Computer-Based Virtual Environment Simulations for Differential Diagnosis in Medical Education

A major problem in medical education is that the knowledge and skills acquired through university teaching do not transfer well to clinical practice. Despite acquiring a vast amount of content knowledge about the functioning of the human body, medical students struggle to transfer that knowledge to one of the core disciplinary practices – differential diagnosis (DD). The lack of learning transfer may stem from current methods of instruction which are focused primarily on imparting massive amounts of content knowledge without adequate attention to situate that knowledge in disciplinary practice.
The project leverages an interdisciplinary collaboration between learning scientists and medical lecturers and practitioners to (a) design a computer-based virtual environment (CVE) simulations learning tool with virtual patients (VPs), (b) investigate its effectiveness on acquisition and transfer of clinical knowledge and clinical reasoning skills, and (c) evaluate the use of standardized virtual patients as a method for objective examination of clinical reasoning and some area of clinical competency.

The major goal of the project is to
1. Develop a medical CVE learning platform with virtual patients to enhance the acquisition and transfer of clinical knowledge and clinical reasoning skills based on foundations of experiential learning and preparation for future learning.
To achieve this main objective, the development process will consist of several iterative steps and will involve design-based research.

With the establishment of a medical CVE learning platform, we then pursue two subsequent study goals:
2. Examine the effectiveness of the developed medical CVE platform by conducting controlled and quasi-experimental studies
3.Conduct studies in ecologically valid settings to examine the influence of CVE practice before or during the clinical internship in the hospital on DD performance.

These three goals are organized in three work packages (WPs) in total. We will illustrate WP 1 in section 3.3 as this contributes to the main goal of the project. Work packages 2 and 3 we will describe in section 3.8 as these contribute to investigations on the effectiveness of the developed medical CVE platform, which can be related to the evaluation strategy.

Innovative Aspects
– First holistic interactive learning platform tailored to the tequirements of the Swiss medical system
– Implementation of the “Situations as Starting Point” approach
– The consensus to enable and support sontextual learning: Prepare students better for their clinical practice, in particular to promote that knowledge is more complete and longer retained.
– A design contrary to traditional medical practice: Bring students closer to clinical expert behavior in differential diagnosis and clinical reasoning, which cannot adequately attained or verified using conventional teaching and assessment methods.
– Teaching and learning environments: The scenarios will be available for students anytime for repetitions and exam preparation. Hence, we will make learning individualized and independent of time and location.
– Interdisciplinary collaboration

Expected Effects
– Take the role model in medical education
– Didactic concept aligned with the curriculum: The didactic concept will be driven by research on experiential learning and preparation for future learning to meet the goals of contextual learning in medical education.
– Contribution to a safe and efficient clinical rractice and a professional career of adaptability: Instead of automated knowledge and pure memorization, students will be prepared to acquire future knowledge built upon distinction ability.
– Purposive performance assessment: The assessment of transfer skills cannot be adequately measured by conventional examination methods.
– Long-term benefits for the Institution: CVE simulations are scalable and not limited to a certain number of students.
– Targeted teaching: Due to the analytics of the scoring system, a lecturer can specifically address the general problems of his students and adapt his teaching accordingly.
– Better quality of distance learning: Since the start of current CoVid-19 situation, distance learning and remote teaching has become more actual than ever.