CLASSIE teaching \u2013 using virtual reality to incorporate medical ethics into clinical decision making

Adrienne Torda

doi:10.1186/s12909-020-02217-y

Abstract

BackgroundTeaching medical ethics (ME) in the clinical environment is often difficult, uncalibrated and medical students get variable exposure to skilled educators. Explicit discussion of ethical dimensions of patient management is often neglected, as clinical teachers may feel inadequately skilled to do this.MethodsWe developed a suite of online modules. Each consisted of a clinical scenario filmed using virtual reality (VR) technology, linked to an adaptive, interactive, online tutorial which explicitly discussed the relevant ethical issues and guidelines. These were embedded in clinical placements of students to encourage the transfer of knowledge from these modules to clinical skill competency.We conducted a pilot study to evaluate these modules which examined student engagement, knowledge gains (self-perceived and measured) and user experience. We also reviewed reflections to assess the incorporation of these modules and transfer of knowledge into the clinical learning and skill development of the students.ResultsEngagement and self-perceived knowledge gains were extremely high. Students found these modules realistic, interesting and helpful. The measured knowledge gains (module exit quiz) were moderate. User experience was positive overall, although students were intolerant of any technical glitches. There was mixed feedback on whether the VR aspect of the clinical scenarios added value. Student reflections showed high level incorporation of these modules into clinical practice of the students and evidence of knowledge transfer (level 3 Kirkpatrick model of evaluation) in over ¾ of students.ConclusionsThis study showed that the use VR clinical scenarios combined with interactive online learning modules resulted in demonstrable high-level student engagement and learning gains in medical ethics and transfer of knowledge to clinical application. It standardised and ensured the student experience of high-quality educational deliverables in clinical years of medical education. This use of VR and online technology can be adapted for use in many areas of the medical curricula where we need to ensure the delivery of well calibrated, high quality, educational deliverables at scale for students.

Highlights

Teaching medical ethics (ME) in the clinical environment is often difficult, uncalibrated and medical students get variable exposure to skilled educators
Students are all assessed at the same level, usually established by National guidelines. To overcome this issue of variable ME teaching in the clinical environment, we developed a suite of online modules, each of which contained a clinical scenario linked to an adaptive online tutorial
Knowledge gains and user experience of virtual reality (VR) learning

Summary

Introduction

Teaching medical ethics (ME) in the clinical environment is often difficult, uncalibrated and medical students get variable exposure to skilled educators. Medical ethics (ME) is quite a controversial and variably taught component of medical curricula in most countries [1,2,3,4]. There is ongoing discussion about the varying importance of teaching ethical knowledge, ethical awareness and skills in medical decision making [5,6,7]. The presence of ME as a core component of medical curricula, even if we cannot quantitate its impact or value, is consistent with the goals and commitment we make to the importance of this component of the curriculum [1, 7, 10]. The presence of ME teaching is mandated for accreditation of medical programs in many countries including Australia, the United States and the United Kingdom [14,15,16]

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Results

Discussion

Conclusion