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Entwicklung von klinischem Denken bei Medizinstudierenden im Laufe des klinischen Studienabschnittes

dc.contributor.advisorRaupach, Tobias Prof. Dr.
dc.contributor.authorde Temple, Insa Amelie
dc.titleEntwicklung von klinischem Denken bei Medizinstudierenden im Laufe des klinischen Studienabschnittesde
dc.contributor.refereeRaupach, Tobias Prof. Dr.
dc.description.abstractengBackground:  Clinical reasoning is a medical core competence and is essential for precise diagnosis and therapy of patients. It is best practiced by repeatedly solving patient cases. In everyday clinical practice, due to a lack of staff, resources and patients with certain clinical pictures, it can be a challenge to guarantee all medical students comparable and good clinical teaching that realistically depicts incidence and prevalence. Simulation with a serious game can be used to train clinical reasoning. Previous studies to serious games in medical education mostly focus on student satisfaction. This study investigated the effectiveness of a digital simulation of an emergency ward regarding appropriate clinical decision-making. Methods:  This prospective trial was conducted from summer 2017 to winter 2018/19 at Göttingen Medical University Centre. A total of 178 students enrolled in either the third or sixth semester of undergraduate medical education took six 90-min sessions of playing a serious game in which they managed virtual patients presenting with various conditions. Learning outcome was assessed by analysing log-files of in-game activity (including choice of diagnostic methods, differential diagnosis and treatment initiation) with regard to history taking and patient management in three virtual patient cases: Non-ST segment elevation myocardial infarction (NSTEMI), pulmonary embolism (PE) and hypertensive crisis. Furthermore, patient hand-over protocols were analysed regarding items that show clinical reasoning and students took a key-feature test in the end of the semester. 8 students per semester took part in a think-aloud-interview, which was later graded by two consultants regarding clinical reasoning. Third-semester students and sixth-semester students were compared in their performance during the summer semester 2017.  The third-semester students were then followed up for 1.5 years, and their final performance was compared to the performance of students who had never been exposed to the game but had otherwise taken the same undergraduate courses. Results:  Students of the third and sixth clinical semester do not differ from each other during the summer semester 2017. Over the course of the semester, the performance score increased from 57.6 ± 1.1% to 65.5 ± 1.2% (p < 0.001; effect size 0.656). Performance remained stable over 1.5 years. The final assessment revealed a strong impact of exposure to the game in management scores (72.6 ± 1.2% vs. 63.5 ± 2.1%, p < 0.001; effect size 0.811). There was no significant change in history-taking skills. Conclusion: In this prospective study with a follow-up of one and a half years, the use of the virtual emergency room EMERGE is associated with a sustained increase in clinical thinking skills in medical students both at the beginning and at the end of their clinical
dc.contributor.coRefereeSennhenn-Kirchner, Sabine PD Dr.
dc.subject.gerKlinisches Denkende
dc.subject.engClinical reasoningde
dc.subject.engSerious gamede
dc.subject.engMedical educationde
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullInnere Medizin - Allgemein- und Gesamtdarstellungen (PPN619875747)de
dc.notes.confirmationsentConfirmation sent 2022-08-03T09:45:02de

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