Council on Medical Student Education in Pediatrics


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COMSEP 2010 Albuquerque Meeting


Leslie H. Fall, MD; Norman B. Berman, MD, Dartmouth Medical School, Dartmouth, Lebanon, NH; Sherilyn Smith, MD, University of Washington, University of Washington, Seattle, WA


Objectives: To explore students’ perspectives on the effectiveness of blending virtual patient e-learning into the clinical clerkship curriculum and to study students’ perceptions of how learning from virtual patients compares to learning from more traditional methodologies and patient encounters. Methods: A prospective multi-institutional study was conducted in six schools’ pediatric clerkships to assess the impact of integrating Web-based virtual patient cases on students’ perceptions of their learning during 2004 – 2005 and 2005 – 2006 academic years. Integration strategies were designed to meet the needs of each school’s curriculum. A student survey was developed, validated and administered at the end of the clerkship to 1141 students. Data were analyzed using mixed-methods approach. Continuous data were tabulated; median scores and skew were calculated. Student responses to the open ended questions from both surveys were analyzed using grounded theory by two investigators who met after independent review of student surveys to compare coding structures and reach consensus. Results: A total of 1006 students completed the survey (response rate = 88%). Overall satisfaction with the cases was high. Students agreed the cases provided a more valuable adjunct to their clinical learning than traditional methods for medical knowledge acquisition (67% of students), creating differential diagnoses (77%) and understanding patient management (65%).  The cases provided an acceptable learning substitute for core problems not seen clinically (81%). Unique themes that emerged from qualitative analysis included that the program allowed students to self-assess their understanding and to integrate and apply their knowledge in a safe practice environment  - an approach which provided a valuable educational adjunct to clinical learning. Students cautioned that time must be provided to complete the cases. An important subgroup of students preferred learning from books or didactics.   Discussion: Blending virtual patients into the clinical clerkship creates an engaging and effective learning environment for most students and provides more valuable adjuvant learning to clinical experiences than do traditional learning methods. However, adequate time must be provided to complete the cases and virtual patients may not be equally perceived as effective by all students.