On 24 February, the Complutense University of Madrid (UCM) started offering to medical students the clinical reasoning training programme known as Practicum Universities. According to the foundations of the project, jointly signed by the Practicum Institute and the European Board of Medical Assessors (EBMA), this initiative “is about future physicians learning to manage uncertainty during medical decision making.” The experience, entirely in English, consists of an online simulation of 20 internal medicine cases offered through the Practicum Script platform.

what could be better than to practice with real patients without risk of harm? 

Acquiring and retaining knowledge is essential for medical training, but knowing how to use such knowledge is equally important. So what could be better than to practice with real patients without risk of harm? This is what Practicum Script offers – a clinical simulation tool that improves critical judgment through clinical cases from everyday practice. The objective of the international Practicum Universities programme – whose executive arm is supported by Jesús Millán and Elena Varas (vice deans of teaching innovation and students, respectively) – is to improve clinical thinking skills among those who are graduating toward their future expertise.

With this agreement, reached in February 2019, UCM joins a select network of European and American medical schools that includes Oxford, Imperial College London, and La Salle México, among more than 20 prestigious medical schools. More than 2000 students in the last two years of medical school are expected to benefit from this initiative. At the academic level, clinical reasoning training is an area with limited representation in study programmes. While Prof. Millán highlights a gap in guiding the students’ thinking process
towards effective integration of knowledge, Practicum Script works precisely
toward that.

Practicum Script is a cognitive acceleration platform that, instead of measuring learning, measures the knowledge that the user applies to solve problems, in this case, focused on adult patient care. First, the platform presents challenging scenarios that work as a game of recognition of clinical patterns for the user to come up with management hypotheses. During this step, an artificial intelligence system (Ocmale©) presents the coincidence with hypotheses formulated by experts. Next, Practicum Script exposes new data to the user, who must decide on the impact of these new data on their generated hypotheses. Finally, the platform provides indicators to enable the user to reflect on the results.

Associated advantages

For Dr. Eduardo Hornos, president of the Practicum Institute, “the main asset of implementing the pilot programme Practicum Script in universities is that it shortens the time to experiential learning.” Dr. Horno’s arrival to the medical programme comes after a successful 10-year career in the field of continuing education. “Learning by doing has always been the starting point of our methodology,” says Dr. Hornos. Learning based on experimentation leads to more profound knowledge and stimulates creativity, critical capacity, and motivation.

“What we propose with Practicum Universities is an approach to the clinical reality of the future, to enable the assimilation of uncertainty as an inherent characteristic of medicine,” explains Dr. Hornos. This will result in more differential diagnoses and, ultimately, better clinical decisions. Assuming that medical error is the third leading cause of death in the US and that many of these errors result from flaws in reasoning processes (according to the British Journal of Medicine in 2016), Practicum Script can help improve critical mental processes during decision making.


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