical decision-making skill in the problem-based learning group were significantly higher than the control group (p < 0.05). However, no significant difference was observed regarding mean post-test scores of both knowledge and clinical decision-making skill between the intervention groups (p > 0.05). CONCLUSIONS Both serious game and problem-based learning are proven to be effective in improving nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. PRACTICE IMPLICATIONS Since learning now occurs beyond classrooms and the new generation of students spend most of their time in virtual places, utilizing technology-based teaching methods like serious games can benefit both educators and students by providing continuous education, saving their time and expenses, etc.
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Affiliation(s)
- Ali Razaghpoor
- Pediatric Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Taheri-Ezbarami
- Department of Nursing, School of Nursing and Midwifery-Guilan University of Medical Sciences, Rasht, Iran.
| | - Fateme Jafaraghaee
- Nursing, Department of Medical-Surgical Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Saman Maroufizadeh
- Department of Biostatistics and Epidemiology, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Atefeh Falakdami
- Medical-Surgical Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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Huang WD, Loid V, Sung JS. Reflecting on gamified learning in medical education: a systematic literature review grounded in the Structure of Observed Learning Outcomes (SOLO) taxonomy 2012-2022. BMC MEDICAL EDUCATION 2024; 24:20. [PMID: 38172852 PMCID: PMC10765768 DOI: 10.1186/s12909-023-04955-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The acquisition of in-depth medical knowledge, skills, and competencies is of utmost importance when training future medical professionals. This systematic literature review delves into the empirical connection between gamified learning in medical education and the Structure of Observed Learning Outcomes (SOLO) taxonomy. METHODS Following PRISMA guidelines, a systematic literature review was conducted in seven databases to identify empirical studies related to gamification and medical education. The literature search was limited to peer-reviewed articles published between January 2012 and December 2022. Articles focusing on games or learning technologies in a broader sense as well as research focusing on nursing or pharmacy education were excluded. RESULTS Upon reviewing 23 qualified empirical studies that applied gamified learning strategies in medical education, 18 (78%) studies are associated with the second lowest level (uni-structural) of the SOLO taxonomy. The mid-level (multi-structural) learning outcomes are associated with three (13%) of the reviewed studies. There are five (22%) studies focusing on the second highest (relational) level of the SOLO. Only one study (4%) is associated with the highest SOLO level (extended-abstract). Finally, three (13%) studies were identified with multiple levels of the SOLO. In addition to the SOLO levels, the review found six (26%) studies emphasizing motivational and engagement support of gamified learning strategies in facilitating intended learning outcome attainment. A total of three (13%) studies, across three SOLO levels, suggested that gamified learning strategies can improve students' soft skills in medical education programs. CONCLUSION These findings collectively emphasize the need for future research and development to design gamified learning experiences capable of fostering higher SOLO taxonomy attainment in medical education. Moreover, there is potential to extend the SOLO framework to encompass motivational and affective learning outcomes, providing a comprehensive understanding of the impact of gamified learning on medical students.
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Affiliation(s)
- Wenhao David Huang
- Biomedical and Translational Science, Carle-Illinois College of Medicine; Education Policy, Organization, and Leadership, College of Education, University of Illinois Urbana-Champaign, Champaign, IL, USA.
| | - Viktoria Loid
- Education Policy, Organization, and Leadership College of Education, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Jung Sun Sung
- Education Policy, Organization, and Leadership College of Education, University of Illinois Urbana-Champaign, Champaign, IL, USA
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Riedel M, Kaefinger K, Stuehrenberg A, Ritter V, Amann N, Graf A, Recker F, Klein E, Kiechle M, Riedel F, Meyer B. ChatGPT's performance in German OB/GYN exams - paving the way for AI-enhanced medical education and clinical practice. Front Med (Lausanne) 2023; 10:1296615. [PMID: 38155661 PMCID: PMC10753765 DOI: 10.3389/fmed.2023.1296615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Background Chat Generative Pre-Trained Transformer (ChatGPT) is an artificial learning and large language model tool developed by OpenAI in 2022. It utilizes deep learning algorithms to process natural language and generate responses, which renders it suitable for conversational interfaces. ChatGPT's potential to transform medical education and clinical practice is currently being explored, but its capabilities and limitations in this domain remain incompletely investigated. The present study aimed to assess ChatGPT's performance in medical knowledge competency for problem assessment in obstetrics and gynecology (OB/GYN). Methods Two datasets were established for analysis: questions (1) from OB/GYN course exams at a German university hospital and (2) from the German medical state licensing exams. In order to assess ChatGPT's performance, questions were entered into the chat interface, and responses were documented. A quantitative analysis compared ChatGPT's accuracy with that of medical students for different levels of difficulty and types of questions. Additionally, a qualitative analysis assessed the quality of ChatGPT's responses regarding ease of understanding, conciseness, accuracy, completeness, and relevance. Non-obvious insights generated by ChatGPT were evaluated, and a density index of insights was established in order to quantify the tool's ability to provide students with relevant and concise medical knowledge. Results ChatGPT demonstrated consistent and comparable performance across both datasets. It provided correct responses at a rate comparable with that of medical students, thereby indicating its ability to handle a diverse spectrum of questions ranging from general knowledge to complex clinical case presentations. The tool's accuracy was partly affected by question difficulty in the medical state exam dataset. Our qualitative assessment revealed that ChatGPT provided mostly accurate, complete, and relevant answers. ChatGPT additionally provided many non-obvious insights, especially in correctly answered questions, which indicates its potential for enhancing autonomous medical learning. Conclusion ChatGPT has promise as a supplementary tool in medical education and clinical practice. Its ability to provide accurate and insightful responses showcases its adaptability to complex clinical scenarios. As AI technologies continue to evolve, ChatGPT and similar tools may contribute to more efficient and personalized learning experiences and assistance for health care providers.
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Affiliation(s)
- Maximilian Riedel
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Katharina Kaefinger
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Antonia Stuehrenberg
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Viktoria Ritter
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Niklas Amann
- Department of Gynecology and Obstetrics, Friedrich–Alexander-University Erlangen–Nuremberg (FAU), Erlangen, Germany
| | - Anna Graf
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Florian Recker
- Department of Gynecology and Obstetrics, Bonn University Hospital, Bonn, Germany
| | - Evelyn Klein
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Marion Kiechle
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Fabian Riedel
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Bastian Meyer
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, Technical University Munich (TU), Munich, Germany
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Buajeeb W, Chokpipatkun J, Achalanan N, Kriwattanawong N, Sipiyaruk K. The development of an online serious game for oral diagnosis and treatment planning: evaluation of knowledge acquisition and retention. BMC MEDICAL EDUCATION 2023; 23:830. [PMID: 37924052 PMCID: PMC10625225 DOI: 10.1186/s12909-023-04789-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/18/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND While serious games seem to be supportive in healthcare education, none of them had been designed to develop competence in diagnosis and treatment planning of oral lesions. Therefore, this research aimed to develop an online simulation-based serious game for training diagnosis and treatment planning of oral lesions (SimOL) and to evaluate its educational impact in terms of knowledge improvement and retention. METHODS As a mandatory task in an oral lesion course, all 28 students were required to participate in SimOL activities. Participants were instructed to complete a pre-knowledge assessment following a one-week washout period prior to the game activity. Subsequent to the game completion, they were tasked to complete a post-knowledge assessment I (Full score = 15) and satisfaction questionnaire. A post-knowledge assessment II was administered a week later to evaluate knowledge retention. RESULTS The findings demonstrated a significant increase in the assessment scores after interacting with the game (P < 0.001), where the pre- and immediate post-knowledge assessment scores were 8.00 (SD = 2.11) and 11.71 (SD = 2.39), respectively. The game also exhibited a positive impact on knowledge retention, as there was no significant difference between the scores of post-knowledge assessment I and II (P > 0.05). Additionally, students perceived the game as positively in all aspects, although the entertainment aspect achieved a slightly lower score of 3.70 (SD = 0.21), in comparison to the usefulness and ease of use with a score of 4.02 (SD = 0.11) and 4.02 (SD = 0.16), respectively. CONCLUSION SimOL demonstrated its potential as an effective learning tool for improving and retaining knowledge for diagnosis and treatment planning of oral lesions. The game was perceived positively by dental students in all aspects, however further improvements should prioritize the enhancement of entertaining components.
