| 1. |
- Kononowicz, A. A., et al.
(författare)
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Virtual patient simulations for health professional education
- 2016
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Ingår i: Cochrane Database of Systematic Reviews. - : John Wiley & Sons. - 1469-493X. ; :5
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Forskningsöversikt (refereegranskat)abstract
- The objective of this review is to evaluate the effectiveness of virtual patient simulation as an educational intervention versus traditional learning, other types of e‐Learning interventions and other forms of virtual patient simulation interventions for delivering pre‐registration and post‐registration healthcare professional education. We will primarily assess the impact of these interventions on learners’ knowledge, skills and attitudes. Our secondary objective is to assess the cost‐effectiveness of these interventions.
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| 2. |
- Kononowicz, Andrzej A., et al.
(författare)
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Virtual Patient Simulations in Health Professions Education : Systematic Review and Meta-Analysis by the Digital Health Education Collaboration
- 2019
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 21:7
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Forskningsöversikt (refereegranskat)abstract
- Background: Virtual patients are interactive digital simulations of clinical scenarios for the purpose of health professions education. There is no current collated evidence on the effectiveness of this form of education.Objective: The goal of this study was to evaluate the effectiveness of virtual patients compared with traditional education, blended with traditional education, compared with other types of digital education, and design variants of virtual patients in health professions education. The outcomes of interest were knowledge, skills, attitudes, and satisfaction.Methods: We performed a systematic review on the effectiveness of virtual patient simulations in pre- and postregistration health professions education following Cochrane methodology. We searched 7 databases from the year 1990 up to September 2018. No language restrictions were applied. We included randomized controlled trials and cluster randomized trials. We independently selected studies, extracted data, and assessed risk of bias and then compared the information in pairs. We contacted study authors for additional information if necessary. All pooled analyses were based on random-effects models.Results: A total of 51 trials involving 4696 participants met our inclusion criteria. Furthermore, 25 studies compared virtual patients with traditional education, 11 studies investigated virtual patients as blended learning, 5 studies compared virtual patients with different forms of digital education, and 10 studies compared different design variants. The pooled analysis of studies comparing the effect of virtual patients to traditional education showed similar results for knowledge (standardized mean difference [SMD]=0.11, 95% CI -0.17 to 0.39, I-2=74%, n=927) and favored virtual patients for skills (SMD=0.90, 95% CI 0.49 to 1.32, I-2=88%, n=897). Studies measuring attitudes and satisfaction predominantly used surveys with item-by-item comparison. Trials comparing virtual patients with different forms of digital education and design variants were not numerous enough to give clear recommendations. Several methodological limitations in the included studies and heterogeneity contributed to a generally low quality of evidence.Conclusions: Low to modest and mixed evidence suggests that when compared with traditional education, virtual patients can more effectively improve skills, and at least as effectively improve knowledge. The skills that improved were clinical reasoning, procedural skills, and a mix of procedural and team skills. We found evidence of effectiveness in both high-income and low-and middle-income countries, demonstrating the global applicability of virtual patients. Further research should explore the utility of different design variants of virtual patients.
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| 3. |
- Stathakarou, N., et al.
(författare)
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Teams managing civilian and military complex trauma: What are the competencies required in austere environments and the potential of simulation technology to address them?
- 2021
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Ingår i: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 27:4
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Tidskriftsartikel (refereegranskat)abstract
- Surgical training in civilian hospitals may not be sufficient for managing complex trauma in a setting where such care is not commonly practiced. Understanding the challenges that civilian teams face when moving to austere environments can inform the competencies that need to be trained. The aim of this study was to explore the competencies required in austere environments for teams managing complex trauma, and how they can be trained with simulation technologies. Ethnographic field observations were conducted, and field notes were synthesized. The field notes were structured with the elements of Activity Theory to generate the teams' competencies that need to be trained. A literature review was conducted to verify the results and identify examples of relevant simulation modalities. The analysis resulted in a structured list of competencies for civilian teams to manage complex trauma in an austere environment and recommendations which simulation technologies could be used in training of those competencies based on published studies. Our study contributes to understanding the challenges that civilian teams face when operating in an austere environment. A systematized list of competencies with suggested simulation technologies directs future research to improve quality of complex trauma training in civilian and military collaboration.
