Formative Research on an Instructional Design Theory for Virtual Patients in Clinical Education: A Pressure Ulcer Prevention Clinical Reasoning Case

Despite advances in health care over the past decades, medical errors and omissions remain significant threats to patient safety and health. A large number of these mistakes are made by trainees, persons who are just beginning to build the case-based experiences that will transform them from novices to expert practitioners. Clinicians use both intuitive and deductive problem-solving skills in caring for patients and they acquire expertise in applying these skills through interaction with many and varied cases. The contemporary heath care environment, with decreased lengths of stay for patients and reduced duty hours for trainees, makes getting optimal patient exposure difficult. Virtual patients (VPs), online, interactive patient cases, may help close the case exposure gap. Evidence has shown that VPs improve clinical reasoning skills, but no formal instructional design theory of VPs has been advanced. The goal was to conduct formative research to develop an instructional design theory of VPs to help novice clinicians cultivate clinical reasoning and diagnostic skills. The instructional design theory, goal-based scenarios (GBS), grounded in the learning theory, Case-based Reasoning, provided methods that promised to be appropriate to the goal. An existing, two-module, multimedia VP, Matt Lane, A Pressure Ulcer Prevention Virtual Patient, was tested with 10 medical trainees to determine which methods of GBS it incorporated and which of its methods were not part of GBS. Leaners\u27 experience of what worked and didn\u27t work to promote learning in the VP was analyzed. The VP was found to incorporate all GBS methods and one significant method, the Life Model, that was not part of GBS. The Life Model Method involved replicating, with a high degree of fidelity, the experiences of a real patient in creating the VP scenario. Recommendations for customization of GBS for VPs included more explicit advertisement of learning goals and leverage of Internet search engines to provide just-in-time resources to support problem-solving. Incorporation of the Life Model was also recommended along with the Simplifying Conditions Method from Elaboration Theory to manage the complexity inherent in the Life Model. The resultant, enhanced GBS theory may be particularly relevant in teaching patient-centered care

An Empirical Evaluation of an Instrument to Determine the Relationship Between Second-Year Medical Students\u27 Perceptions of NERVE VP Design Effectiveness and Students\u27 Ability to Learn and Transfer Skills from NERVE

Meta-analyses and systematic reviews of literature comparing the use of virtual patients (VPs) to traditional educational methods support the efficacy of VPs (Cook, Erwin, & Triola, 2010; Cook & Triola, 2009; McGaghie, Issenberg, Cohen, Barsuk, & Wayne, 2011). However, VP design research has produced a variety of design features (Bateman, Allen, Samani, Kidd, & Davies, 2013; Botezatu, Hult, & Fors, 2010a; Huwendiek & De Leng, 2010), frameworks (Huwendiek et al., 2009b) and principles (Huwendiek et al., 2009a) that are similar in nature, but appear to lack consensus. Consequently, researchers are not sure which VP design principles to apply and few validated guidelines are available. To address this situation, Huwendiek et al. (2014) validated an instrument to evaluate the design of VP simulations that focuses on fostering clinical reasoning. This dissertation examines the predictive validity of one instrument proposed by Huwendiek et al. (2014) that examines VP design features. Empirical research provides evidence for the reliability and validity of the VP design effectiveness measure. However, the relationship between the design features evaluated by the instrument to criterion-referenced measures of student learning and performance remains to be examined. This study examines the predictive validity of Huwendiek et al.\u27s (2014) VP design effectiveness measurement instrument by determining if the design factors evaluated by the instrument are correlated to medical students\u27 performance in: (a) quizzes and VP cases embedded in Neurological Examination Rehearsal Virtual Environment (NERVE), and (b) NERVE-assisted virtual patient/standardized patient (VP/SP) differential diagnosis and SP checklists. It was hypothesized that students\u27 perceptions of effectiveness of NERVE VP design are significantly correlated to the achievement of higher student learning and transfer outcomes in NERVE. The confirmatory factor analyses revealed the effectiveness of NERVE VP design was significantly correlated to student learning and transfer. Significant correlations were found between key design features evaluated by the instrument and students\u27 performance on quizzes and VP cases embedded in NERVE. In addition, significant correlations were found between the NERVE VP design factors evaluated by Huwendiek et al.\u27s (2014) instrument and students\u27 performance in SP checklists. Findings provided empirical evidence supporting the reliability and predictive validity of Huwendiek et al.\u27s (2014) instrument. Future research should examine additional sources of validity for Huwendiek et al.\u27s (2014) VP design effectiveness instrument using larger samples and from other socio-cultural backgrounds and continue to examine the predictive validity of Huwendiek et al.\u27s (2014) instrument at Level 2 (Learning) and Level 3 (Application) of Kirkpatrick\u27s (1975) four-level model of training evaluation

