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Virtual patient simulations for medical education: increasing clinical reasoning skills through deliberate practice

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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.

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 percent 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.

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Created

Date Created
  • 2014

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RESET-ting Professional Development: Fostering Mid-career K-8 Teachers' Identities and Actions as Culturally Responsive Science and Engineering Educators

Description

This qualitative, design-based research study explored the design, implementation, and outcomes of a professional development for mid-career K-8 science and engineering teachers. The Responsive and Empowering Science and Engineering Teacher

This qualitative, design-based research study explored the design, implementation, and outcomes of a professional development for mid-career K-8 science and engineering teachers. The Responsive and Empowering Science and Engineering Teacher (RESET) professional development was designed to support teachers in developing role identities as culturally responsive teachers, change agents disrupting inequitable educational practices, and advocates of students’ equitable access to and participation in science and engineering disciplines. Four mid-career K-8 teachers participated in RESET, which was embedded in a five-week summer program focused on solar energy engineering. The teachers engaged in activities designed to increase their knowledge of and pedagogical strategies for culturally responsive teaching. After each key event, teachers reflected on their experiences in terms of their role identities, including their purposes and goals, self-perceptions, beliefs, and perceived action possibilities for that role. Teachers also engaged in critical discussions examining how the strategies and practices might contribute to more equitable science and engineering practices. An embedded case study design was used, with RESET as the focal case and the four teachers as embedded cases, to examine teachers’ experiences during RESET and actions during the school year. I analyzed teacher surveys, semi-structured interviews, written reflections, audio recordings of the critical discussions, and researcher memos from during RESET and school year observations to determine the influence of RESET on teachers’ role identity development and actions. I also analyzed a series of conjecture maps created to detail the design and adaptations of RESET to explore the extent to which RESET’s targeted enactment processes and outcomes had been achieved and design and process conjectures had been supported. Findings varied across participants, with all four participants at least somewhat achieving the targeted outcomes, indicating that all of the teachers’ role identities were influenced by RESET. Three of four teachers translated their learning into actions as culturally responsive science and engineering teachers during the school year. In terms of RESET’s design, several of the conjectures were supported or partially supported. Implications for the second iteration of RESET and for the general scholarship on professional development for mid-career K-8 science and engineering teachers are discussed.

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Created

Date Created
  • 2021