Evidence map›Paper›PMID 32736583›Full record

Trial reportBMC medical education2020

Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial.

Ruth Plackett, Angelos P Kassianos, Maria Kambouri, Natasha Kay, Sophie Mylan, Jenny Hopwood, Patricia Schartau, Shani Gray, Jessica Timmis, Sarah Bennett and 7 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medical education, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Ruth PlackettDepartment of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. ruth.plackett.15@ucl.ac.uk.ORCID http://orcid.org/0000-0002-3351-1478
Angelos P KassianosDepartment of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Maria KambouriInstitute of Education, UCL, London, UK.
Natasha KayDepartment of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Sophie MylanDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Jenny HopwoodUCL Medical School, UCL, London, UK.
Patricia SchartauPrimary Care and Population Health Department, UCL, London, UK.
Shani GrayDepartment of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Jessica TimmisDepartment of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Sarah BennettUCL Medical School, UCL, London, UK.
Chris ValerioUCL Medical School, UCL, London, UK.
Veena RodriguesNorwich Medical School, UEA, Norwich, UK.
Emily PlayerNorwich Medical School, UEA, Norwich, UK.
Willie HamiltonInstitute of Health Service Research, University of Exeter, Exeter, UK.
Rosalind RaineDepartment of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Stephen DuffyWolfson Institute of Preventive Medicine, QMUL, London, UK.
Jessica SheringhamDepartment of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.

Funding

National Institute for Health Research 106/0001
6 · The paper itself

Abstract

backgroundOnline patient simulations (OPS) are a novel method for teaching clinical reasoning skills to students and could contribute to reducing diagnostic errors. However, little is known about how best to implement and evaluate OPS in medical curricula. The aim of this study was to assess the feasibility, acceptability and potential effects of eCREST - the electronic Clinical Reasoning Educational Simulation Tool.

methodsA feasibility randomised controlled trial was conducted with final year undergraduate students from three UK medical schools in academic year 2016/2017 (cohort one) and 2017/2018 (cohort two). Student volunteers were recruited in cohort one via email and on teaching days, and in cohort two eCREST was also integrated into a relevant module in the curriculum. The intervention group received three patient cases and the control group received teaching as usual; allocation ratio was 1:1. Researchers were blind to allocation. Clinical reasoning skills were measured using a survey after 1 week and a patient case after 1 month.

resultsAcross schools, 264 students participated (18.2% of all eligible). Cohort two had greater uptake (183/833, 22%) than cohort one (81/621, 13%). After 1 week, 99/137 (72%) of the intervention and 86/127 (68%) of the control group remained in the study. eCREST improved students' ability to gather essential information from patients over controls (OR = 1.4; 95% CI 1.1-1.7, n = 148). Of the intervention group, most (80/98, 82%) agreed eCREST helped them to learn clinical reasoning skills.

conclusionseCREST was highly acceptable and improved data gathering skills that could reduce diagnostic errors. Uptake was low but improved when integrated into course delivery. A summative trial is needed to estimate effectiveness.

Indexed as

Education, Medical, UndergraduateSimulation TrainingStudents, MedicalClinical CompetenceClinical ReasoningCurriculumFeasibility StudiesHumansPatient SimulationClinical reasoningFeasibility studyMedical educationMedical studentsOnline learningSimulationVirtual patient

Identifiers

PMID32736583
PMCPMC7395338

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.