Real-Time Case Simulation to Enhance Faculty-Student Partnerships of Practice in Medical Education: Interactive Case-based Online Network (ICON).

Abstract

BACKGROUND: We have developed a user-driven learning system, the Interactive Case-based Online Network (ICON), to enhance teaching in the neuroscience curriculum, foster student’s teamwork skills, facilitate knowledge integration, and encourage active participation of faculty in the student’s learning1. To emulate the non-linear, time-sensitive nature of real patient care and to increase urgency in learning, cases in ICON unfold “live,” in real-time, eliminating the traditional paper case. METHOD: An interdisciplinary group of faculties assumes the roles of virtual patient, attending, and consultant in the case. As the patient’s situation unfolds, students are responsible for the practice of the science, communicating with the patient and the attending, requesting consults, and coordinating the team’s activities. Teams consist of n=8 students and a faculty mentor in small group tutorials. Students communicate with each other and case characters using pagers and instant messaging, facilitating asynchronous and synchronous interactions. As cases progress live, new information and discussions are organized into core learning modules. To measure the impact of ICON on the “process” of learning, we conducted entrance/exit surveys during the 2004 and 2005 ICON iterations (n=80 students). RESULTS: Comparing aggregate responses, significant changes (p<0.05) were reflected in four domains: 1) increased discussion hours outside of tutorials (p=0.004); 2) increased relative contribution by peers (p=0.02); 3) increased active participation of case character faculty in the student’s learning (p=0.00003); 4) decreased relative contribution by the faculty mentor in tutorial (p=0.009). CONCLUSION: These results suggest: 1) students’ learning became less dependent on faculty mentors due in part to interaction with case characters; 2) peer contribution increased and surpassed faculty mentor’s contribution in tutorial. Taken together, the ICON system is a suitable pedagogy for engaging students through urgency in learning and for building an interdisciplinary faculty-student partnership of practice2.