A Study to Design a Learning Tool “Virtual Patient” for Functional Diagnosis and Clinical Reasoning of Respiratory Dysfunction in the Undergraduate Physiotherapy Curriculum (original) (raw)
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“I Have a Cough”: An Interactive Virtual Respiratory Case-Based Module
MedEdPORTAL, 2020
Introduction: The COVID-19 pandemic has radically disrupted traditional models of medical education, forcing rapid evolution in the delivery of clinical training. As a result, clinical educators must quickly transition away from in-person sessions and develop effective virtual learning opportunities instead. This virtual resource was designed to replace a clinical simulation session for the physical examination course for medical students in the preclinical years. Methods: We designed an online interactive module in three sections for preclinical (first-or second-year) medical students who had not yet learned the respiratory physical exam. The first section incorporated demonstration and practice of the components of the respiratory physical exam that could be effectively taught via videoconferencing software. Following this, students conducted a telemedicine encounter with a standardized patient and received patient-centered feedback evaluating their communication skills. The final segment involved a case discussion and clinical reasoning component. Results: These sessions were implemented for 122 first-year medical students. The module was well received by the students. A majority felt that it helped improve their telemedicine communication skills (93%), interpretation of physical exam findings (84%), development of differential diagnosis (95%), and correlation of clinical and basic science content (93%). Discussion: Our pilot educational session demonstrates that this virtual instruction method is an effective tool for teaching basic clinical skills during medical school. Virtual learning resources allow remote instruction to take place and can be a supplement when face-to-face clinical teaching is not possible.
Physiotherapy Theory and Practice, 2020
Background: Clinical reasoning is a fundamental competency in the learning process of health professionals. Since learning with traditional methods presents difficulties, teaching with interactive virtual scenarios is a good alternative. Objective: To describe the impact of a blended training with interactive virtual scenarios for the development of clinical reasoning skills in undergraduate physiotherapy students. Methods: A sample of 92 students solved eight storylines. Assessment error percentage, clinical pattern recognition, satisfaction, and the perception of difficulty were obtained. A proportions test was used to compare baseline and final assessments. To analyze the relationship between the variables, multilevel univariate logistic regression models were built. Results: A significant difference was observed in the error percentage between baseline and final assessment (p < .001). Comparing the last storyline to the first one, there were 2.63 times more possibilities to correctly recognize the pattern. The error percentage was associated with the opportunity to recognize the pattern precisely (p < .001). Thus, for each increasing unit in the error percentage, the possibility to correctly recognize the pattern decreased by 11% (OR = 0.89). Conclusions: The use of this innovative blended training with virtual scenarios allowed students to systematically improve their recognition abilities of clinical patterns and decrease mistakes in the decision-making process.
Virtual Learning for Human Respiratory System Via Non-Immersive VR (V-HURESYS): An Evaluation
Annals of Emerging Technologies in Computing
The science includes a lot of concepts and abstract that cannot be seen by the naked eye. Students have a problem remembering and visualize information contained in the science subject. Hence, the idea of the development of effective visualization learning materials using Virtual Reality is expected. By using VR, the user can visualize the structure and interact with the components inside. The purpose of the present study was to evaluate the effectiveness of application in learning the Human Respiratory System through virtual reality (VR). The evaluation conducted among secondary school students by using the Kirkpatrick Model evaluation model. The data collected from 35 Form 3 students that take a science subject. The overall percentage average of the evaluation is 72%, which considered V-HURESYS application was effective in learning the Human Respiratory System through the VR technique. Keenly, the results of the study will emphasize the student’s performance in their science subje...
Case Studies in Virtual Clinical Environment
2019
Clinical practicum is a major component in nursing education. Students are able to apply their classroom learning to the actual care setting. The clinical practicum setting must provide an authentic environment where students can maximize learning opportunities and demonstrate knowledge, skills, and attitude in caring for patients. Herein lies the challenge. The real world setting and timing may not be enough for students to learn the many complex tasks demanded as course outcomes and expected competencies. The purpose of this study was to describe the usefulness of using multimedia case study courseware in facilitating learning among students. The Virtual Clinical Environment multimedia courseware was structured around five case studies featuring major health concerns among adults, namely : chronic heart failure, stroke, breast cancer, chronic obstructive pulmonary disease, and dementia. Students were asked to use case studies in developing nursing care plans which facilitated auth...