2020 annual report

The South Carolina Coordinating Council for Workforce Development annually publishes a report on council members, activities and accomplishments, and survey results

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

Online courses for healthcare professionals: is there a role for social learning?

Background: All UK postgraduate medical trainees receive supervision from trained supervisors. Training has traditionally been delivered via face to face courses, but with increasing time pressures and complex shift patterns, access to these is difficult. To meet this challenge, we developed a two-week massive open online course (MOOC) for faculty development of clinical supervisors. Summary of Work: The MOOC was developed by a group of experienced medical educators and delivered via the FutureLearn (FL) platform which promotes social learning through interaction. This facilitates building of communities of practice, learner interaction and collaboration. We explored learner perceptions of the course, in particular the value of social learning in the context of busy healthcare professionals. We analysed responses to pre- and post-course surveys for each run of the MOOC in 2015, FL course statistics, and learner discussion board comments. Summary of Results: Over 2015, 7,225 learners registered for the course, though 6% left the course without starting. Of the 3,055 learners who began the course, 35% (1073/3055) were social learners who interacted with other participants. Around 31% (960/3055) learners participated fully in the course; this is significantly higher than the FL average of 22%. Survey responses suggest that 68% learners worked full-time, with over 75% accessing the course at home or while commuting, using laptops, smart phones and tablet devices. Discussion: Learners found the course very accessible due to the bite-sized videos, animations, etc which were manageable at the end of a busy working day. Inter-professional discussions and social learning made the learning environment more engaging. Discussion were rated as high quality as they facilitated sharing of narratives and personal reflections, as well as relevant resources. Conclusion: Social learning added value to the course by promoting sharing of resources and improved interaction between learners within the online environment. Take Home Messages: 1) MOOCs can provide faculty development efficiently with a few caveats. 2) Social learning added a new dimension to the online environment

Desarrollo de una herramienta computacional para el estudio de los marcadores discursivos

Los marcadores discursivos son un conjunto heterogéneo de unidades con significación subjetiva, idiosincrásica e intraducible (Martí Sánchez, 2009). Introducen información relacionada con la actividad comunicativa, contribuyen a construir texto o discurso, facilitando así la interpretación de los mensajes, y siempre comunican más de lo que explícitamente expresan. Es más, su uso y entendimiento implican madurez lingüística. Según esta definición, al grupo de los marcadores discursivos pertenecen términos de distintos tipos, cuyo significado puede variar según el uso y el contexto, y que, además, se clasifican en tipos que pueden ser rasgos distintivos de los diferentes tipos de textos. Asimismo, los marcadores discursivos de cada lengua son elementos propios de la misma. Todo lo antedicho constituye el motivo por el que hemos elegido los marcadores discursivos como objeto de estudio para nuestro análisis contrastivo de textos. Se trata de un elemento lingüístico que caracteriza el tipo de texto y los usos discursivos que se dan en el mismo; por tanto, un emisor competente en una lengua dada se ajustará al uso característico de los marcadores según el tipo de texto. Su estudio y el conocimiento de la frecuencia de uso de cada tipo de marcador atendiendo al contexto, es algo de gran utilidad para profesionales de la traducción, la enseñanza o la escritura