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Affiliation(s)
- Waranun Buajeeb
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Jirachaya Chokpipatkun
- Doctor of Dental Surgery Program, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Napas Achalanan
- Doctor of Dental Surgery Program, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Nawaphat Kriwattanawong
- Doctor of Dental Surgery Program, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kawin Sipiyaruk
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
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Luiz T, Elsenbast C, Breckwoldt J. [Emergencies-Infinite worlds? : Extended reality as a medium in the education, continuing and advanced training in emergency medicine]. DIE ANAESTHESIOLOGIE 2023:10.1007/s00101-023-01305-0. [PMID: 37389588 DOI: 10.1007/s00101-023-01305-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Simulation training is indispensable in emergency medicine, especially for enhancing patient safety. Methods and technologies used include a wide spectrum ranging from simple skill trainers to complex full-scale simulated environments integrating standardized patient actors. Limitations include the simulation of dynamic changes of clinical symptoms, the depiction of emotions and patient movements as well as complex environments, such as lively traffic. Extended reality (XR) holds the potential to overcome these limitations. METHODS/AIMS Starting with the technological basis and the didactic considerations in the field of XR, the paper reflects the potentials and limitations of this new technology in the domain of medical simulation training. Further focus is put on the integration of XR into existing training curricula. RESULTS The XR covers various technologies, ranging from PC-based applications that are similar to conventional computer games, over virtual realities enabling spatially freely navigable 3‑dimensional simulation (using closed 3D glasses: head mounted displays, HMD), to mixed-reality applications that combine virtual elements and real physical objects; however, technology alone does not stimulate learning. As with other simulation methods, it is crucial with XR to implement learning objectives, methods and technologies in a suitable teaching-learning arrangement and to familiarize teachers and students with the new technology. Evidence in the literature with respect to learning success is limited by the heterogeneity of technologies, target groups, teaching-learning arrangements and learning outcomes. Overall, significant increases can be shown for the intrinsic motivation of learners, and for high emotional participation (measured as perceived presence in the virtual environment). DISCUSSION Technological developments and the increasing use of digital media in emergency medical education and training favor the leap from XR-based pure demonstration projects to educational practice. Decisive for the educational success are the clear orientation towards concrete learning goals and a thorough familiarization with the new technology. CONCLUSION Simulation training based on XR expands the spectrum of existing simulation methods to integrate new dimensions of learning objectives. Further research on the effectiveness of this method is needed.
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Affiliation(s)
- Thomas Luiz
- Digital Healthcare, Fraunhofer IESE, Fraunhofer-Platz 1, 67663, Kaiserslautern, Deutschland.
| | - Christian Elsenbast
- Digital Healthcare, Fraunhofer IESE, Fraunhofer-Platz 1, 67663, Kaiserslautern, Deutschland
| | - Jan Breckwoldt
- Institut für Anästhesiologie, Universitätsspital Zürich, Zürich, Schweiz
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Argueta-Muñoz FD, Olvera-Cortés HE, Durán-Cárdenas C, Hernández-Gutiérrez L, Gutierrez-Barreto SE. Instructional Design and Its Usability for Branching Model as an Educational Strategy. Cureus 2023; 15:e39182. [PMID: 37332404 PMCID: PMC10276579 DOI: 10.7759/cureus.39182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
INTRODUCTION Serious Games (SG) are an educational strategy used in the health professions with positive results in teaching diagnosis and facilitating the application of concepts and knowledge transfer. A type of SG is the branching scenario, which has the potential for a linear story or multiple options to achieve learning goals. There must be evidence for this type of SG's instructional design (InD) and usability. OBJECTIVE Propose an InD for the branching scenario and rate its usability. MATERIALS AND METHODS We conducted a two-phase study. In the first phase, we drafted an InD based on the literature review, and then, we applied an expert validation process through a modified Delphi technique. With the consent of InD, we built five branching scenarios. In the second phase, we apply an instrument to measure the SG usability of the branching scenarios in a cross-sectional study with 216 undergraduate medical students. RESULTS A proposal for an InD for branching scenarios was elaborated. This InD has five dimensions with steps and definitions that help the designer fulfill the requirements for the SG. With the InD, we developed five branching scenarios for undergraduate medical students. Finally, the rates for the usability of the branchings had high scores. The branching SG with multiple options offers different outcomes for the same clinical problem in a single activity. DISCUSSION The proposal of a specific InD for branching scenarios considered SG theory and was tested, at least in user usability. The steps proposed include the specificity of the requirements of an SG, such as levels, checkpoints, avatars, and gameplay characteristics, among others, in contrast to the other InD that do not explicitly consider them. One of the limitations of this study is that we applied it only using the H5P software to develop branching scenarios with no other evidence of the performance of the InD in different contexts or platforms. CONCLUSIONS We propose using an InD to construct branching scenarios. This kind of SG has specific characteristics for its correct operation. Using structured steps in developing SG improves the probability of developing decision-making skills. Using an instrument to assess the usability of at least one dimension of the SG is also recommended to identify opportunity areas.
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Affiliation(s)
| | - Hugo E Olvera-Cortés
- Medical Education and Simulation, National Autonomous University of Mexico, Mexico City, MEX
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Harendza S, Bußenius L, Gärtner J, Heuser M, Ahles J, Prediger S. "Fit for the finals" - project report on a telemedical training with simulated patients, peers, and assessors for the licensing exam. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc17. [PMID: 37361248 PMCID: PMC10285374 DOI: 10.3205/zma001599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/11/2023] [Accepted: 02/06/2023] [Indexed: 06/28/2023]
Abstract
Background Undergraduate medical students take the licensing exam (M3) as a two-day oral-practical examination. The main requirements are to demonstrate history taking skills and coherent case presentations. The aim of this project was to establish a training in which students can test their communication skills during history taking and their clinical reasoning skills in focused case presentations. Methods In the newly developed training, final-year students took four telemedical histories in the role of physicians from simulated patients (SP). They received further findings for two SPs and presented these in a handover, in which they also received a handover of two SPs which they had not seen themselves. Each student presented one of the two received SPs in a case discussion with a senior physician. Feedback was given to the participants on their communication and interpersonal skills by the SPs with the ComCare questionnaire and on the case presentation by the senior physician. Sixty-two students from the universities of Hamburg and Freiburg in their final year participated in September 2022 and evaluated the training. Results Participants felt that the training was very appropriate for exam preparation. The SPs' feedback on communication and the senior physician's feedback on clinical reasoning skills received the highest ratings in importance to the students. Participants highly valued the practice opportunity for structured history taking and case presentation and would like to have more such opportunities in the curriculum. Conclusion Essential elements of the medical licensing exam can be represented, including feedback, in this telemedical training and it can be offered independent of location.