Virtual Patient: Development of a Clinical Cases Simulator as a Tool for Medical Education
Virtual Patient: Development of a Clinical Cases Simulator as a Tool for Medical Education, 2022
Despite undeniable advances in medicine, medical errors still remain a problem that threatens healthcare professionals. An aggravating factor was the COVID-19 pandemic: as the number of cases of the disease increased, health centers began to limit student access, representing a break in traditional medical education. In countermeasure, the simulation of procedures has figured as an option, as teams can learn and practice in a safe environment. The objective of this work is to demonstrate the developing process of an accessible and functional virtual simulator in order to reproduce clinical situations. The medical students can improve their behavior when in usual or unusual cases. The research was managed through a university project with professors and students of Medicine and Information Technology. The project consisted of three stages: a systematic literature review of the main medical scientific databases; a database of clinical cases development to guide a web simulation structure, with the formulation of the medical consultation; a standard definition via BPMN (Business Process Model and Notation) for the operational organization of the medical services was built. As results: a comparative survey of the simulators on the market was carried out; a flowchart template was developed on the HEFLO BPMN platform for procedures, and an initial simulation structure in a cloud platform. The multipurpose character of the tool is highlighted, and it can be used both in individual studies and in an evaluative activity, mainly because of its editable function, which guarantees its adaptation to the different contexts of medical education.
Virtual patient simulation: Promotion of clinical reasoning abilities of medical students
Knowledge Management & E-Learning: An International Journal (KM&EL), 2013
Objectives: Virtual patient simulation (VPS) is used in the education of health care professionals. This method brings an opportunity for the learner to examine necessary diagnostic and therapeutic skills. The aim of this study was to assess the efficacy of VPS on clinical reasoning abilities of medical students and to evaluate their attitude towards VPS in clinical endocrinology course in a teacher centered educational environment. Methods: Fifty-one medical students in their 6th academic year were simply randomized in two groups, ...
The virtual patient as a learning tool: a mixed quantitative qualitative study
BMC Medical Education
Background: The use of simulation in medical education has been widely accepted. There are different types of medical simulators that vary in both accuracy to emulate the real world (fidelity) and cost of development or acquisition. There is significant evidence that supports the use of high-fidelity simulators (i.e. mannequins or dummies) to prepare students for clinical environments, less attention has been given to low-fidelity simulators. This article aims to present evidence regarding the effectiveness of a low-fidelity simulator: Virtual Patient (VP), which develops several interactive computer-based clinical scenarios, seeking to promote an alternative learning environment and the development of necessary medical skills such as clinical reasoning in students of medicine. Methods: A quasi-experimental study was designed to investigate the results on the development of history taking and clinical reasoning skills in a group of undergraduate medical students, in a course devised under the concepts of constructivism in education, which used the Virtual Patient as the fundamental teaching tool. Results were measured through a mixed, quantitative and qualitative study, triangulating the results of the students' skills evaluation when facing a clinical case represented by an actor patient before and after the course. Additionally, the description of the students' and tool's performance was measured by way of a qualitative study. Results: The comparison of the students' skills on the evaluation matrix before-and-after the course evidenced a statistically significant advance (p < 0.01) in all aspects (interview, physical exam, clinical judgment, relevance of medical exams, and presentation of case). Students described the VP as an easy-to-use and motivating tool for learning without stress, especially at the beginning of their career. VP allowed them to create logical and structured processes, to be wrong without consequences, and to review and reassess information available. From the professor perspective, it allowed a better follow-up of the students' learning process and favored reflections on the teaching-learning process.
