using computer-simulated case-based scenarios to improve learning
DESCRIPTION
Using Computer-Simulated Case-Based Scenarios to Improve Learning. David M. Segal PhD Assistant Professor. Department of Health Professions College of Health & Public Affairs University of Central Florida. Case-based Learning. - PowerPoint PPT PresentationTRANSCRIPT
Using Computer-Simulated Case-Based Scenarios to Improve Learning
Department of Health ProfessionsCollege of Health & Public AffairsUniversity of Central Florida
David M. Segal PhDAssistant Professor
Case-based Learning
The effectiveness of case-based instruction in education is supported by a significant body of research
Teaching health science students how to work in teams in the classroom with members of varying experience and skill levels offers valuable real-life simulated learning which will better prepare them for the healthcare workplace
Students with strong critical thinking skills make better clinical decisions
Focus shifts towards higher order processing skills rather than merely content
How can we assess context-specific critical learning?
How can technology mediate this?
Pedagogy Poll Question
How many use the following teaching methods to deliver your content?
a. case-based learningb. problem-based learningc. team-based learningd. collaborative learninge. web-based instruction (WebCT, Blackboard)f. other
CBL Poll Question
What system do you use to implement case-based teaching?
a. paper-basedb. wordc. powerpointd. wimbae. animationsf. immersive (second-life, active worlds)g. mannequinsh. standardized patientsi. role-plays (students)
What is critical thinking?
Students demonstrate the ability to think by being able to:
• Analyze complex issues and make informed decisions;
• Synthesize information in order to arrive at reasoned conclusions;
• Evaluate the logic, validity, and relevance of data;
• Solve challenging problems;
• Use knowledge and understanding to generate and explore new questions;
• Distinguish between observation and inference;
• Identify the axioms/assumptions in any argument and judge their validity;
• Identify the nature of the reasoning being used. Know when inductive or deductive reasoning is required;
• Use circular reasoning to reflect on decisions.
Program Decision-Making Learning Outcomes
• Demonstrate proficiency with scientific content
• Demonstrate critical thinking skills in critically evaluating context-specific data for relevance, consistency, and fidelity
• Demonstrate proficient decision-making skills to determine the best diagnosis and treatment for simulated patient
• Demonstrate proficiency with integration of scientific content to identify the etiology, pathogenesis, clinical manifestations, diagnosis, and treatment for patient
• Demonstrate information fluency by retrieving, interpreting, and critically evaluating published literature for most relevant evidence-based scientific studies
• Articulate clinical expertise by communicating the risks and benefits for different courses of action to treat patients
Kim et al, Medical Education, 40:867-876, 2006
Coursework
• Intro to Pharmacology HSC 3157 450 studentsOnline• Pathophysiology HSC 4550 150 students f2f• Medical Pharmacology 1 HSC 4148 80 students f2f
680 students
• Intro to Pharmacology HSC 3157 450 studentsOnline
• Pathophysiology HSC 4550 150 students Online• Medical Pharmacology 2 HSC 4149 45 students Online• Pathology/Pharmacology PHT 5306 35 students f2f
680 students
• Intro to Pharmacology HSC 3157 150 studentsOnline
150 students
FALL
SPR
ING
SU
MM
ER
ANNUAL TOTAL: 1,510 students
WebCT Limitations
How can you assess critical thinking and decision making skills in WebCT environment?
How can you implement critical thinking exercises in large online classes?
How can you grade asynchronous activities with large online classes?
How can you conduct group collaborative work with text-based synchronous chatrooms?
Patient Case Library
Over 300 cases are available
Initial history, additional history, differential diagnosis, laboratory & diagnostics, diagnosis, treatment, subsequent history
Primary System disorders
Immunity (25)Oxygen transport (15)Cardiopulmonary (35)Fluid/electrolyte (15)Acid-base (15)Renal/bladder (35)Urogenital (30)Gastrointestinal (35)Endocrinology (25)Musculoskeletal (35)Integumentary (20)Neurological (35)
MyCaseSpace
CBL dynamic, interactive, learning management systemVirtual charactersLibrary (50 avatars, 9 languages, 6 races, genders, 6 facial gestures)Multi-nodal casesSelf-assessmentReflective learningStudent-centered learningCritical thinking and decision-making triggers and activitiesCurriculum learning objectives and competencies mapping
Familial Case Studies
Improved Clinical Decision-Making Outcomesusing Case study Learning
SIMULATED CASES RESULTS
Pre- and post-examinations of clinical case scenarios
Group I: 11 +/- 2% (p<0.001)Group II: 19 +/- 3% (p<0.001)Group III: 31 +/- 4% (p<0.001)
*positive improvements in scores relative to control group IV
Group I: Online static text case scenarios (n=200)
Group II: Online interactive case scenarios (n=200)
Group III: Online interactive virtual character case scenarios (n=200)Group IV: No case scenario training (control; n=200)
Post-usage survey resultsparticipant opinions about validity, performance characteristics, and utility
for training
1. Are the scenarios enjoyable?
2. Do the scenarios address important clinical competencies?
3. Do participants view the simulation as a learning tool?
4. Is improved technical fidelity required for authenticity?
5. Was the session realistic?
1 2 3 4 5
Q5
Q4
Q3
Q2
Q1
Group I I IGroup I IGroup I
Improved Clinical Decision-Making Outcomesusing Case study Learning
stronglyagree
stronglydisagree
agreeor
disagree
* statistically significant difference (p<0.001)
**
*
*
*
*
*
*
*
*
Group I: Online static text case scenarios
Group II: Online interactive case scenarios
Group III: Online interactive virtual character
case scenarios
Group IV: No case scenario training (control)
Diagnosis
Initial history
Additional history
Laboratory &diagnostics
Treatments
Differentialdiagnosis
8%
92%
62%52%
23%
Sequential Decision-Making Processing
45%
30%
54%
5%
Case Simulation Scoring Means by Iterations
1: 35 +/- 10%2: 48 +/- 12%3: 55 +/- 10%4: 69 +/- 8%5: 78 +/- 9%6: 83 +/- 6%7: 85 +/- 5%8: 91 +/- 5%9: 94 +/- 5%
Reflective Thinking Decision-Making
Collaborative Technology Poll Question
What technology have you used to promote collaborative learning in
your students?
a. classroom paper-basedb. videoconferencingc. classroom response systemsd. immersive environmente. other
iLinc Virtual classroom
Inter-disciplinary, inter-institutional
Team-based Cooperative Active learning
Synchronous interactions
Group discussions with Q&A
Virtual Grand Rounds
Multi-disciplinary Collaborative Groups
Individual case workGroup I: Medical Pharmacology 1 (n=29) 16 +/- 6%
Group II: Medical Pharmacology 2 (n=24) 18 +/- 8%
Group III: Pathophysiology (n=25) 26 +/- 8%
Collaborative case workGroup IV: Pathophysiology/Med Pharm 1 (n=80)37 +/- 8%
Group V: Pathophysiology/Med Pharm 2 (n=80) 44 +/- 6%
RESULTS:
Students prefer computer simulated case studies for convenient access, collaboration, and varied attributes
Cases can be designed with multi-nodal decision points to enhance interactive experience
Improvements in student critical thinking and decision-making skills are observed in cases which are relevant and realistic cases compared to challenging and engaging attributes
Most significant improvements observed in cases with basic science and clinical aspects
Computer-simulated case scenarios can be developed for any discipline using this system and these case-building concepts
Contact: David Segal, [email protected]