Assessing clinical reasoning skills following a virtual patient dizziness curriculum-Reference-Cited by-同舟云学术

Assessing clinical reasoning skills following a virtual patient dizziness curriculum

Published:2023-12-12 Issue:0 Volume:0 Page:
ISSN:2194-8011
Container-title:Diagnosis
language:en
Short-container-title:

Author:

Kotwal Susrutha¹^ORCID,Singh Amteshwar¹^ORCID,Tackett Sean²,Bery Anand K.³,Omron Rodney⁴,Gold Daniel⁵,Newman-Toker David E.⁵,Wright Scott M.²

Affiliation:

1. Department of Medicine, Division of Hospital Medicine, Johns Hopkins Bayview Medical Center , Johns Hopkins University School of Medicine , Baltimore , MD , USA

2. Department of Medicine, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center , Johns Hopkins University School of Medicine , Baltimore , MD , USA

3. Department of Medicine, Division of Neurology , The Ottawa Hospital , Ottawa , Canada

4. Department of Emergency Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA

5. Department of Neurology, Division of Neuro-Visual & Vestibular Disorders , Johns Hopkins Hospital, Johns Hopkins University School of Medicine , Baltimore , MD , USA

Abstract

Abstract Objectives Dizziness is a common medical symptom that is frequently misdiagnosed. While virtual patient (VP) education has been shown to improve diagnostic accuracy for dizziness as assessed by VPs, trainee performance has not been assessed on human subjects. The study aimed to assess whether internal medicine (IM) interns after training on a VP-based dizziness curriculum using a deliberate practice framework would demonstrate improved clinical reasoning when assessed in an objective structured clinical examination (OSCE). Methods All available interns volunteered and were randomized 2:1 to intervention (VP education) vs. control (standard clinical teaching) groups. This quasi-experimental study was conducted at one academic medical center from January to May 2021. Both groups completed pre-posttest VP case assessments (scored as correct diagnosis across six VP cases) and participated in an OSCE done 6 weeks later. The OSCEs were recorded and assessed using a rubric that was systematically developed and validated. Results Out of 21 available interns, 20 participated. Between intervention (n=13) and control (n=7), mean pretest VP diagnostic accuracy scores did not differ; the posttest VP scores improved for the intervention group (3.5 [SD 1.3] vs. 1.6 [SD 0.8], p=0.007). On the OSCE, the means scores were higher in the intervention (n=11) compared to control group (n=4) for physical exam (8.4 [SD 4.6] vs. 3.9 [SD 4.0], p=0.003) and total rubric score (43.4 [SD 12.2] vs. 32.6 [SD 11.3], p=0.04). Conclusions The VP-based dizziness curriculum resulted in improved diagnostic accuracy among IM interns with enhanced physical exam skills retained at 6 weeks post-intervention.

Publisher

Walter de Gruyter GmbH

Subject

Biochemistry (medical),Clinical Biochemistry,Public Health, Environmental and Occupational Health,Health Policy,Medicine (miscellaneous)

Link

https://www.degruyter.com/document/doi/10.1515/dx-2023-0099/pdf

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