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Using E lectronic V irtual P atients to Develop Skills for E vidence- B ased M edicine and C linical R easoning. Ralph Aarons, MD, PhD and Susan S. Albright MedBiquitous Annual Conference 2011. Foundations of Evidence-Based Medicine and Clinical Reasoning. Medical Evidence.
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UsingElectronic Virtual Patients to Develop Skills for Evidence- Based Medicine and Clinical Reasoning Ralph Aarons, MD, PhD and Susan S. Albright MedBiquitous Annual Conference 2011
Foundations of Evidence-Based Medicine and Clinical Reasoning Medical Evidence Clinical Reasoning perception perception cognition cognition
‘Traditional’ approach to problem solving Presentation of problem Priorknowledge + apply reasoning Solution of problem Knowledgerequired beforeproblem encountered
‘PBL’ approach to problem solving Learning related to problem Presentation of problem Solutionsof problem Knowledgearises fromwork on the problem!
‘PBL’ approach to problem solving Knowledge: Basic science Integration Clinical science Skills: Discussion Teamwork Research Presentation Feedback Knowledge & skills arise fromthe problem!
Paper cases Virtual cases on tusk
PBL Whiteboard Headings Problem List What We Know Want to Know Hypotheses LQs
PBL Whiteboard Headings Problem List What We Know Want to Know Hypotheses LQs
Asking Clinical Questions • Background Questions(PBL1, Learning Questions) • general knowledge • many sources in HSL • [database, e-Books, e-Journals, • OvidMEDLINE,PubMed, TUSK, etc.] • Foreground Questions(PBL2, advanced LQ’s) • specific knowledge to make a clinical decision • 3 or 4 essential components • Patient and/or Problem • Intervention • Comparative intervention (…optional, if relevant) • Clinical Outcome
P4 Cases *H. S. Barrows
PBL core materials on TUSK….. …linked inside all group folders 4 - 5 students 1 facilitator per tutorial group Group - works through VP case (using ‘global’ navigation) ….individual work (LQs) outside group ..….....each group folder is unique ……….PICO submitted to librarian 45 – 50 PBL tutorial groups Background + ForegroundLQs
*P4 Portable Patient Problem Pack • A simulated patient (cards TUSK) • An exercise in clinical reasoning • EVIDENCE: select History • EVIDENCE:select Exam • EVIDENCE:select Tests and Procedures • EVIDENCE: select Consultants • Manage the patient’s problem *H. S. Barrows
ICR core materials on TUSK….. 20 students 1 master clinician per tutorial group Individual – works VP case (using ‘linear’ navigation) …….explore VP cases outside group ..….....answer questions during case ………. sub-groups submit group work NEW cases withMaster Clinician 10 ICR tutorial groups
Critical Thinking TUSK Case Simulator PBL *ZaidAlsagoff, 2008 CLINICAL REASONING
TUSK is now open source ! Contact: tusk@tufts.edu if you want to join