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Affiliation(s)
- Sigrid Harendza
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
| | - Lisa Bußenius
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
| | - Julia Gärtner
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
| | - Miriam Heuser
- Albert-Ludwigs-Universität Freiburg, Medizinische Fakultät, Studiendekanat, Freiburg, Germany
| | - Jonathan Ahles
- Albert-Ludwigs-Universität Freiburg, Medizinische Fakultät, Studiendekanat, Freiburg, Germany
| | - Sarah Prediger
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
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Eysenbach G, Zary N, Broseus J, Morieux PJ, Di Ceglie V, Gravoulet J, D'Aveni M. A Serious Game About Hematology for Health Care Workers (SUPER HEMO): Development and Validation Study. JMIR Serious Games 2023; 11:e40350. [PMID: 36780215 PMCID: PMC9972200 DOI: 10.2196/40350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 12/07/2022] [Accepted: 01/09/2023] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Complete blood count (CBC) and hemostatic screening tests are among the most commonly prescribed blood tests worldwide. All health care workers (nurse practitioners, pharmacists, dentists, midwives, and physicians) are expected to correctly interpret the results in their daily practice. Currently, the undergraduate hematology curriculum consists predominantly of lecture-based teaching. Because hematology combines basic science (blood cells and hemostasis physiology) and clinical skills, students report that they do not easily master hematology with only lecture-based teaching. Having interviewed students at the University of Lorraine, we considered it necessary to develop new teaching approaches and methods. OBJECTIVE We aimed to develop and validate a serious game about CBC analysis for health care students. Our primary objective was to help students perceive hematology as being a playful and easy topic and for them to feel truly involved in taking care of their patients by analyzing blood tests. We considered that this game-based approach would be attractive to students as an addition to the classic lecture-based approach and improve their knowledge and skills in hematology. METHODS We developed an adventure game called SUPER HEMO, a video game in which the player assumes the role of a protagonist in an interactive story driven by exploration and problem-solving tests. Following validation with beta testing by a panel of volunteer students, we used a novel, integrated teaching approach. We added 1.5 hours of gaming to the standard curriculum for a small group of volunteer students. Physician and pharmacy students in their third year at a single French university were invited to attend this extracurricular course. Pregame and postgame tests and satisfaction surveys were immediately recorded. Final hematology exam results were analyzed. RESULTS A total of 86 of 324 physician students (26.5%) and 67 of 115 pharmacy students (58%) opted to participate. Median scores on the pre- and posttests were 6 out of 10 versus 7 out of 10, respectively, for the physician students, (P<.001) and 7.5 out of 10 versus 8 out of 10, respectively, for the pharmacy students (P<.001). At the final hematology evaluation, physician students who played SUPER HEMO had a slightly better median score than those who did not: 13 out of 20 versus 12 out of 20, respectively (P=.002). Pharmacy students who played SUPER HEMO had a median score of 21.75 out of 30; this was not significantly different from pharmacy students who did not play SUPER HEMO (20/30; P=.12). Among the participants who answered the survey (n=143), more than 86% (123/143) believed they had strengthened their knowledge and nearly 80% (114/143) of them had fun. CONCLUSIONS Feedback from this game session provided evidence to support the integration of interactive teaching methods in undergraduate hematology teaching. The development of SUPER HEMO is intended to be completed so that it can become a support tool for continuing education.
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Affiliation(s)
| | | | - Julien Broseus
- Centre Hospitalier Régional Universitaire, Nancy, France.,Faculté de Médecine, Maïeutique et Métiers de la Santé, Université de Lorraine, Vandoeuvre-Lès-Nancy, France
| | | | | | | | - Maud D'Aveni
- Centre Hospitalier Régional Universitaire, Nancy, France.,Faculté de Médecine, Maïeutique et Métiers de la Santé, Université de Lorraine, Vandoeuvre-Lès-Nancy, France
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Anders S, Steen A, Müller T, Krause W, Sanwald A, Raupach T, Ondruschka B, Krebs O. Adventure Legal Medicine: a free online serious game for supplementary use in undergraduate medical education. Int J Legal Med 2023; 137:545-549. [PMID: 36625885 PMCID: PMC9902303 DOI: 10.1007/s00414-023-02946-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023]
Abstract
Serious games (computer-based learning games) are increasingly used in medical education at various levels, as user access is independent of location and time and promotes non-linear learning. In legal medicine, interactive digital media are still scarce. The freely accessible online serious game "Adventure Legal Medicine" was developed as part of the "Hamburg Open Online University". The goal was to teach the basics of forensic casework in a point-and-click adventure setting consisting of five cases. During development, 40 medical students were asked to evaluate the game anonymously. The System Usability Scale (SUS) resulted in a mean score of 86.7 (SD 8.3), which corresponds to above-average usability. Further specific evaluations revealed a good to very good rating of the game with no differences in terms of gender (p = 0.214), first-year versus advanced students (p = 0.393) and students who never/rarely or sometimes/often played computer games (p = 0.780). Since there are only a few digital media so far that allow curricular integration into undergraduate teaching in legal medicine, this serious game represents a possibility to integrate digital media into both face-to-face teaching and distance learning and to use it as a supplement to the medical school's own teaching offer, encouraging users to actively engage with the subject.
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Affiliation(s)
- Sven Anders
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529, Hamburg, Germany.
| | - Antonia Steen
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Tjark Müller
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany ,grid.418956.70000 0004 0493 3318Leibniz-Institut Für Wissensmedien, Tübingen, Germany
| | - Waldemar Krause
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Annika Sanwald
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Tobias Raupach
- grid.15090.3d0000 0000 8786 803XDepartment of Medical Education, University Hospital Bonn, Bonn, Germany
| | - Benjamin Ondruschka
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Oliver Krebs
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
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Inaugural Pan-Canadian RADGames: Results From a Successful Approach to Radiology Education for Medical Students. Acad Radiol 2023; 30:113-121. [PMID: 35995693 DOI: 10.1016/j.acra.2022.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/27/2022] [Accepted: 07/02/2022] [Indexed: 01/13/2023]
Abstract
RATIONALE AND OBJECTIVES A goal in radiology undergraduate medical education is to improve exposure to the field. In 2022, the Canadian Association of Radiologists' Medical Student Network hosted for the first time "RADGames," an interactive image interpretation contest for medical students across Canada. This program was aimed to spark interest in radiology and improve students' image interpretation skills through gamification with expert guidance. MATERIALS AND METHODS Volunteers from Radiology Interest Groups in Canadian medical schools set up a virtual event for the competition using breakout rooms and a quiz platform. Participant recruitment was through social media and advertisement by medical student associations. Participants were surveyed anonymously for feedback following the event. Data about previous exposure to and knowledge of radiology, and an evaluation of the event including self-perceived impact on participants' understanding of the field were collected. RESULTS Eighty seven medical students from 15 of Canada's 17 medical schools competed against one another virtually. Forty seven (54%) responded to the post-event evaluation survey. All responses about the event itself were favourable. Respondents overwhelmingly indicated that RADGames increased their interest in radiology (38, 81%), their understanding of the work of a radiologist (31, 66%) and their knowledge about medical imaging (46, 98%), and improved their confidence in basic imaging interpretation (36, 77%). CONCLUSION The Canadian Association of Radiologists' Medical Student Network hosted Canada's first national image interpretation competition for medical students, RADGames. Feedback was overwhelmingly positive, with perceived benefits to participants on their understanding of and interest in radiology.
