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Increasing Reasoning Awareness: Video Analysis of Students' Two-Party Virtual Patient Interactions.
Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-1110-0782
Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
2018 (English)In: JMIR medical education, ISSN 2369-3762, Vol. 4, no 1, article id e4Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Collaborative reasoning occurs in clinical practice but is rarely developed during education. The computerized virtual patient (VP) cases allow for a stepwise exploration of cases and thus stimulate active learning. Peer settings during VP sessions are believed to have benefits in terms of reasoning but have received scant attention in the literature.

OBJECTIVE: The objective of this study was to thoroughly investigate interactions during medical students' clinical reasoning in two-party VP settings.

METHODS: An in-depth exploration of students' interactions in dyad settings of VP sessions was performed. For this purpose, two prerecorded VP sessions lasting 1 hour each were observed, transcribed in full, and analyzed. The transcriptions were analyzed using thematic analysis, and short clips from the videos were selected for subsequent analysis in relation to clinical reasoning and clinical aspects.

RESULTS: Four categories of interactions were identified: (1) task-related dialogue, in which students negotiated a shared understanding of the task and strategies for information gathering; (2) case-related insights and perspectives were gained, and the students consolidated and applied preexisting biomedical knowledge into a clinical setting; (3) clinical reasoning interactions were made explicit. In these, hypotheses were followed up and clinical examples were used. The researchers observed interactions not only between students and the VP but also (4) interactions with other resources, such as textbooks. The interactions are discussed in relation to theories of clinical reasoning and peer learning.

CONCLUSIONS: The dyad VP setting is conducive to activities that promote analytic clinical reasoning. In this setting, components such as peer interaction, access to different resources, and reduced time constraints provided a productive situation in which the students pursued different lines of reasoning.

Place, publisher, year, edition, pages
JMIR Publications , 2018. Vol. 4, no 1, article id e4
Keywords [en]
clinical decision making, computer-assisted instruction, medical education, problem solving
National Category
Pedagogy
Identifiers
URN: urn:nbn:se:oru:diva-69847DOI: 10.2196/mededu.9137PubMedID: 29487043OAI: oai:DiVA.org:oru-69847DiVA, id: diva2:1258496
Available from: 2018-10-24 Created: 2018-10-24 Last updated: 2018-10-29Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • harvard1
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