ProQuest LLC eBooks, 2014
Virtual Patient Simulations (VPS) are web-based exercises involving simulated patients in virtual environments. This study investigates the utility of VPS for increasing medical student clinical reasoning skills, collaboration, and engagement. Many studies indicate that VPS provide medical students with essential practice in clinical decision making before they encounter real life patients. The utility of a recursive, inductive VPS for increasing clinical decision-making skills, collaboration, or engagement is unknown. Following a design-based methodology, VPS were implemented in two phases with two different cohorts of first year medical students: spring and fall of 2013. Participants were 108 medical students and six of their clinical faculty tutors. Students collaborated in teams of three to complete a series of virtual patient cases, submitting a ballpark diagnosis at the conclusion of each session. Student participants subsequently completed an electronic, 28-item Exit Survey. Finally, students participated in a randomized controlled trial comparing traditional (tutor-led) and VPS case instruction methods. This sequence of activities rendered quantitative and qualitative data that were triangulated during data analysis to increase the validity of findings. After practicing through four VPS cases, student triad teams selected accurate ballpark diagnosis 92% of the time. Pre-post test results revealed that PPT was significantly more effective than VPS after 20 minutes of instruction. PPT instruction resulted in significantly higher learning gains, but both modalities supported significant learning gains in clinical reasoning. Students collaborated well and held rich clinical discussions; the central phenomenon that emerged was "synthesizing evidence inductively to make clinical decisions." Using an inductive process, student teams collaborated to analyze patient data, and in nearly all instances successfully solved the case, while remaining cognitively engaged. This is the first design-based study regarding virtual patient simulation, reporting iterative phases of implementation and design improvement, culminating in local theories (petite generalizations) about VPS design. A thick, rich description of environment, process, and findings may benefit other researchers and institutions in designing and implementing effective VPS.
Malaysian Journal of Medicine and Health Sciences, 2022
Introduction: Anatomy is perceived to be an onerous subject as it contains complex information that necessitates three-dimensional visualization to comprehend. During COVID-19 pandemic, there was a paradigm shift to online distance learning including practical sessions. Innovative instructional techniques of learning anatomy are clearly needed.Methods: An e-Anatomy kit composing of 5 components: i) pre-recorded cadaveric demonstrations, ii) Complete Anatomy application, iii) interactive diagram labelling, iv) schematic diagram and v) mnemonics were designed to improve the Respiratory Module virtual practical experience of medical students from Faculty of Medicine, Universiti Teknologi MARA, Malaysia. The students were divided into 2 groups: the control group had regular discussion and the experimental group received an e-Anatomy kit. Pre-and post-test containing Anatomy questions as well as questionnaires regarding student perceptions were also given to the students. Results: There was significant difference between the means of pre-and post-test assessment in both control and e-Anatomy kit groups. There were no differences of post-test assessments between the control and e-Anatomy kit groups. However, in post-test assessments, the mean percentage difference of the e-Anatomy kit group is higher (15.8%) in comparison to the control group (10.3%). The students perceived the e-Anatomy kit as engaging, interesting and effective. Conclusion: e-Anatomy kit is an efficient and engaging approach as an alternative or adjunct to face-to-face anatomy teaching, especially under COVID-19 pandemic.
A Clinical Case Simulation Tool for Medical Education
Information Technology in Bio- and Medical Informatics, 2016
The human being, even if potentially inclined to learn, needs incentives to do it effectively. In these context, the virtual environments could simulate challenges of clinical practice and, at the same time, consider the personal experiences, allows the student's stimulus and also offer additional theoretical content updated and of excellent quality. The purpose of the project is to develop a Clinical Case Simulation Tool (CCST), it´s supposed to be a supporter to the acquisition of clinical skills for medical education. This is an experimental study of applied technology for health education. The project is multidisciplinary between health sciences, computing and education. The development of an application to store real clinical cases is the starting point of this study. The structure of the proposed clinical case comprises the description of the case, clinical history, complementary tests, questions and further reading. The access to the application is password protected, composed of access profiles with specific characteristics such as teacher, coordinator, student. All clinical cases are linked to a specific college and discipline. The Clinical Cases simulator platform was created for storage of clinical cases and to provide technological support for preparing courses, workshops and support classroom teaching. This may be considered as an innovative approach, given the use of a digital system that enables the storage of clinical data and laboratory tests, as sounds of cardiac auscultation, pulmonary auscultation, images and videos.