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| 4. |
- Wagner, F. L., et al.
(författare)
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Current status and ongoing needs for the teaching and assessment of clinical reasoning – an international mixed-methods study from the students` and teachers` perspective
- 2024
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Ingår i: BMC Medical Education. - : BioMed Central (BMC). - 1472-6920. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clinical reasoning (CR) is a crucial ability that can prevent errors in patient care. Despite its important role, CR is often not taught explicitly and, even when it is taught, typically not all aspects of this ability are addressed in health professions education. Recent research has shown the need for explicit teaching of CR for both students and teachers. To further develop the teaching and learning of CR we need to improve the understanding of students' and teachers' needs regarding content as well as teaching and assessment methods for a student and trainer CR curriculum. Methods: Parallel mixed-methods design that used web-surveys and semi-structured interviews to gather data from both students (nsurvey = 100; ninterviews = 13) and teachers (nsurvey = 112; ninterviews = 28). The interviews and surveys contained similar questions to allow for triangulation of the results. This study was conducted as part of the EU-funded project DID-ACT (https://did-act.eu). Results: Both the surveys and interview data emphasized the need for content in a clinical reasoning (CR) curriculum such as “gathering, interpreting and synthesizing patient information”, “generating differential diagnoses”, “developing a diagnostic and a treatment plan” and “collaborative and interprofessional aspects of CR”. There was high agreement that case-based learning and simulations are most useful for teaching CR. Clinical and oral examinations were favored for the assessment of CR. The preferred format for a train-the-trainer (TTT)-course was blended learning. There was also some agreement between the survey and interview participants regarding contents of a TTT-course (e.g. teaching and assessment methods for CR). The interviewees placed special importance on interprofessional aspects also for the TTT-course. Conclusions: We found some consensus on needed content, teaching and assessment methods for a student and TTT-course in CR. Future research could investigate the effects of CR curricula on desired outcomes, such as patient care.
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| 5. |
- Berman, Anne H., et al.
(författare)
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Virtual Patients in a Behavioral Medicine Massive Open Online Course (MOOC) : A Qualitative and Quantitative Analysis of Participants' Perceptions
- 2017
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Ingår i: Academic Psychiatry. - : Springer Science and Business Media LLC. - 1042-9670 .- 1545-7230. ; 41:5, s. 631-641
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Tidskriftsartikel (refereegranskat)abstract
- Objective The purpose of this article is to explore learners' perceptions of using virtual patients in a behavioral medicine Massive Open Online Course (MOOCs) and thereby describe innovative ways of disseminating knowledge in health-related areas. Methods A 5-week MOOC on behavioral medicine was hosted on the edX platform. The authors developed two branched virtual patients consisting of video recordings of a live standardized patient, with multiple clinical decision points and narration unfolding depending on learners' choices. Students interacted with the virtual patients to treat stress and sleep problems. Answers to the exit survey and participant comments from the discussion forum were analyzed qualitatively and quantitatively. Results In total, 19,236 participants enrolled in the MOOC, out of which 740 received the final certificate. The virtual patients were completed by 2317 and 1640 participants respectively. Among survey respondents (n = 442), 83.1% agreed that the virtual patient exercise was helpful. The qualitative analysis resulted in themes covering what it was like to work with the virtual patient, with subthemes on learner-centered education, emotions/eustress, game comparisons, what the participants learned, what surprised them, how confident participants felt about applying interventions in practice, suggestions for improvement, and previous experiences of virtual patients. Conclusions Students were enthusiastic about interacting with the virtual patients as a means to apply new knowledge about behavioral medicine interventions. The most common suggestion was to incorporate more interactive cases with various levels of complexity. Further research should include patient outcomes and focus on interprofessional aspects of learning with virtual patients in a MOOC.
