Script-theory virtual case: A novel tool for education and research.

Abstract:

:Context/Setting: The script theory of diagnostic reasoning proposes that clinicians evaluate cases in the context of an "illness script," iteratively testing internal hypotheses against new information eventually reaching a diagnosis. We present a novel tool for teaching diagnostic reasoning to undergraduate medical students based on an adaptation of script theory. INTERVENTION:We developed a virtual patient case that used clinically authentic audio and video, interactive three-dimensional (3D) body images, and a simulated electronic medical record. Next, we used interactive slide bars to record respondents' likelihood estimates of diagnostic possibilities at various stages of the case. Responses were dynamically compared to data from expert clinicians and peers. Comparative frequency distributions were presented to the learner and final diagnostic likelihood estimates were analyzed. Detailed student feedback was collected. OBSERVATIONS:Over two academic years, 322 students participated. Student diagnostic likelihood estimates were similar year to year, but were consistently different from expert clinician estimates. Student feedback was overwhelmingly positive: students found the case was novel, innovative, clinically authentic, and a valuable learning experience. DISCUSSION:We demonstrate the successful implementation of a novel approach to teaching diagnostic reasoning. Future study may delineate reasoning processes associated with differences between novice and expert responses.

journal_name

Med Teach

journal_title

Medical teacher

authors

Hayward J,Cheung A,Velji A,Altarejos J,Gill P,Scarfe A,Lewis M

doi

10.3109/0142159X.2016.1170776

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

1130-1138

issue

11

eissn

0142-159X

issn

1466-187X

journal_volume

38

pub_type

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