Division of Infectious Diseases, Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Children's National Research Institute, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Med Educ Online. 2023 Dec;28(1):2178871. doi: 10.1080/10872981.2023.2178871.
Critical thinking is essential for the accurate diagnosis and management of patients. It is correlated with academic success.
Our objective was to design a novel tool for interactive online learning to improve knowledge and to assess trainees' critical thinking skills using the framework of the American Philosophical Association (APA).
Residents, fellows and students participated in an online, self-directed case-based vignette activity to learn malaria diagnosis and management. Pre and post-tests with multiple choice and open-ended case-based questions assessed knowledge and critical thinking. Comparison between pre and post-test scores across subgroups were performed using paired t-tests or one-way ANOVA.
Between 4 April 2017 to 14 July 2019, 62 of 75 (82%) eligible subjects completed both the pre and the post-test. Improved post-test scores occurred in 90% of medical students, p=0.001, 77% of residents, p<0.001, 60% of fellows, p=0.72 and 75% of trainees overall, p=<0.001. Fellows had higher pre-test scores than students or residents but there was no difference by level of training on the post-test.
This interactive online learning activity effectively imparted medical knowledge and improved trainee responses to questions requiring critical thinking. To our knowledge, this is the first time the APA's critical thinking framework has been incorporated into interactive online learning and assessment of critical thinking skills in medical trainees. We applied this innovation specifically in global health education, but there is obvious potential to expand it to a wide variety of areas of clinical training.
批判性思维对于准确诊断和治疗患者至关重要。它与学术成功相关。
我们的目的是设计一种新的工具,用于在线互动学习,以提高知识水平,并使用美国哲学协会(APA)的框架评估学员的批判性思维技能。
住院医师、研究员和学生参与了一项在线、自我指导的基于案例的小插曲活动,以学习疟疾的诊断和管理。使用多项选择题和基于案例的开放式问题的预测试和后测试评估知识和批判性思维。使用配对 t 检验或单因素方差分析比较亚组之间的预测试和后测试分数。
在 2017 年 4 月 4 日至 2019 年 7 月 14 日期间,符合条件的 75 名受试者中有 62 名完成了预测试和后测试。90%的医学生、77%的住院医师、60%的研究员和 75%的受训者的后测试分数都有所提高,p=0.001;p<0.001;p=0.72;p<0.001。研究员的预测试分数高于学生或住院医师,但在后测试中,培训水平之间没有差异。
这种互动式在线学习活动有效地传授了医学知识,并提高了学员对需要批判性思维的问题的反应能力。据我们所知,这是首次将 APA 的批判性思维框架应用于医学学员的互动式在线学习和批判性思维技能评估。我们将这一创新专门应用于全球健康教育,但显然有可能将其扩展到更广泛的临床培训领域。