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Riedel M, Amann N, Recker F, Hennigs A, Heublein S, Meyer B, Karge A, Eisenkolb G, Lammert J, Graf A, Klein E, Weiss M, Riedel F. The COVID-19 pandemic and its impact on medical teaching in obstetrics and gynecology-A nationwide expert survey among teaching coordinators at German university hospitals. PLoS One 2022; 17:e0269562. [PMID: 35930549 PMCID: PMC9355177 DOI: 10.1371/journal.pone.0269562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has imposed severe challenges on medical education at German university hospitals. In this first German nationwide expert survey, we addressed the responsible university teaching coordinators in obstetrics and gynecology departments and investigated their experiences during the pandemic as well as their opinions on future developments, especially with regard to the broader implementation of e-learning in the standard curriculum. METHODS The questionnaire included 42 items and was disseminated among teaching coordinators at all 41 departments of obstetrics and gynecology at German university hospitals via an email that included a weblink to the online survey provider. Responses were collected between 19 April and 7 June 2021. RESULTS In total, 30 responses were collected from 41 departments across Germany and their respective teaching coordinators in obstetrics and gynecology. The general opinion of the medical teaching provided during the pandemic was positive, whereas the teaching quality in practical skills was considered inferior and not equivalent to the standard face-to-face curriculum. Lectures and seminars had to be substituted by remote-learning alternatives, while clinical clerkships were reduced in length and provided less patient contact. Students in their final year experienced only a few differences in the clinical and teaching routine. Teaching coordinators in obstetrics and gynecology stated that they intend to incorporate more e-learning into the curriculum in the future. CONCLUSION The medical educators' views presented here may help to complement the already-thoroughly investigated experiences of students under the restrictions of the COVID-19 pandemic. Medical educators in obstetrics and gynecology at German university hospitals have successfully established online and hybrid teaching alternatives to their standard face-to-face courses. Building on recent experiences, digitalization could help to improve future medical education.
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Affiliation(s)
- Maximilian Riedel
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Niklas Amann
- Department of Gynecology and Obstetrics, Friedrich–Alexander-University Erlangen–Nuremberg (FAU), Erlangen, Germany
| | - Florian Recker
- Department of Gynecology and Obstetrics, Bonn University Hospital, Bonn, Germany
| | - André Hennigs
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heublein
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Bastian Meyer
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Anne Karge
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Gabriel Eisenkolb
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Jacqueline Lammert
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Anna Graf
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Evelyn Klein
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Martin Weiss
- Department of Women’s Health, University of Tübingen, Tübingen, Germany
- NMI Natural and Medical Sciences Institute, University of Tübingen, Reutlingen, Germany
| | - Fabian Riedel
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
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Bujanda A, Bujanda E. DIABESCAPE: un proyecto educativo innovador sobre diabetes. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bujanda A, Bujanda E. DIABESCAPE: An innovative educational project on diabetes. ENDOCRINOL DIAB NUTR 2022; 69:392-400. [PMID: 35778355 DOI: 10.1016/j.endien.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/23/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The aim of this study was to assess the effectiveness of a gamification-based educational intervention to improve knowledge about diabetes, targeting GCSE-level vocational training students who will work in the field of social/health care. MATERIALS AND METHODS This was a quasi-experimental study aimed at further education students in Auxiliary Nursing Care and Care of People in a Situation of Dependency at the educational centres in the Autonomous Region of Navarra. After assessing the students' prior knowledge, a random draw was carried out to determine which classes would form part of the control group and which the intervention group. In the traditional programme, a one-and-a-half-hour session was held and in the innovation programme, they had an Escape Room with a brief explanation lasting a total of two hours. In both educational programmes, they completed a pre-test and then a post-test one week after the interventions to assess the degree of knowledge acquisition, in addition to a satisfaction questionnaire. The project ran from October 2019 to February 2020. RESULTS 302 students took part (162 from the intervention group and 140 from the control group) with a mean age of 18.4 years; 87.4% were female; and 52.7% were studying in vocational training in Care for People in a Situation of Dependency. The post-test knowledge score was 32.70 (SD 10.637) in the control group and 38.07 (SD 11.421) in the intervention group (p = 0.000). Meanwhile the level of satisfaction was 8.19 (SD 1.594) in the control group and 8.60 (SD 1.163) in the intervention group (p = 0.020). CONCLUSIONS Gamified education enhances knowledge acquisition with respect to the traditional methodology and improves student satisfaction. Further studies are needed to verify the effectiveness of these innovative educational methods in the medium and long term.
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Affiliation(s)
| | - Elena Bujanda
- Asociación Navarra de Diabetes, Pamplona, Navarra, Spain
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Plass AM, Covic A, Lohrberg L, Albright G, Goldman R, Von Steinbüchel N. Effectiveness of a minimal virtual motivational interviewing training for first years medical students: differentiating between pre-test and then-test. PATIENT EDUCATION AND COUNSELING 2022; 105:1457-1462. [PMID: 34598801 DOI: 10.1016/j.pec.2021.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/16/2021] [Accepted: 09/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Shifting towards patient-centeredness, medical doctors need patient-centered communication skills. Motivational Interviewing (MI) is an evidence-based, collaborative, goal-oriented communication technique to strengthen a person's own motivation and commitment to change. The purpose of this study is to evaluate the effectiveness of a brief virtual role-play MI-training program on MI-knowledge and skills in first-year undergraduate medical students, making use of both a pre-test and a then-test (retrospective pre-test) to check for response shift in evaluating the educational intervention. METHODS Four 10-15 min MI-game-based training conversations embedded in the Kognito Conversation Platform™ were offered to the students using a single-group Interrupted Time Series design. RESULTS Participants included 339 undergraduate medical students (RR= 83.1%). The one-hour MI virtual training proved effective in two ways: participants gained knowledge and skills, and increased awareness of the existing intrinsic knowledge and skill they already possess to communicate with future patients in a patient-centered way. CONCLUSION A brief one-hour MI-training simulation can be effective even if offered at an early stage during medical education. Furthermore, response shift varied and was not present in all students. PRACTICE IMPLICATION The addition of a then-test to the study design reveals results that otherwise would not have been found.
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Affiliation(s)
- Anne Marie Plass
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany.
| | - Amra Covic
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Louisa Lohrberg
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Glenn Albright
- Baruch College, City University of New York, USA; Kognito, New York, USA
| | | | - Nicole Von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
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Aster A, Scheithauer S, Middeke AC, Zegota S, Clauberg S, Artelt T, Schuelper N, Raupach T. Use of a Serious Game to Teach Infectious Disease Management in Medical School: Effectiveness and Transfer to a Clinical Examination. Front Med (Lausanne) 2022; 9:863764. [PMID: 35547200 PMCID: PMC9082676 DOI: 10.3389/fmed.2022.863764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose Physicians of all specialties must be familiar with important principles of infectious diseases, but curricular time for this content is limited and clinical teaching requires considerable resources in terms of available patients and teachers. Serious games are scalable interventions that can help standardize teaching. This study assessed whether knowledge and skills acquired in a serious game translate to better performance in a clinical examination. Methods Fifth-year undergraduate medical students (n = 100) at Goettingen Medical School were randomized to three groups receiving different levels of exposure to virtual patients presenting with signs and symptoms of either infective endocarditis or community-acquired pneumonia in a serious game simulating an accident and emergency department. Student performance was assessed based on game logfiles and an objective standardized clinical examination (OSCE). Results Higher exposure to virtual patients in the serious game did not result in superior OSCE scores. However, there was good agreement between student performance in the OSCE and in game logfiles (r = 0.477, p = 0.005). An Item Response Theory analysis suggested that items from the serious game covered a wider range of ability, thus better differentiating between students within a given cohort. Conclusion Repeated exposure to virtual patients with infectious diseases in a serious game did not directly impact on exam performance but game logfiles might be good and resource-sparing indicators of student ability. One advantage of using serious games in medical education is standardized content, a lower inhibition threshold to learn, and a need of less staff time compared to small-group clinical teaching.
