Abstract
IntroductionIn recent years, researchers have recognized the need to examine the relative effectiveness of different simulation approaches and the experiences of physicians operating within such environments. The current study experimentally examined the reflective judgments, cognitive processing, and clinical reasoning performance of physicians across live and video simulation environments.MethodsThirty-eight physicians were randomly assigned to a live scenario or video case condition. Both conditions encompassed two components: (a) patient encounter and (b) video reflection activity. Following the condition-specific patient encounter (i.e., live scenario or video), the participants completed a Post Encounter Form (PEF), microanalytic questions, and a mental effort question. Participants were then instructed to re-watch the video (i.e., video condition) or a video recording of their live patient encounter (i.e., live scenario) while thinking aloud about how they came to the diagnosis and management plan.ResultsAlthough significant differences did not emerge across all measures, physicians in the live scenario condition exhibited superior performance in clinical reasoning (i.e., PEF) and a distinct profile of reflective judgments and cognitive processing. Generally, the live condition participants focused more attention on aspects of the clinical reasoning process and demonstrated higher level cognitive processing than the video group.ConclusionsThe current study sheds light on the differential effects of live scenario and video simulation approaches. Physicians who engaged in live scenario simulations outperformed and showed a distinct pattern of cognitive reactions and judgments compared to physicians who practiced their clinical reasoning via video simulation. Additionally, the current study points to the potential advantages of video self-reflection following live scenarios while also shedding some light on the debate regarding whether video-guided reflection, specifically, is advantageous. The utility of context-specific, micro-level assessments that incorporate multiple methods as physicians complete different parts of clinical tasks is also discussed.
Highlights
In recent years, researchers have recognized the need to examine the relative effectiveness of different simulation approaches and the experiences of physicians operating within such environments
We experimentally examined the differential effects of two simulation learning environments across performance outcomes as well as the task-specific perceptions, cognitive reactions, and reflective judgments of medical professionals during clinical reasoning
Differences in clinical reasoning performance Consistent with expectations, we found that physicians from the live scenario showed stronger clinical reasoning abilities than those in the video condition
Summary
Researchers have recognized the need to examine the relative effectiveness of different simulation approaches and the experiences of physicians operating within such environments. Simulation-based formats, which include virtual patients, pre-recorded videos (i.e., vignettes depicting a doctor-patient encounter [6]), and live scenarios (i.e., structured narrative embedded within a simulated clinical setting) [7, 8] have increased in popularity over the years. Their popularity has grown, in part, because they closely mirror authentic, clinical settings and patient-provider interactions [6], afford opportunities to practice myriad clinical activities in different contexts [9], and enable extensive opportunities for reflection [10, 11]
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