During 2019 and 2020, the Practicum Foundation developed an international multicentre study, in partnership with the European Board of Medical Assessors, consisting on the application of the simulator Practicum Script in the subject of Internal Medicine to senior medical students from more than 20 top medical universities. The pilot, known as Practicum Universities, was aimed to validate the utility of Practicum Script as a clinical reasoning training tool in undergraduate teaching and assessment, in terms of perceived benefits by medical students and educators as well as the psychometric properties for formative purposes.
More than 2.500 medical students from Europe and America participated in the international experience. The levels of satisfaction and perceived benefits, both by the medical educators and the participating students, were very satisfactory, as shown in the following graphs with results collected through an online survey:
How likely are you to recommend the incorporation of the Practicum Script methodology as a clinical reasoning training tool at your medical school?
How would you rate
your overall satisfaction and interest
in the Practicum Script training experience?
Source: Alchemer, former SurveyGizmo
Please rate on a scale from 1 (useless) to 5 (extremely useful) the benefits of Practicum Script
(n = 459)
|It improves reasoning and problem-solving skills||1.6%||3.9%||15.5%||39.5%||39.5%|
|It stimulates reading on medical topics||2.6%||5.3%||19.5%||30.3%||42.4%|
|It boosts thinking skills in terms of differential diagnoses||1.6%||1.6%||9.7%||37.4%||49.7%|
|It gives greater confidence and autonomy for decision making (i.e., without supervision by tutors or mentors)||2.6%||5.3%||17.6%||36.1%||38.4%|
|It helps with the application of theoretical knowledge into real-life situations||1.3%||3.9%||13.7%||44.2%||36.8%|
In addition, the statistical analysis of the students' results has proved Practicum Script effecitve in terms of validity, reliability, and discrimination of students' clinical reasoning skills. Also, the application of a cognitive diagnostic model aimed at the creation of cognitive profiles for clinical reasoning skills and the early identification of knowledge/reasoning gaps is being explored. The development of CDM-based Practicum Script may represent a revolutionary new psychometric paradigm, offering the possibility of more qualitative feedback regarding specific clinical reasoning skills (e.g., interpretation, comparison, prediction, inference, and knowledge application, among others).
There is a strong need for effective approaches tailored to the development of clinical reasoning skills, and Practicum Script could contribute meaningfully to this endpoint. The outcomes of the study will be shortly published in a specialized journal in medical education.