The document discusses the use of electronic voting (clickers) in enhancing clinical reasoning skills among medical students at two universities in the Netherlands. By implementing real-time audience polling during lectures, instructors can evaluate and adapt to students' knowledge levels while also facilitating interactive learning through multimedia clinical cases. Overall, the program aims to improve student engagement and clinical reasoning capabilities while reducing logistical challenges in traditional learning environments.

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. Electronic voting? Audience Polling System Vote with clicker, laptop or PDA Real-time results

3. Where are you from? Africa North America South America Asia Europe Oceania 10

4. Why electronic voting? Activates & stimulates learning Gains insight in level of students’ knowledge Tutor adapts to lack of knowlegde Discussion Data for evaluation and research

5. Different ways to use… Pre- and Post testing Entrance level determination Evaluation Competition Clinical reasoning

6. Current situation 350 medical students each year Divided into 30 groups Each group his own professor 10 times a year Prepare medical case on paper Discussion

7. Pilot situation Implementing clinical reasoning skills in the lecture hall 350 students with clickers 1 professor Each lecture can be a clinical reasoning lecture

8. How does it work? Clinical case with multi media Branching slides Students determine clinical reasoning path Majority of votes counts

9. Clinical Case: Debby 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

11. Prioritize Head Knee 10

12. X- right knee

13. In the meantime… While waiting for the X- ray of the right knee patient starts to vomit. She also complaints of enormous headache. What will you do now?

14. Head X- ray CT 10

15. X - head

16. CT head

17. Team Scores Europe 100 Asia 100 South America 100 Oceania 133.33 North America 200

18. Advantages Presenting cases with multi media More times a year Less professors needed Mistakes in clinical reasoning can be corrected on the spot Insight in level of clinical reasoning skills of large group of students Reduces the costs and logistics More interactive lectures

19. Disadvantages Professor needs more time to prepare one case Majority feedback instead of individual Inactive students less involvement

20. Conclusions Clinical reasoning with clickers is a good supplement to the current small group situation Clickers offer change to practice more cases of clinical reasoning

21. Questions ?

22. The use of clickers in large groups is a good method for training students in clinical reasoning Strongly agree Agree Neutral Disagree Strongly disagree 10

23. I’m using or thinking about using clickers in my classroom or faculty Strongly Agree Agree Neutral Disagree Strongly Disagree 10

25. PLEASE RETURN THE CLICKERS

26. Pilot results Compare midterm exams with last year students on clinical reasoning exam Level = results exam of this year must be improved Exam date June 5 th Current data: opinions of students (n=270) and professors (n=7)

27. Costs Free software: www.turningtechnologies.com RF-receiver: € 400,- Clicker: € 50,- 1RF-receiver for 1000 clickers

28. The project Collaboration AMC and LUMC Financed by SURF Foundation AMC: clickers and RF receiver LUMC: laptops and WiFi Stimulate and train tutors to use electronic voting as a tool for improving their lectures and increase interaction during lectures