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Affiliation(s)
- Alexandra Aster
- Institute of Medical Education, University Hospital Bonn, Bonn, Germany
| | - Simone Scheithauer
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | | | - Simon Zegota
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany
| | - Sigrid Clauberg
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Tanja Artelt
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | | | - Tobias Raupach
- Institute of Medical Education, University Hospital Bonn, Bonn, Germany
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Plackett R, Kassianos AP, Mylan S, Kambouri M, Raine R, Sheringham J. The effectiveness of using virtual patient educational tools to improve medical students' clinical reasoning skills: a systematic review. BMC MEDICAL EDUCATION 2022; 22:365. [PMID: 35550085 PMCID: PMC9098350 DOI: 10.1186/s12909-022-03410-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/19/2022] [Indexed: 06/10/2023]
Abstract
BACKGROUND Use of virtual patient educational tools could fill the current gap in the teaching of clinical reasoning skills. However, there is a limited understanding of their effectiveness. The aim of this study was to synthesise the evidence to understand the effectiveness of virtual patient tools aimed at improving undergraduate medical students' clinical reasoning skills. METHODS We searched MEDLINE, EMBASE, CINAHL, ERIC, Scopus, Web of Science and PsycINFO from 1990 to January 2022, to identify all experimental articles testing the effectiveness of virtual patient educational tools on medical students' clinical reasoning skills. Quality of the articles was assessed using an adapted form of the MERSQI and the Newcastle-Ottawa Scale. A narrative synthesis summarised intervention features, how virtual patient tools were evaluated and reported effectiveness. RESULTS The search revealed 8,186 articles, with 19 articles meeting the inclusion criteria. Average study quality was moderate (M = 6.5, SD = 2.7), with nearly half not reporting any measurement of validity or reliability for their clinical reasoning outcome measure (8/19, 42%). Eleven articles found a positive effect of virtual patient tools on reasoning (11/19, 58%). Four reported no significant effect and four reported mixed effects (4/19, 21%). Several domains of clinical reasoning were evaluated. Data gathering, ideas about diagnosis and patient management were more often found to improve after virtual patient use (34/47 analyses, 72%) than application of knowledge, flexibility in thinking and problem-solving (3/7 analyses, 43%). CONCLUSIONS Using virtual patient tools could effectively complement current teaching especially if opportunities for face-to-face teaching or other methods are limited, as there was some evidence that virtual patient educational tools can improve undergraduate medical students' clinical reasoning skills. Evaluations that measured more case specific clinical reasoning domains, such as data gathering, showed more consistent improvement than general measures like problem-solving. Case specific measures might be more sensitive to change given the context dependent nature of clinical reasoning. Consistent use of validated clinical reasoning measures is needed to enable a meta-analysis to estimate effectiveness.
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Affiliation(s)
- Ruth Plackett
- Department of Applied Health Research, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Angelos P Kassianos
- Department of Applied Health Research, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Sophie Mylan
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, England
| | | | - Rosalind Raine
- Department of Applied Health Research, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Jessica Sheringham
- Department of Applied Health Research, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK
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Kelkar A, Bhandary S, Chacko T. Addressing the need to develop critical thinking skills in the new competency-based medical education post graduate curriculum in pathology: Experience-sharing of the process of development and validation of script concordance test. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2022. [DOI: 10.4103/amhs.amhs_227_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Elsenbast C, Sachs S, Pranghofer J, Luiz T. [Learning with digital media in emergency medicine-a path through the jungle of possibilities]. Notf Rett Med 2021; 25:314-322. [PMID: 34873392 PMCID: PMC8637524 DOI: 10.1007/s10049-021-00957-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 01/20/2023]
Abstract
Hintergrund Digitale Medien, wie Podcasts, Wikis, E‑Portfolios und Extended-Reality-Anwendungen, bieten hervorragende Lernmöglichkeiten mit einem hohen Grad an Vernetzung und Flexibilität für die Lernenden, aber auch für Lernbegleitende. Dies ermöglicht nicht nur ortsunabhängiges und pandemieresilientes Lernen, sondern auch ein hohes Maß an Autonomie der Lernenden. Der Megatrend der Digitalisierung eröffnet vielfältige Möglichkeiten, aber auch Stolpersteine und Grenzen. Zielsetzung Dieser Beitrag soll Lesenden aus den Bereichen Notfallmedizin, Rettungsdienst und (Notfall‑)Pflege einen Überblick, Denkanstöße und Hinweise auf mögliche Stolpersteine geben. Dabei ist ein Spagat zwischen Didaktik und Medizin sowie dem heterogenen Adressatenkreis der Leserschaft notwendig. Methoden Mittels eines narrativen Reviews wird eine Einschätzung digitaler Medien vorgenommen. Die Medien werden einer Bewertung aus Sicht der Bildungspraxis unterzogen. Ergebnisse und Schlussfolgerung Lernen verändert sich nicht nur durch neue Lerntechnologien, sondern auch durch die wachsende Bedeutung des informellen Lernens, die zunehmende Bedeutung des schnellen Zugriffs auf qualitativ hochwertiges Wissen, sich schneller verändernde Berufsbiografien und den Einsatz digitaler Universalwerkzeuge. So ist im Dschungel der Möglichkeiten eine Einschätzung wissenschaftlicher Qualitätskriterien oft schwierig und eine differenzierte Betrachtung notwendig. Grundsätzlich ist die Frage nach den geeigneten Methoden zu stellen. Es muss kritisch hinterfragt werden, ob die Lern‑/Kompetenzziele mit den geplanten digitalisierten Medien erreicht werden können. Digitale Medien können und sollen die praktische Ausbildung in der Arbeitsrealität nicht ersetzen.
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Affiliation(s)
- Christian Elsenbast
- Fraunhofer-Institut für Experimentelles Software Engineering IESE, Digital Healthcare, Fraunhofer-Platz 1, 67663 Kaiserslautern, Deutschland
| | - Sebastian Sachs
- Malteser Hilfsdienst gemeinnützige GmbH, Bildungszentrum HRS, Wetzlar, Deutschland
| | - Johannes Pranghofer
- Malteser Hilfsdienst gemeinnützige GmbH, Bildungszentrum HRS, Wetzlar, Deutschland
| | - Thomas Luiz
- Fraunhofer-Institut für Experimentelles Software Engineering IESE, Digital Healthcare, Fraunhofer-Platz 1, 67663 Kaiserslautern, Deutschland
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Zairi I, Ben Dhiab M, Mzoughi K, Ben Mrad I, Kraiem S. Assessing medical student satisfaction and interest with serious game. LA TUNISIE MEDICALE 2021; 99:1030-1035. [PMID: 35288906 PMCID: PMC9390128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Serious games are interactive and entertaining digital software with an educational purpose, and they are increasingly being used in undergraduate medical education. Effective serious games attempt to form positive mood in order to encourage players to continue the play, leading to increased interest in gameplay and satisfaction as well as better academic performances. AIM To determine the medical students' satisfaction, situational and individual interest during a serious game. METHODS This was a prospective study performed during a 2-year period (2018-2019 and 2019-2020). A total of 108 third-year medical students participated in this study. Students were asked to play a serious game on a computer for 20 minutes. A set of questionnaires containing evaluation grids to measure the satisfaction and interest was given to students. The effectiveness of the game was assessed using pre and post-tests. RESULTS Following the exclusion criteria of students due to missing data, complete data were available for 97 students. Satisfaction and interest experienced by the students were high. The median of the game performance of students was 418, 04 points. There was a positive relationship between ease of use and game performance. There was a negative correlation between the three scales of interest and game performance. There was a significant difference between the mean scores of pre-tests and post-tests (p<0.01). CONCLUSION The results of this study suggest the potentials of serious game on medical student's satisfaction, interest and learning achievement.
