ralph aarons, md, phdandsusan s. albright medbiquitous annual conference 2011
DESCRIPTION
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, PhDandSusan S. Albright MedBiquitous Annual Conference 2011. Foundations of Evidence-Based Medicine and Clinical Reasoning. Medical Evidence. - PowerPoint PPT PresentationTRANSCRIPT
Using Electronic Virtual Patients to Develop Skills for Evidence- Based Medicine and Clinical
Reasoning
Ralph Aarons, MD, PhD and Susan S. Albright
MedBiquitous Annual Conference 2011
MedicalEvidence
Clinical Reasoning
Foundations of Evidence-Based Medicine and Clinical Reasoning
perception
cognition
perception
cognition
Presentation of problem
Solution of problem
‘Traditional’ approach to problem solving
Prior knowledge+
apply reasoning
Knowledge required BEFORE problem encountered
Presentation of problem
Solutions of problem
Learning related to problem
‘PBL’ approach to problem solving
Knowledge ARISES FROM work on the problem!
Knowledge:Basic science IntegrationClinical science
Skills:DiscussionTeamworkResearchPresentationFeedback
Knowledge & skills arise from the problem!
‘PBL’ approach to problem solving
Paper cases
Virtual caseson tusk
PBL Whiteboard Headings
What We KnowWant to Know Hypotheses LQsProblem
List
PBL Whiteboard Headings
What We KnowWant to Know Hypotheses LQsProblem
List
Asking Clinical QuestionsBackground 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
o Patient and/or Problemo Interventiono Comparative intervention (…optional, if relevant)o Clinical Outcome
P4 Cases*H. S. Barrows
4 - 5 students 1 facilitator
per tutorial group
45 – 50 PBL tutorial groups
PBL core materials on TUSK…..…linked inside all group folders
Group - works through VP case (using ‘global’ navigation)
….individual work (LQs) outside group
..….....each group folder is unique
……….PICO submitted to librarian
Background + Foreground LQs
*P4
• 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
Portable Patient Problem Pack*H. S. Barrows
the assignment
the form to send to librarian
the form received back from librarian
review, grade, feedback
20 students 1 master clinician
per tutorial group
10ICR tutorial groups
ICR core materials on TUSK…..
Individual – works VP case (using ‘linear’ navigation)
…….explore VP cases outside group
..….....answer questions during case
………. sub-groups submit group work
NEW cases with Master Clinician
illness script
descriptor table
Critical Thinking
CLINICAL REASONING
TUSKCase
SimulatorPBL
*Zaid Alsagoff, 2008