Practicum Script is a digital learning methodology that combines real patient cases, dilemmatic scenarios and expert analysis for training clinical reasoning and feeding clinical debate. Within a new proposal for universities, Practicum Mentoring displays in real time the performance of the students to facilitate a collaborative reflection on the resolution of the clinical cases that make up our undergraduate programme of clinical reasoning. This innovative interface has been designed to facilitate clinical debates in the classroom, mediated by a mentor.
Beyond learning about the case, the debate contributes to the incorporation of the concept of complexity in decision-making
“The mentor is a professor who starts with an inductive interrogation dialog”, explains Dr Eduardo Hornos, Practicum Script’s general director and president of Practicum Foundation. “In the process —he continues— the students discover their knowledge gaps and incorporate thinking skills while the teacher exploits the immense contribution of failures, separating those caused by lack of knowledge from those caused by cognitive failures.” The purpose is to move towards the assimilation of know-how at the early stage of medical training. By investigating “whys”, Practicum Mentoring breaks with the classic linearity of the plausible single answer and values the deconstruction of the error.
The access to the teaching team is through a virtual teachers’ room. Within a given course, the teacher can select a case, share the students’ results and compare their decisions with those by experts. Through different navigation tabs, the teacher can see the average grade of the group in hypotheses formulation or in clinical scenarios and review any step in the resolution of the case, along with the available bibliography. Some universities in Europe (Spain), Asia and America (Latin America) have been using Practicum Mentoring and appreciate how much time it saves in terms of preparing materials and organizing face-to-face or online discussion seminars.
“The idea is that the teacher saves time and resources in preparing these debate sessions, but above all, the students become protagonists of their own learning”, explains Dr Hornos. In place of a master class or a manual lesson, Practicum Mentoring challenges students to become actively involved. “Swapping one task for another with greater impact and involvement and appealing to Socratic maieutics are, in fact, two of the most notable distinguishing characteristics of Practicum Mentoring, along with the repurposing of error as a source of learning”, underlines the expert in neurosciences .
Within the framework of pedagogy, Practicum Mentoring can be understood as having the goal of shortening the students’ time to clinical maturity. Through key questions, the mentor leads the student to think. The debriefing explores the critical aspects of the simulated experience and provides a technological solution that complements the students’ self-learning with peer learning and mentor guidance. According to Dr Hornos, thinking about how we have thought and why we chose to proceed a certain way constitutes an extraordinary metacognitive strategy that overlaps knowledge, skills and attitudes, boosts self-confidence and increases the understanding of content.
Complexity in decision-making
Practicum Script comprises the following three steps: (1) formulation of hypotheses, (2) decision-making in the face of new data and (3) observation of results. Practicum Mentoring guides students through each of these steps. After the debriefing session in Practicum Mentoring, the students can review the case in their personal Practicum Script portfolio. “Beyond learning about the case, the debate contributes to the incorporation of the concept of complexity in decision-making”, emphasizes Dr Eduardo Pleguezuelos, academic secretary of Practicum Foundation.
Practicum Mentoring allows for a structured analysis of processes activated before and during decision-making in a safe digital environment. Users can be trained to automatically recognize complex patterns and get closer to the actual medical practice. In summary, we first “challenge students to make decisions autonomously and then encourage them to defend their ‘approach to the approach'”, says Dr Pleguezuelos.
Apart from the knowledge that the students acquire about the case – which they can transfer to similar patients in the future – the group sessions of Practicum Mentoring reinforce the delivery to the patient of a personalized medicine far from algorithms and performance guidelines and help deal with dissent in real clinical practice. Practicum Mentoring builds knowledge, skills and attitudes, boosts self-confidence and increases the students’ understanding of content.