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Affiliation(s)
- Ihsen Zairi
- 1- Service de cardiologie, Hôpital Habib Thameur, Faculté de Médecine de Tunis, Université de Tunis El Manar
| | - Mohamed Ben Dhiab
- 2- Service de médecine légal, Hôpital Farhat Hached, Faculté de Médecine de Sousse, Université de Sousse.
| | - Khadija Mzoughi
- 1- Service de cardiologie, Hôpital Habib Thameur, Faculté de Médecine de Tunis, Université de Tunis El Manar
| | - Imtinen Ben Mrad
- 1- Service de cardiologie, Hôpital Habib Thameur, Faculté de Médecine de Tunis, Université de Tunis El Manar
| | - Sondos Kraiem
- 1- Service de cardiologie, Hôpital Habib Thameur, Faculté de Médecine de Tunis, Université de Tunis El Manar
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Mansoory MS, Khazaei MR, Azizi SM, Niromand E. Comparison of the effectiveness of lecture instruction and virtual reality-based serious gaming instruction on the medical students' learning outcome about approach to coma. BMC MEDICAL EDUCATION 2021; 21:347. [PMID: 34130676 PMCID: PMC8207643 DOI: 10.1186/s12909-021-02771-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 05/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND New approaches to e-learning and the use of virtual reality technology and serious game in medical education are on the rise. Therefore, the purpose of this study was to compare the effectiveness of lecture method and virtual reality-based serious gaming (VRBSG) method on students learning outcomes about the approach to coma. METHODS We adopted a randomized trial method for this study and selected 50 medical students dividing them into experimental and control groups. Students' learning outcome was measured with a 10-item test. Serious game usability scale was used to evaluate the usability of the serious game. Descriptive and inferential statistics were used for data analysis by SPSS-22 software. RESULTS Students' familiarity with e-learning and VRBSG was low. The mean usability of a VRBSG was 126.78 ± 10.34 out of 150. The majority of students were eager to be instructed through VRBSG. The mean score of learning outcomes in the experimental group was significantly higher than the control group (t = - 2.457, P = 0.019). CONCLUSION Students' learning outcomes in the VRBSG group in the test approach to coma were significantly better than the lecture group. The usability of the serious game instruction method was high. Taken together, instruction through VRBSG had an effective role in medical students' learning.
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Affiliation(s)
- Meysam Siyah Mansoory
- Department of Biomedical Engineering, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Rasool Khazaei
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyyed Mohsen Azizi
- Medical Education and Development Center, Arak University of Medical Sciences, Arak, Iran
| | - Elham Niromand
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Raupach T, de Temple I, Middeke A, Anders S, Morton C, Schuelper N. Effectiveness of a serious game addressing guideline adherence: cohort study with 1.5-year follow-up. BMC MEDICAL EDUCATION 2021; 21:189. [PMID: 33785000 PMCID: PMC8008024 DOI: 10.1186/s12909-021-02591-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/28/2021] [Indexed: 06/10/2023]
Abstract
BACKGROUND Patients presenting with acute shortness of breath and chest pain should be managed according to guideline recommendations. Serious games can be used to train clinical reasoning. However, only few studies have used outcomes beyond student satisfaction, and most of the published evidence is based on short-term follow-up. This study investigated the effectiveness of a digital simulation of an emergency ward regarding appropriate clinical decision-making. METHODS In this prospective trial that ran from summer 2017 to winter 2018/19 at Göttingen Medical University Centre, a total of 178 students enrolled in either the fourth or the fifth year of undergraduate medical education took six 90-min sessions of playing a serious game ('training phase') in which they managed virtual patients presenting with various conditions. Learning outcome was assessed by analysing log-files of in-game activity (including choice of diagnostic methods, differential diagnosis and treatment initiation) with regard to history taking and patient management in three virtual patient cases: Non-ST segment elevation myocardial infarction (NSTEMI), pulmonary embolism (PE) and hypertensive crisis. Fourth-year students were followed up for 1.5 years, and their final performance was compared to the performance of students who had never been exposed to the game but had otherwise taken the same five-year undergraduate course. RESULTS During the training phase, overall performance scores increased from 57.6 ± 1.1% to 65.5 ± 1.2% (p < 0.001; effect size 0.656). Performance remained stable over 1.5 years, and the final assessment revealed a strong impact of ever-exposure to the game on management scores (72.6 ± 1.2% vs. 63.5 ± 2.1%, p < 0.001; effect size 0.811). Pre-exposed students were more than twice as likely to correctly diagnose NSTEMI and PE and showed significantly greater adherence to guideline recommendations (e.g., troponin measurement and D-dimer testing in suspected PE). CONCLUSIONS The considerable difference observed between previously exposed and unexposed students suggests a long-term effect of using the game although retention of specific virtual patient cases rather than general principles might partially account for this effect. Thus, the game may foster the implementation of guideline recommendations.
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Affiliation(s)
- Tobias Raupach
- Department of Cardiology and Pneumology, Göttingen University Medical Centre, Robert-Koch-Straße 40, 37075 Göttingen, Germany
- Department of Medical Education, University Hospital Bonn, Venusberg-Campus 1, Gebäude 33, 53127 Bonn, Germany
| | - Insa de Temple
- Department of Cardiology and Pneumology, Göttingen University Medical Centre, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Angélina Middeke
- Department of Cardiology and Pneumology, Göttingen University Medical Centre, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Sven Anders
- Department of Legal Medicine, University Medical Centre Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
| | - Caroline Morton
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - Nikolai Schuelper
- Medius KLINIK Ostfildern-Ruit, Hedelfinger Straße 166, 73760 Ostfildern-Ruit, Germany
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Seifert T, Becker T, Büttcher AF, Herwig N, Raupach T. Restructuring the clinical curriculum at University Medical Center Göttingen: effects of distance teaching on students' satisfaction and learning outcome. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc1. [PMID: 33659606 PMCID: PMC7899111 DOI: 10.3205/zma001397] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/16/2020] [Accepted: 11/24/2020] [Indexed: 05/28/2023]
Abstract
Introduction: In summer term 2020, the clinical phase of the undergraduate medical curriculum at University Medical Center Göttingen was restructured since distance teaching had to be used predominantly due to contact restrictions during the COVID-19 pandemic. This paper investigates the impact of restructuring the clinical curriculum on medical students' satisfaction and learning outcomes. Methods: In each cohort, the 13-week curriculum was divided into two parts: During the first 9 weeks, factual knowledge was imparted using distance teaching by means of a modified inverted classroom approach. This was followed by a 4-week period of adapted classroom teaching involving both real and virtual patients in order to train students' practical skills. The evaluation of the 21 clinical modules comprised students' satisfaction with distance teaching as well as students' learning outcome. The latter was assessed by means of comparative self-assessment (CSA) gain and the results of the module exams, respectively. Data of summer term 2020 (= distance teaching, DT) were compared with respective data of winter term 2019/20 (= classroom teaching, CT) and analysed for differences and correlations. Results: Response rates of evaluations were 51.3% in CT and 19.3% in DT. There was no significant difference between mean scores in module exams in CT and DT, respectively. However, CSA gain was significantly lower in DT (p=0.047) compared with CT. Further analyses revealed that CSA gain depended on the time point of data collection: CSA gain was lower the more time had passed since the end of a specific module. Moreover, we found positive correlations between CSA gain and students' satisfaction with various aspects of distance teaching, particularly with "communication between teachers and students" (rho=0.674; p=0.002). Discussion and conclusions: Although some limitations and confounding factors have to be taken into account (such as evaluation response rates, assessment time points, and proportion of familiar items in module exams), the following recommendations can be derived from our findings: A valid assessment of students' learning outcome by means of exam results requires that as few exam items as possible are familiar to the students. CSA gain seems to be valid if assessment time points are standardised and not contaminated by students' learning activities for other modules. Good communication between teachers and students may contribute to increase students' satisfaction with distance teaching.
