Increasing Reasoning Awareness: Video Analysis of Students' Two-Party Virtual Patient Interactions.

Samuel Edelbring,Ingrid E Lundberg,Ioannis Parodis

doi:10.2196/mededu.9137

Samuel Edelbring, Ingrid E Lundberg + Show 1 more

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https://doi.org/10.2196/mededu.9137

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Abstract

BackgroundCollaborative reasoning occurs in clinical practice but is rarely developed during education. The computerized virtual patient (VP) cases allow for a stepwise exploration of cases and thus stimulate active learning. Peer settings during VP sessions are believed to have benefits in terms of reasoning but have received scant attention in the literature.ObjectiveThe objective of this study was to thoroughly investigate interactions during medical students’ clinical reasoning in two-party VP settings.MethodsAn in-depth exploration of students’ interactions in dyad settings of VP sessions was performed. For this purpose, two prerecorded VP sessions lasting 1 hour each were observed, transcribed in full, and analyzed. The transcriptions were analyzed using thematic analysis, and short clips from the videos were selected for subsequent analysis in relation to clinical reasoning and clinical aspects.ResultsFour categories of interactions were identified: (1) task-related dialogue, in which students negotiated a shared understanding of the task and strategies for information gathering; (2) case-related insights and perspectives were gained, and the students consolidated and applied preexisting biomedical knowledge into a clinical setting; (3) clinical reasoning interactions were made explicit. In these, hypotheses were followed up and clinical examples were used. The researchers observed interactions not only between students and the VP but also (4) interactions with other resources, such as textbooks. The interactions are discussed in relation to theories of clinical reasoning and peer learning.ConclusionsThe dyad VP setting is conducive to activities that promote analytic clinical reasoning. In this setting, components such as peer interaction, access to different resources, and reduced time constraints provided a productive situation in which the students pursued different lines of reasoning.

Highlights

In professional education, students need to apply facts and concepts into relevant work-life situations
The dyad virtual patient (VP) setting is conducive to activities that promote analytic clinical reasoning
JMIR Med Educ 2018 | vol 4 | iss. 1 | e4 | p. 2 perceptions on how the assignment would be followed up by their supervisors, and, more directly, how the interface worked, in particular where they had to click to navigate in the VP software: Yes, exactly

Summary

Introduction

Students need to apply facts and concepts into relevant work-life situations. It can be challenging to apply biomedical knowledge when entering into clinical practice; this application has previously been described as “slow, awkward, or absent” [1]. In the context of medicine, clinical experiences and thorough biomedical knowledge are combined within clinical reasoning, facilitating diagnostic and management processes in relation to patients [3]. The nature of clinical reasoning has been thoroughly researched; yet, in our experience, it is still rare for medical educators to arrange learning activities that enable any insight into, or guidance of, students’ reasoning processes. Collaborative reasoning occurs in clinical practice but is rarely developed during education. Peer settings during VP sessions are believed to have benefits in terms of reasoning but have received scant attention in the literature

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