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Clinical reasoning skills enhancements with the use of simulations and algorithms
Start date: Sep 1, 2014, End date: Aug 31, 2016 PROJECT  FINISHED 

Education for clinical practice is a complex process, involving the development of a body of knowledge, skills and multiple aspects of professionalism. The traditional approaches, with modules in single discipline biosciences, bear little relationship to eventual learner needs for clinical practice. Practitioners act by synthesizing a range of relevant information, identifying and testing solutions. Developing competence in this crucial process requires an approach that differs from traditional teaching, where students are recipients of information. Problem-Based Learning (PBL) is one example of widespread form of learning which uses patient simulation to create a learning style close to the needs of practice. Virtual patients (VPs) are encouraging students to use their knowledge base to explore simple management decisions as they work through patient scenarios. The CROSESUS project has introduced innovative pedagogy methods using scenario-based learning tools, virtual cases and patients, and thus has enabled future physicians and healthcare professionals to simulate important steps in the diagnostic and therapeutic process before exposure to patients. CROESUS has transferred know-how and best practices from the institutions which have already gone through a successful implementation of authentic, motivating, competency-based learning styles into the medical curriculum, and linked it with the existing regional medical education network MEFANET (Czech/Slovak) as well as with other European projects with similar objectives. The project partnership has been based upon long-standing collaborations and awareness of each other’s work, and shared research interests between three institutions: (1) Institute of Biostatistics and Analysis at Masaryk University (Czechia), (2) Department of Medical education at St George's University of London (United Kingdom) and (3) Faculty of Medicine at Pavol Jozef Šafárik University in Košice (Slovakia). CROESUS has trained academics to implement the VP/PBL methodology – the training focused on how to create the VPs using OpenLabyrinth software, on how to construct the narrative and options within a VP, and on how to facilitate PBL sessions appropriately for student groups. The project has delivered two substantial intellectual outputs: (1) Guidelines on virtual patients and problem-based learning and (2) IT platform for scenario-based learning. The first one represents the methodology & guidelines on the use of VPs in PBL sessions. It includes useful tips on authoring VPs and their proper use for supporting medical students in developing their clinical reasoning and decision making skills. The second one – the IT platform for authoring and playing VPs – was selected based on the results from several surveys and a scoping review. The IT platform is available together with a set of 14 VPs, which can be used to enrich curricula of 10 clinical disciplines: (1) Radiology and Imaging, (2) Dentistry, (3) Ophthalmology and Optometry, (4) Anaesthesiology and Intensive Care Medicine, (5) Psychiatry, Psychology, Sexology, (6) General Practice Medicine, (7) Paediatrics, Neonatology, (8) Internal Medicine, (9) Surgery, Traumatology and Orthopaedics, (10) Infectology. This set of VPs is available on-line (at the CROESUS’ website) as well as offline through XML-formatted files storing information according to the MedBiquitous Virtual Patient Data Standard (ANSI norm), which is suitable to share or exchange the patient cases between different institutions. The academic networks, such as MEFANET or ePBLnet, were hit by the CROESUS outputs during its dissemination events and with the published material. CROESUS is already having a substantial impact on new projects which have come out from these networks – the particular results from CROESUS’ surveys, methodologies as well as from the set of developed VPs are being used as foundation stones in building new programs towards medical curriculum innovations. Other stakeholders, such as institutions and people involved in health care, can benefit from the CROESUS outputs by improving the care for patients with a particular impact on patient safety. These are expected improvements, which may come from medicine and healthcare professionals who have been better prepared for developing clinical competency, and whose clinical competency has been better demonstrated and therefore assessed through the use of authentic virtual patients.
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