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Affiliation(s)
- Theresa Seifert
- Universitätsmedizin Göttingen, Bereich Medizindidaktik und Ausbildungsforschung, Göttingen, Germany
| | - Tim Becker
- Universitätsmedizin Göttingen, Bereich Medizindidaktik und Ausbildungsforschung, Göttingen, Germany
| | | | - Nadine Herwig
- Universitätsmedizin Göttingen, Bereich Medizindidaktik und Ausbildungsforschung, Göttingen, Germany
| | - Tobias Raupach
- Universitätsmedizin Göttingen, Bereich Medizindidaktik und Ausbildungsforschung, Göttingen, Germany
- Universitätsmedizin Göttingen, Klinik für Kardiologie und Pneumologie, Göttingen, Germany
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Teaching Disaster Medicine With a Novel Game-Based Computer Application: A Case Study at Sichuan University. Disaster Med Public Health Prep 2020; 16:548-554. [PMID: 33191895 DOI: 10.1017/dmp.2020.309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study evaluates the effectiveness of our game-based pedagogical technique by comparing the learning, enjoyment, interest, and motivation of medical students who learned about best practices for patient surge in a natural disaster with a novel game-based computer application, with those of medical students who learned about it with a traditional lecture. METHODS We conducted our study by modifying an existing optional course in disaster medicine that we taught at Sichuan University. More specifically, in 2017, while our application was still in development, we taught this course by lecture. In this iteration, 63 third-grade medical students voluntarily joined our course as our 'lecture group.' Once our application was complete in 2018, 68 third-grade medical students voluntarily joined this course as the 'game group.' We examined the different effects of these learning methods on student achievement using pre -, post -, and final tests. RESULTS Both teaching methods significantly increased short-term knowledge and there was no statistical difference between the 2 methods (p > 0.05). However, the game group demonstrated significantly higher knowledge retention than the traditional lecture group (p < 0.05). CONCLUSION Our game-based computer application proved to be an effective tool for teaching medical students best practices for caring for patient surge in a natural disaster.
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Siqueira TV, Nascimento JDSG, Oliveira JLGD, Regino DDSG, Dalri MCB. The use of serious games as an innovative educational strategy for learning cardiopulmonary resuscitation: an integrative review. ACTA ACUST UNITED AC 2020; 41:e20190293. [PMID: 33111759 DOI: 10.1590/1983-1447.2020.20190293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 03/06/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To analyze the scientific evidence available in literature on the use of serious games for health students to learn about cardiopulmonary resuscitation. METHODS Integrative review in PubMed / MEDLINE®, LILACS, Scopus and CINAHL databases. Included primary studies, in Portuguese, English or Spanish, from January 2009 to August 2019. The Rayyan software was used for study selection. RESULTS We identified 115 studies, and 8 composed the sample, categorizing two domains: : Intention of the study with regard to cardiopulmonary resuscitation through the serious game, and method used by the serious game to teach CPR. CONCLUSION Medical students are the main audience for serious game learning, and the main intentions of the games are to compare their effectiveness with traditional methodologies and knowledge retention. The method adopted is the description of a cardiorespiratory arrest for training. The serious game proved effective for learning cardiopulmonary resuscitation.
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Affiliation(s)
- Tainá Vilhar Siqueira
- Hospital de Clínicas da Universidade Federal do Triângulo Mineiro (UFTM). Uberaba, Minas Gerais, Brasil
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Plackett R, Kassianos AP, Kambouri M, Kay N, Mylan S, Hopwood J, Schartau P, Gray S, Timmis J, Bennett S, Valerio C, Rodrigues V, Player E, Hamilton W, Raine R, Duffy S, Sheringham J. Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial. BMC MEDICAL EDUCATION 2020; 20:245. [PMID: 32736583 PMCID: PMC7395338 DOI: 10.1186/s12909-020-02168-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/22/2020] [Indexed: 05/25/2023]
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.
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Affiliation(s)
- Ruth Plackett
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Angelos P Kassianos
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | | | - Natasha Kay
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Sophie Mylan
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Shani Gray
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Jessica Timmis
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | | | | | | | | | - Willie Hamilton
- Institute of Health Service Research, University of Exeter, Exeter, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Stephen Duffy
- Wolfson Institute of Preventive Medicine, QMUL, London, UK
| | - Jessica Sheringham
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Tolks D, Lampert C, Dadaczynski K, Maslon E, Paulus P, Sailer M. Spielerische Ansätze in Prävention und Gesundheitsförderung: Serious Games und Gamification. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:698-707. [DOI: 10.1007/s00103-020-03156-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
ZusammenfassungDigitale Spieleanwendungen können im Bereich Prävention und Gesundheitsförderung eingesetzt werden, um etwa gesundheitsrelevante Informationen zu vermitteln oder Verhaltensänderungen zu evozieren. Dabei sind die beiden relevantesten spielerischen Ansätze Serious Games (Spiele mit ernsthaftem Hintergrund) und Gamification (Anwendung spieltypischer Elemente in spielfremden Kontexten). Der Begriff Serious Games umschreibt Spiele, die eingesetzt werden, um ernsthafte Inhalte, wie zum Beispiel gesundheitliche Themen, zu vermitteln. Bei Gamification werden Spieldesignelemente, wie beispielsweise Punkte, Bestenlisten, Auszeichnungen, Profilgestaltung und Teamevents, eingesetzt, um eine Motivations- und Leistungssteigerung etwa in Lernumgebungen zu bewirken. Der vorliegende narrative Beitrag beleuchtet die Wirkungsweise und Studienlage sowie die Vor- und Nachteile spielerischer Anwendungen in der Prävention und Gesundheitsförderung und führt einige dieser Anwendungen exemplarisch auf.Serious Games und Gamification zeigen in der Prävention und Gesundheitsförderung ein großes Potenzial. Insbesondere bei schwer erreichbaren und desinteressierten Zielgruppen kann ein direkter Bezug zu deren Lebenswelt hergestellt werden. Grundlagen für den wirkungsvollen Einsatz spielerischer Ansätze in der Arbeit und Ausbildung von Gesundheitsberufen sind die bereits hohe Vertrautheit mit dem Medium Spiel sowie die direkte Adressierung der psychologischen Grundbedürfnisse zur Steigerung der Motivation.
