Chon Seung-Hun, Hilgers Sabrina, Timmermann Ferdinand, Dratsch Thomas, Plum Patrick Sven, Berlth Felix, Datta Rabi, Alakus Hakan, Schlößer Hans Anton, Schramm Christoph, Pinto Dos Santos Daniel, Bruns Christiane, Kleinert Robert
Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany.
Faculty of Medicine, University of Cologne, Cologne, Germany.
JMIR Serious Games. 2018 Jul 4;6(3):e10693. doi: 10.2196/10693.
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.
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.
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.
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.
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.
客观结构化临床考试是测试临床核心能力中陈述性知识和过程性知识的标准方法。学生在参加考试前接受客观结构化临床考试培训是很有必要的。然而，建立客观结构化临床考试培训资源消耗大，因此练习时间往往有限。基于网络的沉浸式患者模拟器，如ALICE（临床教育人工学习界面），可能会填补这一空白，因为它们允许用户按照自己的节奏并以可调整的重复次数在家中训练复杂的医疗程序。此前已证明ALICE对知识获取和学习动机有积极影响。
因此，本研究的目的是开发一个基于网络的课程，教授陈述性知识和过程性知识，并让学生为实际的客观结构化临床考试站做好准备。此外，我们想测试ALICE对知识获取和学生学习动机的影响。
开发了一个特定的课程，以便将2个外科客观结构化临床考试站的相关医学内容纳入ALICE模拟器框架。共有160名医学生参与了该研究，其中100名学生可以使用ALICE，并将他们的表现与对照组的60名学生进行比较。在不同层面验证了模拟器的性能，并在研究期间的不同时间点测试了学生的知识获取和学习动机。
该课程是根据克恩循环开发的。实施了4个虚拟临床病例，并采用了不同的教学方法（结构化反馈、主题演讲、小组讨论和由实际教员进行的总结汇报），以巩固陈述性知识和过程性知识。使用ALICE对陈述性知识获取和客观结构化临床考试表现有显著影响。模拟器验证在表面效度、内容效度、结构效度和预测效度方面均为阳性。学生表现出高度的学习动机，并喜欢使用ALICE。
ALICE提供基于网络的客观结构化临床考试准备培训，并且由于其对知识获取和学生学习动机有积极影响，可作为一种选择性的教学干预手段。
