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. 2018 Jul 4;6(3):e10693.
doi: 10.2196/10693.

Web-Based Immersive Patient Simulator as a Curricular Tool for Objective Structured Clinical Examination Preparation in Surgery: Development and Evaluation

Seung-Hun Chon  1 , Sabrina Hilgers  2 , Ferdinand Timmermann  2 , Thomas Dratsch  2 , Patrick Sven Plum  1 , Felix Berlth  1 , Rabi Datta  1 , Hakan Alakus  1 , Hans Anton Schlößer  1 , Christoph Schramm  3 , Daniel Pinto Dos Santos  4 , Christiane Bruns  1 , Robert Kleinert  1
Affiliations

Web-Based Immersive Patient Simulator as a Curricular Tool for Objective Structured Clinical Examination Preparation in Surgery: Development and Evaluation

Seung-Hun Chon et al. JMIR Serious Games. .

Abstract

Background: Objective Structured Clinical Examination is a standard method of testing declarative and process knowledge in clinical core competencies. It is desirable that students undergo Objective Structured Clinical Examination training before participating in the exam. However, establishing Objective Structured Clinical Examination training is resource intensive and therefore there is often limited practice time. Web-based immersive patient simulators such as ALICE (Artificial Learning Interface of Clinical Education) can possibly fill this gap as they allow for the training of complex medical procedures at the user's individual pace and with an adaptable number of repetitions at home. ALICE has previously been shown to positively influence knowledge gain and motivation.

Objective: Therefore, the aim of this study was to develop a Web-based curriculum that teaches declarative and process knowledge and prepares students for a real Objective Structured Clinical Examination station. Furthermore, we wanted to test the influence of ALICE on knowledge gain and student motivation.

Methods: A specific curriculum was developed in order to implement the relevant medical content of 2 surgical Objective Structured Clinical Examination stations into the ALICE simulator framework. A total of 160 medical students were included in the study, where 100 students had access to ALICE and their performance was compared to 60 students in a control group. The simulator performance was validated on different levels and students' knowledge gain and motivation were tested at different points during the study.

Results: The curriculum was developed according to the Kern cycle. Four virtual clinical cases were implemented with different teaching methods (structured feedback, keynote speech, group discussion, and debriefing by a real instructor) in order to consolidate declarative and process knowledge. Working with ALICE had significant impact on declarative knowledge gain and Objective Structured Clinical Examination performance. Simulator validation was positive for face, content, construct, and predictive validity. Students showed high levels of motivation and enjoyed working with ALICE.

Conclusions: ALICE offers Web-based training for Objective Structured Clinical Examination preparation and can be used as a selective didactic intervention as it has positive effect on knowledge gain and student motivation.

Keywords: Objective Structured Clinical Examination; artificial learning interface; immersive patient simulator; simulator-based curriculum.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Impressions of ALICE (Artificial Learning Interface of Clinical Education) where students navigate freely and treat virtual patients.
Figure 2
Figure 2
Group distribution of participants; 100 students used ALICE and were compared to a control group with 60 students. MCQ: multiple choice question; OSCE: Objective Structured Clinical Examination.
Figure 3
Figure 3
Increase in multiple-choice question (MCQ) scores showing working with ALICE had a positive impact on declarative knowledge.
Figure 4
Figure 4
Working with ALICE had a positive impact on students’ process knowledge (Y axis shows number of students).
Figure 5
Figure 5
Working with ALICE led to a significant increase in process knowledge (Y axis shows number of students).
Figure 6
Figure 6
Comparison of ALICE performance in the fourth case and Objective Structured Clinical Examination (OSCE) performance of the control group (Y axis shows number of students).
Figure 7
Figure 7
Likert scale (1=extremely satisfied, 2=very satisfied, 3=somewhat satisfied, 4=somewhat dissatisfied, 5=very dissatisfied, 6=extremely dissatisfied) revealed that students felt that ALICE represented a virtual Objective Structured Clinical Examination (OSCE) situation and can help them prepare for an OSCE.
See this image and copyright information in PMC

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