On June 9, the Practicum Foundation will be holding a webinar titled “Practicum Universities: pilot application of the clinical reasoning simulator Practicum Script for medical students.” The Association for Medical Education in Europe (AMEE) will host the session. The aim of the online seminar is to present details about the experience of using Practicum Script in undergradute teaching and assessment medical education. Prof. Cees van der Vleuten, a Karolinska Institutet Prize recipient, will discuss the need for approaches tailored to the development of clinical reasoning skills. Eduardo Pleguezuelos, Carlos Collares and Matthew Lineberry will join the speakers’ team. 

cees van der vleuten, eduardo pleguezuelos, carlos collares and matthew lineberry join forces for the webinar

More than 2000 students, 20 top medical schools and 50 experts from the US, Europe and Latin America are anticipated to take part in the Practicum Universities initiative. This multicentre pilot study, recently praised by the AMEE president, Trevor Gibbs, represents a large collaboration to test a clinical reasoning tool in graduate medical education. The project, coordinated by the Practicum Foundation and the European Board of Medical Assessors (EBMA), aims at assessing the ability of senior medical students to manage uncertainty in clinical practice. Practicum Script is an online tool directed to enhance problem-solving skills and introduce the concept of clinical doubt in decision making.

While announcing the online seminar, Eduardo Pleguezuelos (academic secretary of the Practicum Foundation) expressed his gratitude to AMEE for organizing the event. “Practicum Script has been a leader in online clinical reasoning training, and we are certain that the appropriate use of simulation may strengthen the students’ approach in the clinical setting. Amid the current Covid-19 crisis, when many medical schools are moving to online platforms, Practicum Script could be a valuable educational resource to mitigate the disruption of the activities.” The research initially aimed at assisting European medical schools in assessing applied knowledge in graduate medical education, but its scope has widened.

Practicum has garnered support from leading experts in medical evaluation. The webinar will count on the participation of Cees van der Vleuten, Director of the School of Health Professions Education at Maastricht University and Director of EBMA, who received the Karolinska Institutet Prize for Research in Medical Education in 2012. Along with him will be Carlos Collares, assistant professor at Maastricht and psychometric specialist at EBMA, and Matthew Lineberry, Director of Simulation Research, Assessment, and Outcomes at the University of Kansas. The three speakers, along with Dr. Pleguezuelos, are focused on assessments to improve performance. 

During the webinar, the speakers will present the methodology of Practicum Script as an assessment for learning tool and the key features of the ongoing pilot project involving medical students, along with a plan for the analysis of the students’ performances and level of satisfaction. In short, the assessment materials consist of 20 clinical cases in internal medicine validated by a reference panel comprising 20 internists from 16 medical schools. For each clinical case, final-year medical students are asked to generate hypotheses in a free-text format, which are then compared with hypotheses from experts. Cognitive diagnostic modelling will be used to determine the profiles of specific clinical reasoning skills that are needed.

First results

After a successful track record in CPD/CME, which will also be addressed in the webinar, Practicum Script is proving effective in graduate medical education. According to the president of the Practicum Foundation, Dr. Eduardo Hornos, “our approach to the medical CV introduces the acquisition of clinical experience in an environment free of risks.” In his opinion, “introducing simulated scenarios based on real-life patients will help students be ready for the complexity of the clinical setting, which is something that they have been already saying.” Most respondents to a survey have rated Practicum Script as an excellent and highly recommended clinical tool to integrate into their study plans.

Here are some of the comments: “I very much liked how Practicum Script ‘gamifies’ clinical reasoning and case solving,” “we can learn from our mistakes” and “it led me to overcome some challenges in clinical practice.” For Prof. Lineberry, “the cases can stimulate productive debates, and I hope these aspects are helping participants broaden the perspectives that they are familiar with.” A research published by him and Drs. Hornos and Pleguezuelos in Medical Education last year concluded that “even when their positions remain unchanged, by knowing about controversies, the examinees may calibrate their certainty and apply more diverse thinking going forward.”


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