From the Division of Medical Education Research and Curriculum Development (A.M., T.R., N.S.), Study Deanery of University Medical Centre Göttingen, Göttingen; Department of Legal Medicine (S.A.), University Medical Centre Hamburg-Eppendorf, Hamburg; Department of Cardiology and Pneumology (T.R.), University Medical Centre Göttingen, Göttingen, Germany; Health Behaviour Research Centre (T.R.), University College London, London, United Kingdom; and Department of Haematology and Medical Oncology (N.S.), University Medical Centre Göttingen, Göttingen, Germany.
Simul Healthc. 2020 Apr;15(2):75-81. doi: 10.1097/SIH.0000000000000407.
Serious Games can be used effectively for clinical reasoning training in medical education. Case specificity of learning outcome elicited by Serious Games has not been studied in detail. This study investigated whether learning outcome elicited by repeated exposure to virtual patient cases is transferable to other cases addressing similar problems.
In this monocentric, prospective, randomized trial, 69 fifth-year medical students participated in ten 90-minute sessions of using a computer-based emergency ward simulation game. Students were randomized to 3 groups (A, B, AB) and subsequently exposed to up to 46 different virtual patients. Group A was presented with 2 specific cases that were not shown in group B and vice versa. Group AB was exposed to all 4 specific cases. After 6 weeks of using the game as a learning resource, students were presented with 4 cases addressing similar problems. For each case, an aggregate score reflecting clinical reasoning was calculated, and performance was compared across groups.
In the final session, there were no significant between-group differences regarding the sum score reflecting aggregated performance in all 4 cases (A: 66.5 ± 7.2% vs. B: 61.9 ± 12.4% vs. AB: 64.8 ± 11.1%, P = 0.399). An item-by-item analysis revealed that there were no between-group differences regarding correct therapeutic interventions.
Previous exposure had limited impact on subsequent performance in similar cases. This study suggests that case specificity of learning outcome elicited by the serious game is low and that acquired higher-order cognitive functions may transfer to similar virtual patients.
严肃游戏可有效地用于医学教育中的临床推理培训。严肃游戏所产生的学习结果的案例特异性尚未得到详细研究。本研究调查了通过重复接触虚拟患者案例所产生的学习结果是否可以转移到解决类似问题的其他案例中。
在这项单中心、前瞻性、随机试验中，69 名五年级医学生参加了十次 90 分钟的计算机急诊病房模拟游戏使用课程。学生被随机分为 3 组（A、B、AB），随后接触了多达 46 个不同的虚拟患者。组 A 展示了 2 个特定案例，这些案例在组 B 中没有展示，反之亦然。AB 组接触了所有 4 个特定案例。在使用游戏作为学习资源 6 周后，学生们接触了 4 个解决类似问题的案例。对于每个案例，计算反映临床推理的综合得分，并比较组间的表现。
在最后一次会议中，在反映所有 4 个案例综合表现的总分方面，组间没有显著差异（A：66.5±7.2%比 B：61.9±12.4%比 AB：64.8±11.1%，P=0.399）。逐项分析显示，在正确的治疗干预方面，组间没有差异。
先前的暴露对类似案例中的后续表现影响有限。本研究表明，严肃游戏所产生的学习结果的案例特异性较低，并且获得的高级认知功能可能会转移到类似的虚拟患者。
