Mary C. Ottolini MD, MPH and Susan McCune MD, Children's National Medical Center
Objective: To develop realistic clinical simulations to teach medical students information within the context with which they will apply it in practice. We are developing and evaluating a case-based interactive CD-ROM program to teach students to discern signs and symptoms that differentiate common newborn problems.
Method: The cases are organized and presented using Authorware as the basic software authoring program. In discussing pathophysiology, small animation movies have been created in Flash.
Results: The design of the cases emphasizes clinical reasoning, formulation of a differential diagnosis and a firm understanding of the pathophysiologic basis of the disorder. After the chief complaint, the trainee is prompted to select all potential diagnoses. Trainees are then asked to collect history, physical and laboratory data, and they are asked to limit the differential diagnosis after each step. They receive feedback in each section.. Cases of neonatal jaundice serve as typical presentations of common and potentially dangerous diagnoses if not appropriately diagnosed and managed. The computer gives the “expert” version, describing the key features of the case are and how they relate to the differential. The trainee views the physical exam on the newborn, by clicking on different parts of the exam, viewing video and still clips as well as listening to heart and lung sounds. Finally the student selects and receives feedback as to the most appropriate lab/radiological tests. In addition students can refresh their knowledge of key basic science principles by clicking to view animated tutorials depicting biochemical or pathophysiologic processes.
Conclusions: The program evaluation is in progress and consists of comparing scores on paper cases and a standardized patient exam between groups of students who complete the computer cases and those who are in the traditional curriculum.