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Transfer of Clinical Reasoning Trained With a Serious Game to Comparable Clinical Problems. ACTA ACUST UNITED AC 2020; 15:75-81. [DOI: 10.1097/sih.0000000000000407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Blanié A, Amorim MA, Benhamou D. Comparative value of a simulation by gaming and a traditional teaching method to improve clinical reasoning skills necessary to detect patient deterioration: a randomized study in nursing students. BMC MEDICAL EDUCATION 2020; 20:53. [PMID: 32075641 PMCID: PMC7031947 DOI: 10.1186/s12909-020-1939-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/16/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Early detection and response to patient deterioration influence patient prognosis. Nursing education is therefore essential. The objective of this randomized controlled trial was to compare the respective educational value of simulation by gaming (SG) and a traditional teaching (TT) method to improve clinical reasoning (CR) skills necessary to detect patient deterioration. METHODS In a prospective multicenter study, and after consent, 2nd year nursing students were randomized into two groups: Simulation by gaming "SG": the student played individually with a serious game consisting of 2 cases followed by a common debriefing with an instructor;Traditional Teaching "TT": the student worked on the same cases in text paper format followed by a traditional teaching course with a PowerPoint presentation by an instructor. CR skill was measured by script concordance tests (80 SCTs, score 0-100) immediately after the session (primary outcome) and on month later. Other outcomes included students' satisfaction, motivation and professional impact. RESULTS One hundred forty-six students were randomized. Immediately after training, the SCTs scores were 59 ± 9 in SG group (n = 73) and 58 ± 8 in TT group (n = 73) (p = 0.43). One month later, the SCTs scores were 59 ± 10 in SG group (n = 65) and 58 ± 8 in TT group (n = 54) (p = 0.77). Global satisfaction and motivation were highly valued in both groups although significantly greater in the SG group (p < 0.05). The students declared that the training course would have a positive professional impact, with no difference between groups. CONCLUSIONS In this study assessing nursing student CR to detect patient deterioration, no significant educational difference (SCT), neither immediate nor 1 month later, was observed between training by SG and the TT course. However, satisfaction and motivation were found to be greater with the use of SG. TRIAL REGISTRATION ClinicalTrials.gov; NCT03428269. Registered 30 january 2018.
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Affiliation(s)
- Antonia Blanié
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275, Le Kremlin Bicêtre, France.
- Département d'Anesthésie-Réanimation, CHU Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France.
- CIAMS, Université d'Orléans, 45067, Orléans, France.
| | - Michel-Ange Amorim
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
| | - Dan Benhamou
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275, Le Kremlin Bicêtre, France
- Département d'Anesthésie-Réanimation, CHU Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
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Jawaid M, Bakhtiar N, Masood Z, Mehar AK. Effect of Paper- and Computer-based Simulated Instructions on Clinical Reasoning Skills of Undergraduate Medical Students: A Randomized Control Trial. Cureus 2019; 11:e6071. [PMID: 31832289 PMCID: PMC6892578 DOI: 10.7759/cureus.6071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 11/04/2019] [Indexed: 11/06/2022] Open
Abstract
Background and objectives Skilled clinical reasoning is a critical tool for physicians. Educators agree that this skill should be formally taught and assessed. Objectives related to the mastery of clinical reasoning skills appear in the documentation of most medical schools and licensing bodies. We conducted this study to assess the differences in clinical reasoning skills in medical students following paper- and computer-based simulated instructions. Materials and methods A total of 52 sixth semester medical students of the Dow University of Health Sciences were included in this study. A tutorial was delivered to all students on clinical reasoning and its importance in clinical practice. Students were divided randomly into two groups: group A received paper-based instructions while group B received computer-based instructions (as Flash-based scenarios developed with Articulate Storyline software [https://articulate.com/p/storyline-3]) focused on clinical reasoning skills in history-taking of acute and chronic upper abdominal pain. After one week, both groups were tested at two objective structured clinical examination (OSCE) stations to assess acute and chronic pain history-taking skills in relation to clinical reasoning. Results There were 27 students in group A and 25 students in group B. The mean OSCE score for group A (paper-based) was 28.6 ± 9.4 and that for group B (computer-based) was 38.5 ± 6.0. Group B's mean score was statistically significantly greater (p < 0.001) than group A's mean score for clinical reasoning skills. Conclusion A computer simulation program can enhance clinical reasoning skills. This technology could be used to acquaint students with real-life experiences and identify potential areas for more training before facing real patients.
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Affiliation(s)
| | - Nighat Bakhtiar
- General Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Zubia Masood
- General Surgery, Ziauddin Medical University, Karachi, PAK
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Chon SH, Timmermann F, Dratsch T, Schuelper N, Plum P, Berlth F, Datta RR, Schramm C, Haneder S, Späth MR, Dübbers M, Kleinert J, Raupach T, Bruns C, Kleinert R. Serious Games in Surgical Medical Education: A Virtual Emergency Department as a Tool for Teaching Clinical Reasoning to Medical Students. JMIR Serious Games 2019; 7:e13028. [PMID: 30835239 PMCID: PMC6423463 DOI: 10.2196/13028] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/21/2019] [Accepted: 02/17/2019] [Indexed: 12/27/2022] Open
Abstract
Background Serious games enable the simulation of daily working practices and constitute a potential tool for teaching both declarative and procedural knowledge. The availability of educational serious games offering a high-fidelity, three-dimensional environment in combination with profound medical background is limited, and most published studies have assessed student satisfaction rather than learning outcome as a function of game use. Objective This study aimed to test the effect of a serious game simulating an emergency department (“EMERGE”) on students’ declarative and procedural knowledge, as well as their satisfaction with the serious game. Methods This nonrandomized trial was performed at the Department of General, Visceral and Cancer Surgery at University Hospital Cologne, Germany. A total of 140 medical students in the clinical part of their training (5th to 12th semester) self-selected to participate in this experimental study. Declarative knowledge (measured with 20 multiple choice questions) and procedural knowledge (measured with written questions derived from an Objective Structured Clinical Examination station) were assessed before and after working with EMERGE. Students’ impression of the effectiveness and applicability of EMERGE were measured on a 6-point Likert scale. Results A pretest-posttest comparison yielded a significant increase in declarative knowledge. The percentage of correct answers to multiple choice questions increased from before (mean 60.4, SD 16.6) to after (mean 76.0, SD 11.6) playing EMERGE (P<.001). The effect on declarative knowledge was larger in students in lower semesters than in students in higher semesters (P<.001). Additionally, students’ overall impression of EMERGE was positive. Conclusions Students self-selecting to use a serious game in addition to formal teaching gain declarative and procedural knowledge.
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Affiliation(s)
- Seung-Hun Chon
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | | | | | - Nikolai Schuelper
- Department of Haematology and Medical Oncology, University Medical Centre Göttingen, Göttingen, Germany
| | - Patrick Plum
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Felix Berlth
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Rabi Raj Datta
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Christoph Schramm
- Department of Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Martin Richard Späth
- Department II of Internal Medicine and Center for Molecular Medicine, University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, University of Cologne, Cologne, Germany
| | - Martin Dübbers
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Julia Kleinert
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Tobias Raupach
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany.,Division of Medical Education Research and Curriculum Development, University Medical Centre Göttingen, Göttingen, Germany
| | - Christiane Bruns
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Robert Kleinert
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
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