Improving clinical reasoning skills by electronic voting

Dr. Peter de JongLeiden University Medical Center

The Netherlands

Nynke BosRoel SijstermansDr. Mario MaasAcademic Medical CenterThe Netherlands

Electronic voting?

• Audience Polling System• Vote with clicker, laptop or PDA• Real-time results

Where are you from?

0% 0% 0%0%0%0%

1. Africa2. North America3. South America4. Asia5. Europe6. Oceania

10

Why electronic voting?

• Activates & stimulates learning• Gains insight in level of students’ knowledge • Tutor adapts to lack of knowlegde• Discussion• Data for evaluation and research

Different ways to use…

• Pre- and Post testing• Entrance level determination• Evaluation• Competition• Clinical reasoning

Current situation

• 350 medical students each year• Divided into 30 groups• Each group his own professor• 10 times a year• Prepare medical case on paper• Discussion

Pilot situation

• Implementing clinical reasoning skills in the lecture hall

• 350 students with clickers• 1 professor• Each lecture can be a clinical reasoning lecture

How does it work?

• Clinical case with multi media• Branching slides• Students determine clinical reasoning path• Majority of votes counts

Clinical Case: Debby

• A 17 year old girl is brought into the ER after a scooter accident. She was shortly unconscious at the scene. She complaints of headache and a painful right knee

Prioritize

0%0%

1. Head2. Knee

10

X- right knee

In the meantime…

While waiting for the X- ray of the right kneepatient starts to vomit.

She also complaints of enormous headache.

What will you do now?

Head

10

0%0%

1. X- ray2. CT

X - head

CT head

Team Scores

200 Oceania

200 North America

177 Asia

150 Europe

Advantages

• Presenting cases with multi media• More times a year• Less professors needed• Mistakes in clinical reasoning can be corrected

on the spot• Insight in level of clinical reasoning skills of

large group of students• Reduces the costs and logistics• More interactive lectures

Disadvantages

• Professor needs more time to prepare one case

• Majority feedback instead of individual• Inactive students less involvement

Conclusions

• Clinical reasoning with clickers is a good supplement to the current small group situation

• Clickers offer change to practice more cases of clinical reasoning

Further information

• www.keepad.com • Software: www.turningtechnologies.com

1RF-receiver for 1000 clickers

Questions

?

The use of clickers in large groups is a good method for training students in clinical reasoning

0% 0% 0%0%0%

1. Strongly agree2. Agree3. Neutral4. Disagree5. Strongly disagree

10

I’m using or thinking about using clickers in my classroom or faculty

0% 0% 0%0%0%

1. Strongly Agree2. Agree3. Neutral4. Disagree5. Strongly Disagree

10

PLEASE RETURN THE CLICKERS

Pilot results

• Compare midterm exams with last year students on clinical reasoning exam

• Level = results exam of this year must be improved

• Exam date June 5th

• Current data: opinions of students (n=270) and professors (n=7)

The project

• Collaboration AMC and LUMC• Financed by SURF Foundation• AMC: clickers and RF receiver• LUMC: laptops and WiFi

Stimulate and train tutors to use electronic voting as a tool for improving their lectures and increase interaction during lectures