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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. Many studies indicate that VPS provide medical students with essential practice in clinical decision making before they encounter real life

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.
ContributorsMcCoy, Lise (Author) / Wetzel, Keith (Thesis advisor) / Ewbank, Ann (Thesis advisor) / Simon, Harvey (Committee member) / Arizona State University (Publisher)
Created2014
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Description
Today’s science education has been highly criticized in the United States despite reform efforts that attempt to promote more wholistic and integrated goals for teaching and learning science, which include both the understanding of key content and the acquisition of scientific skills. Outdoor education may be a means with which

Today’s science education has been highly criticized in the United States despite reform efforts that attempt to promote more wholistic and integrated goals for teaching and learning science, which include both the understanding of key content and the acquisition of scientific skills. Outdoor education may be a means with which to better engage students in science, but educators often find this type of teaching difficult to adopt for a variety of reasons. Nature journaling may be a useful access point to outdoor education for teachers experiencing those barriers. This study examines a six-month implementation of nature journaling activities in a high school Ecology & Animal Behavior course. It was found that students completing nature journaling in this classroom utilized both scientific knowledge and scientific practices in their work, and that instances and depth of these demonstrations increased as a general trend over time, which may be considered successful learning according to situativity theory. Further, students communicated their understanding of what they were accomplishing through their journal work as highly beneficial, though their own perceptions of their competencies in scientific practices did not change. Though additional research needs to be conducted, this study points to a potentially positive relationship between modern science education and outdoor learning through nature journal activities.
ContributorsSuloff, Sarah (Author) / Weinberg, Andrea (Thesis advisor) / Jordan, Michelle (Committee member) / Franz, Nico (Committee member) / Arizona State University (Publisher)
Created2021