Web-Based Immersive Patient Simulator as a Curricular Tool for Objective Structured Clinical Examination Preparation in Surgery: Development and Evaluation

Seung-Hun Chon; Sabrina Hilgers; Ferdinand Timmermann; Thomas Dratsch; Patrick Sven Plum; Felix Berlth; Rabi Datta; Hakan Alakus; Hans Anton Schlößer; Christoph Schramm; Daniel Pinto Dos Santos; Christiane Bruns; Robert Kleinert

doi:10.2196/10693

Web-Based Immersive Patient Simulator as a Curricular Tool for Objective Structured Clinical Examination Preparation in Surgery: Development and Evaluation

JMIR Serious Games. 2018 Jul 4;6(3):e10693. doi: 10.2196/10693.

Affiliations

¹ Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany.
² Faculty of Medicine, University of Cologne, Cologne, Germany.
³ Department of Gastroenterology and Hepatology, University Hospital Cologne, Cologne, Germany.
⁴ Department of Radiology, University Hospital of Cologne, Cologne, Germany.

PMID: 29973333
PMCID: PMC6052344
DOI: 10.2196/10693

Abstract

Background: Objective Structured Clinical Examination is a standard method of testing declarative and process knowledge in clinical core competencies. It is desirable that students undergo Objective Structured Clinical Examination training before participating in the exam. However, establishing Objective Structured Clinical Examination training is resource intensive and therefore there is often limited practice time. Web-based immersive patient simulators such as ALICE (Artificial Learning Interface of Clinical Education) can possibly fill this gap as they allow for the training of complex medical procedures at the user's individual pace and with an adaptable number of repetitions at home. ALICE has previously been shown to positively influence knowledge gain and motivation.

Objective: Therefore, the aim of this study was to develop a Web-based curriculum that teaches declarative and process knowledge and prepares students for a real Objective Structured Clinical Examination station. Furthermore, we wanted to test the influence of ALICE on knowledge gain and student motivation.

Methods: A specific curriculum was developed in order to implement the relevant medical content of 2 surgical Objective Structured Clinical Examination stations into the ALICE simulator framework. A total of 160 medical students were included in the study, where 100 students had access to ALICE and their performance was compared to 60 students in a control group. The simulator performance was validated on different levels and students' knowledge gain and motivation were tested at different points during the study.

Results: The curriculum was developed according to the Kern cycle. Four virtual clinical cases were implemented with different teaching methods (structured feedback, keynote speech, group discussion, and debriefing by a real instructor) in order to consolidate declarative and process knowledge. Working with ALICE had significant impact on declarative knowledge gain and Objective Structured Clinical Examination performance. Simulator validation was positive for face, content, construct, and predictive validity. Students showed high levels of motivation and enjoyed working with ALICE.

Conclusions: ALICE offers Web-based training for Objective Structured Clinical Examination preparation and can be used as a selective didactic intervention as it has positive effect on knowledge gain and student motivation.

Keywords: Objective Structured Clinical Examination; artificial learning interface; immersive patient simulator; simulator-based curriculum.

©Seung-Hun Chon, Sabrina Hilgers, Ferdinand Timmermann, Thomas Dratsch, Patrick Sven Plum, Felix Berlth, Rabi Datta, Hakan Alakus, Hans Anton Schlößer, Christoph Schramm, Daniel Pinto dos Santos, Christiane Bruns, Robert Kleinert. Originally published in JMIR Serious Games (http://games.jmir.org), 04.07.2018.