Abstract
• Bedside teaching is the cornerstone of clinical medical education through which valuable history-taking and physical examination skills, patient management, and the modeling of professional behaviors can be learnt via direct observation and hand-on participation.
• However, the ongoing COVID-19 Pandemic presents a major challenge to clinical teaching as medical students are excluded from traditional bedside teaching due to infection risk.
• To meet urgent educational need, a virtual interactive simulation platform that comprises of real-life clinical cases which are collected during medical consultation with patient history, real clinical signs including clinical photo, heart sounds, breath sounds, and bowel sounds, will be developed.
• Through this remote platform, students can familiarize themselves with the clinical approach to real life cases, appreciate clinical signs, and learn about the management of common medical diseases.
Brief write-up
Project objectives
Bedside teaching is the cornerstone of clinical medical education through which valuable history and physical examination skills, patient management, and the modelling of professional behaviours can be learnt via direct observation and hand-on participation. The current Coronary Virus Disease 2019 (COVID-19) pandemic has presented as a major challenge to clinical education due to the exclusion of medical students from traditional bedside teaching in an effort of minimize infection risk. In order to provide uninterrupted medical education in a safe environment, we propose to initiate a virtual interactive platform which comprises real-life cases of common medical conditions with real clinical signs such as heart rate, heart sound, breath sound, bowel sounds that can be accessed by the students remotely. Through this virtual platform, students can familiarise themselves with the clinical approach to real life cases, appreciate clinical signs, and learn about the management of common medical disease.
Activities, process and outcomes
4 commonly encountered medical conditions will be identified by the project supervisors. Real-life representative patients with these medical conditions will be selected. Relevant presenting history, physical finding and investigation result will be collected and compiled into a comprehensive case scenario. Multimedia resources such as auscultation physical signs including heart sounds, breath sound and bowel sound will be recorded using an electronic stethoscope with wireless recorder. Clinical photos and video will be collected in accordance with Hospital Authority guidelines. This multimedia information will be incorporated throughout the case scenario where appropriate. Relevant multiple-choice questions (MCQ) at level suitable for junior clinical clerkship (appropriating medical year 4 level) will be set at different stages of the case scenario. Explanation will be given for the answers. The clinical progress of the patients after treatment will be recorded for teaching purpose too. The interactive platform will be built using an online eLearning software and in consultation with Professor Vivian Lee from the Centre for Learning Enhancement And Research. Additional short case scenario will be added with relevant MCQs tagged if available. The course created with the online platform will be available even after the annual subscription expires.
By simulating traditional bedside teaching, students will be able to sharpen history taking skills, appreciate important clinical signs, learn to interpret relevant investigation, and develop critical thinking skills through this interactive learning platform. Students can also learn about the management of common medical problems and appreciate the evolution of the diseases through following up the progress of these patients.
Deliverables and evaluation
Volunteers from medical year 4-6 students were asked to test and assess the platform based on these 10 aspects using a 10 points scale on an online evaluation form. The 10 aspects are as follow:
1. Case complexity
2. Clarity of clinical information
3. Clarity of multimedia information
4. Clarity of instruction
5. Appropriateness of MCQ difficulty
6. Ease of usage of this learning platform
7. Usefulness of the clinical skills learnt
8. Similarity of this platform to bed-side teaching
9. Confidence in managing similar patients in real life
10. Overall learning experience using this platform
The overall response rate was fair. Among the 80 invitations sent out, 42 have responded. Of the responded, students found this platform easy to use with useful clinical skills obtained through using it. Although most of the students did not think that this platform can replace real-life bed-side teaching, the overall satisfaction rate was high with majority rating it 8 and 9 out of 10 points.
Dissemination, diffusion, impact and sharing of good practices
This project is published on
https://interactivesimulatorofclinicalteaching.000webhostapp.com. This project has been tested and evaluated by medical year 4 and 6 students. This platform is designed to be universal and can be expanded to cover other medical subspecialties and other specialties.
Impact on teaching and learning
This project facilitates the continuous medical education and clinical skills acquisition during the ongoing COVID-19 epidemic. It helps to overcome some of the restrictions over bedside teaching due to the need for infection control measures. Students can familiarize themselves with some of the common cardiac conditions using this virtual platform.
