April 9, 2013 9:45 – 11:15am
Manon M Schladen, EdS1, Robert Hafey, MS2, Craig Stevenson, MS2, Alexander Libin, PhD2, Neil Weissman, MD1
1MedStar Health Research Institute, 2SiTEL of MedStar Health
Patient contact is the favored strategy for increasing diagnostic expertise. However, changes in clinical education, notably the 80-hour resident duty week, have narrowed trainees’ opportunities for case exposure. Online interactive cases, virtual patients (VPs), may help fill this gap. However, there is little understanding of how the various types of technology available for creating VPs work to enhance learning. The purpose of this study was to explore which characteristics of game technology worked and didn’t work in a VP designed to teach electronic fetal monitoring (EFM) data interpretation and its application in intrapartum management. The skills of seven obstetrical trainees were baselined using an online, text-based EFM case scenario. Subsequently, trainees played the EFM game where their objective was to diagnose and manage the labor and delivery of a high-risk VP. QUAL-quan methods were used. The virtual clinical environment of the EFM game allowed more nuanced expression of EFM skills than did the multiple-choice text scenario format. The mimetic character of virtual objects in the EFM VP enhanced engagement, but only so long as the task they afforded was meaningful in the context of both clinical appropriateness and the learner’s own health care role. The perceived potential of game technology-based VPs to reduce determinism in testing and allow for more granular, enacted demonstration of expertise emerged as a preliminary finding and requires further study.