Improving clinical reasoning skills by means of electronic voting

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Presentation held at the Ottawa Conference, 2008, Melbourne Australia

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Improving clinical reasoning skills by means of electronic voting

  1. 1. Improving clinical reasoning skills by electronic voting Dr. Peter de Jong Leiden University Medical Center The Netherlands Nynke Bos Roel Sijstermans Dr. Mario Maas Academic Medical Center The Netherlands
  2. 2. Electronic voting? <ul><li>Audience Polling System </li></ul><ul><li>Vote with clicker, laptop or PDA </li></ul><ul><li>Real-time results </li></ul>
  3. 3. Where are you from? <ul><li>Africa </li></ul><ul><li>North America </li></ul><ul><li>South America </li></ul><ul><li>Asia </li></ul><ul><li>Europe </li></ul><ul><li>Oceania </li></ul>10
  4. 4. Why electronic voting? <ul><li>Activates & stimulates learning </li></ul><ul><li>Gains insight in level of students’ knowledge </li></ul><ul><li>Tutor adapts to lack of knowlegde </li></ul><ul><li>Discussion </li></ul><ul><li>Data for evaluation and research </li></ul>
  5. 5. Different ways to use… <ul><li>Pre- and Post testing </li></ul><ul><li>Entrance level determination </li></ul><ul><li>Evaluation </li></ul><ul><li>Competition </li></ul><ul><li>Clinical reasoning </li></ul>
  6. 6. Current situation <ul><li>350 medical students each year </li></ul><ul><li>Divided into 30 groups </li></ul><ul><li>Each group his own professor </li></ul><ul><li>10 times a year </li></ul><ul><li>Prepare medical case on paper </li></ul><ul><li>Discussion </li></ul>
  7. 7. Pilot situation <ul><li>Implementing clinical reasoning skills in the lecture hall </li></ul><ul><li>350 students with clickers </li></ul><ul><li>1 professor </li></ul><ul><li>Each lecture can be a clinical reasoning lecture </li></ul>
  8. 8. How does it work? <ul><li>Clinical case with multi media </li></ul><ul><li>Branching slides </li></ul><ul><li>Students determine clinical reasoning path </li></ul><ul><li>Majority of votes counts </li></ul>
  9. 9. Clinical Case: Debby <ul><li>A 17 year old girl is brought into the ER after a scooter accident. She was shortly unconscious at the scene. She complaints of headache and a painful right knee </li></ul>
  10. 11. Prioritize <ul><li>Head </li></ul><ul><li>Knee </li></ul>10
  11. 12. X- right knee
  12. 13. In the meantime… <ul><li>While waiting for the X- ray of the right knee </li></ul><ul><li>patient starts to vomit. </li></ul><ul><li>She also complaints of enormous headache. </li></ul><ul><li>What will you do now? </li></ul>
  13. 14. Head <ul><li>X- ray </li></ul><ul><li>CT </li></ul>10
  14. 15. X - head
  15. 16. CT head
  16. 17. Team Scores Europe 150 Asia 177 North America 200 Oceania 200
  17. 18. Advantages <ul><li>Presenting cases with multi media </li></ul><ul><li>More times a year </li></ul><ul><li>Less professors needed </li></ul><ul><li>Mistakes in clinical reasoning can be corrected on the spot </li></ul><ul><li>Insight in level of clinical reasoning skills of large group of students </li></ul><ul><li>Reduces the costs and logistics </li></ul><ul><li>More interactive lectures </li></ul>
  18. 19. Disadvantages <ul><li>Professor needs more time to prepare one case </li></ul><ul><li>Majority feedback instead of individual </li></ul><ul><li>Inactive students less involvement </li></ul>
  19. 20. Conclusions <ul><li>Clinical reasoning with clickers is a good supplement to the current small group situation </li></ul><ul><li>Clickers offer change to practice more cases of clinical reasoning </li></ul>
  20. 21. Further information <ul><li>www.keepad.com </li></ul><ul><li>Software: www.turningtechnologies.com </li></ul><ul><li>1RF-receiver for 1000 clickers </li></ul>
  21. 22. Questions ?
  22. 23. The use of clickers in large groups is a good method for training students in clinical reasoning <ul><li>Strongly agree </li></ul><ul><li>Agree </li></ul><ul><li>Neutral </li></ul><ul><li>Disagree </li></ul><ul><li>Strongly disagree </li></ul>10
  23. 24. I’m using or thinking about using clickers in my classroom or faculty <ul><li>Strongly Agree </li></ul><ul><li>Agree </li></ul><ul><li>Neutral </li></ul><ul><li>Disagree </li></ul><ul><li>Strongly Disagree </li></ul>10
  24. 25. PLEASE RETURN THE CLICKERS
  25. 26. Pilot results <ul><li>Compare midterm exams with last year students on clinical reasoning exam </li></ul><ul><li>Level = results exam of this year must be improved </li></ul><ul><li>Exam date June 5 th </li></ul><ul><li>Current data: opinions of students (n=270) and professors (n=7) </li></ul>
  26. 27. The project <ul><li>Collaboration AMC and LUMC </li></ul><ul><li>Financed by SURF Foundation </li></ul><ul><li>AMC: clickers and RF receiver </li></ul><ul><li>LUMC: laptops and WiFi </li></ul>Stimulate and train tutors to use electronic voting as a tool for improving their lectures and increase interaction during lectures

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