Gruenberg Katherine, Brock Tina, Garcia Joshua, MacDougall Conan
University of California, San Francisco, CA, USA.
Monash University, Parkville, VIC, Australia.
J Med Educ Curric Dev. 2020 Nov 26;7:2382120520977189. doi: 10.1177/2382120520977189. eCollection 2020 Jan-Dec.
Therapeutic reasoning-the mental process of making judgments and decisions about treatment-is developed through acquisition of knowledge and application in actual or simulated experiences. Health professions education frequently uses collaborative small group work to practice therapeutic reasoning. This pilot study compared the impact of a web-based/mobile tool for collaborative case work and discussion to usual practice on student perceptions and performance on questions designed to test therapeutic knowledge and reasoning.
In a therapeutics course that includes case-based workshops, student teams of 3 to 4 were randomly assigned to usual workshop preparation (group SOAP sheet) or preparation using the Practice Improvement using Virtual Online Training (PIVOT) platform. PIVOT was also used in the workshop to review the case and student responses. The next week, groups crossed over to the other condition. Students rated favorability with the preparatory and in-workshop experiences and provided comments about the PIVOT platform via a survey. Student performance on examination items related to the 2 workshop topics was compared.
One hundred and eleven students (94%) completed post-workshop surveys after both workshops. The majority of students (57%) preferred using the PIVOT platform for workshop collaboration. Favorability ratings for the in-workshop experience did not change significantly from first to second study week, regardless of sequence of exposure. There was no relationship between examination item scores and the workshop platform the students were exposed to for that content ( = .29). Student responses highlighted the efficiency of working independently before collaborating as a group and the ability to see other students' thought processes as valuable aspects of PIVOT. Students expressed frustration with the PIVOT user interface and the lack of anonymity when discussing their answers in the workshop.
A web-based/mobile platform for student team collaboration on therapeutic reasoning cases discussed in small group settings yielded favorable ratings, examination performance comparable to standard approaches, and was preferred by a majority of students. During the rapid shift to substantial online learning for the COVID-19 pandemic, virtual collaboration tools like PIVOT may help health professions teachers to better support groups working virtually on scaffolded therapeutic reasoning tasks.
治疗性推理——关于治疗的判断和决策的思维过程——是通过获取知识并在实际或模拟经验中应用来发展的。健康职业教育经常使用协作性小组工作来练习治疗性推理。这项试点研究比较了一种基于网络/移动的协作案例工作和讨论工具与常规做法对学生在旨在测试治疗知识和推理的问题上的认知和表现的影响。
在一门包括基于案例的研讨会的治疗学课程中，将3至4人的学生小组随机分配到常规研讨会准备（小组SOAP表）或使用虚拟在线培训实践改进（PIVOT）平台进行准备。PIVOT也用于研讨会中以回顾案例和学生的回答。下周，各小组互换条件。学生对准备阶段和研讨会期间的体验进行了好感度评分，并通过调查对PIVOT平台发表了评论。比较了学生在与两个研讨会主题相关的考试项目上的表现。
111名学生（94%）在两个研讨会后都完成了研讨会后的调查。大多数学生（57%）更喜欢使用PIVOT平台进行研讨会协作。无论接触顺序如何，研讨会期间体验的好感度评分在第一和第二学习周之间没有显著变化。考试项目得分与学生接触该内容的研讨会平台之间没有关系（r = 0.29）。学生的回答强调了在小组协作前独立工作的效率以及将看到其他学生的思维过程视为PIVOT的宝贵方面。学生们对PIVOT用户界面以及在研讨会上讨论答案时缺乏匿名性表示沮丧。
一个基于网络/移动的平台，用于学生团队在小组环境中讨论治疗性推理案例，获得了良好的评分，考试表现与标准方法相当，并且受到大多数学生的青睐。在因2019冠状病毒病大流行而迅速转向大量在线学习的过程中，像PIVOT这样的虚拟协作工具可能有助于健康职业教师更好地支持小组实际开展有支架的治疗性推理任务。
