COMSEP 2009 Baltimore Meeting with APPD
INTEGRATION STRATEGIES FOR THE USE OF VIRTUAL PATIENTS IN THE CLINICAL CLERKSHIP
Norman Berman,MD, Leslie Fall, MD, Dartmouth, Lebanon, NH, Sherilyn Smith, MD, University of Washington, David Levine, MD, Morehouse School of Medicine, Christopher Maloney, MD, PhD, University of Utah School of Medicine, Michael . Potts, MD, U of Illinois College of Medicine at Rockford, Benjamin Siegel, MD, Boston University School of Medicine
PURPOSE: The purpose of the study is to explore student perceptions of virtual patient use in the clinical clerkship, including learning effectiveness and satisfaction, and to develop a conceptual framework to evaluate the effects of different integration strategies on student perceptions of this innovation. METHODS: A prospective, multi-institutional study was conducted at 6 Pediatric clerkships using the Computer-assisted Learning In Pediatrics Program (CLIPP) virtual patients over 2 academic years. Integration strategies were designed to meet the needs of each school, and integration was scored for components of virtual patient use, and elimination of redundant teaching. A student survey instrument was developed and validated, and administered to students at the end of the clerkship. Data were analyzed using confirmatory factor analysis and structural equation modeling. RESULTS: Overall student satisfaction with CLIPP was high and students reported that CLIPP was more effective than traditional methods. The structural model demonstrated that elimination of redundant teaching was directly associated with perceived effectiveness of the integration strategy (p <0.00001). A higher use score had a significant negative effect on perceived integration (p<0.0001), but positively impacted perceived knowledge gain (p<0.0001) and skills gain (p<0.001). Positive student perceptions of integration directly and powerfully affected satisfaction (p<0.00001) and perceived knowledge (p <0.00001) and skill (p <0.0001) gain. CONCLUSIONS: An integration strategy balancing use of virtual patients with elimination of some other requirements was significantly associated with student satisfaction and with their perceptions of the effectiveness of the program in improving their knowledge and skills. Obtaining a positive student perception of integration is critical in achieving the desired outcomes of computer-assisted instruction.