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| 6. |
- Hadadgar, Arash, et al.
(författare)
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Creating and validating e-cases as educational tools in general practitioners' continuing medical education context
- 2018
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Ingår i: Bio-Algorithms and Med-Systems. - : Walter de Gruyter. - 1895-9091 .- 1896-530X. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed at creating electronic cases (e-cases) and analyzing their validity as a diagnostic assessment tool within the context of continuing medical education (CME) to measure general practitioners' (GPs) knowledge of common infectious disease. Methods: We designed assessment e-cases in an electronic CME platform. The e-cases were designed to measure GPs' knowledge about diagnosis and treatment of common infectious disease in outpatient settings. The data collected were analyzed for five forms of evidence: content, response process, internal structure, relations with other variables and consequences. Results: A total of 46 GPs participated in the study. Among them, 87% perceived the e-cases as resembling the patients whom they visit in their everyday practice. Although attendance in this activity made 85% of the participants more cautious about prescription of antibiotics, we could not detect any statistically significant association between the assessment scores and the physicians' previous antibiotic prescription. The diagnos- e tic assessment with e-cases was supported by most of the elements of validity evidence, including content, response process, internal structure and consequences. Conclusions: Overall, evidence suggests that using e-cases might be a valid diagnostic assessment CME activity to measure GPs' knowledge of common infectious disease, but more research is necessary.
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| 7. |
- Hege, Inga, et al.
(författare)
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A qualitative analysis of virtual patient descriptions in healthcare education based on a systematic literature review
- 2016
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Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 16
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Forskningsöversikt (refereegranskat)abstract
- Background: Virtual Patients (VPs) have been in the focus of research in healthcare education for many years. The aim of our study was to analyze how virtual patients are described in the healthcare education literature, and how the identified concepts relate to each other.Methods: We performed a literature review and extracted 185 descriptions of virtual patients from the articles. In a qualitative content analysis approach we inductively-deductively developed categories and deducted subcategories. We constructed a concept map to illustrate these concepts and their interrelations.Results: We developed the following five main categories: Patient, Teacher, Virtual Patient, Curriculum, and Learner. The concept map includes these categories and highlights aspects such as the under-valued role of patients in shaping their virtual representation and opposing concepts, such as standardization of learner activity versus learner-centeredness.Conclusions: The presented concept map synthesizes VP descriptions and serves as a basis for both, VP use and discussions of research topics related to virtual patients.
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| 8. |
- Hege, Inga, et al.
(författare)
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Developing a European longitudinal and interprofessional curriculum for clinical reasoning
- 2023
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Ingår i: Diagnosis. - : Walter de Gruyter GmbH. - 2194-8011 .- 2194-802X.
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Tidskriftsartikel (refereegranskat)abstract
- Clinical reasoning is a complex and crucial ability health professions students need to acquire during their education. Despite its importance, explicit clinical reasoning teaching is not yet implemented in most health professions educational programs. Therefore, we carried out an international and interprofessional project to plan and develop a clinical reasoning curriculum with a train-the-trainer course to support educators in teaching this curriculum to students. We developed a framework and curricular blueprint. Then we created 25 student and 7 train-the-trainer learning units and we piloted 11 of these learning units at our institutions. Learners and faculty reported high satisfaction and they also provided helpful suggestions for improvements. One of the main challenges we faced was the heterogeneous understanding of clinical reasoning within and across professions. However, we learned from each other while discussing these different views and perspectives on clinical reasoning and were able to come to a shared understanding as the basis for developing the curriculum. Our curriculum fills an important gap in the availability of explicit clinical reasoning educational materials both for students and faculty and is unique with having specialists from different countries, schools, and professions. Faculty time and time for teaching clinical reasoning in existing curricula remain important barriers for implementation of clinical reasoning teaching.
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