Virtual Coaching and Deliberate Practice to Enhance Medical Students' Clinical Reasoning during Oral Case Presentations

Authors

Nicole Akar-Ghibril MD, Harvard School of Medicine
Cristina Carter MD, National Institutes of Health
Gabrina Dixon MD, MEd, George Washington University School of Medicine and Health Sciences
Ellen Goldman MEd, MBA, George Washington University School of Medicine and Health Sciences
Mary C. Ottolini MD, MPH, MEd, Maine Medical CenterFollow

Submission Type

Original Research

Abstract

ABSTRACT:

Introduction

Oral case presentations (OP) provide an opportunity for medical students to practice clinical reasoning and communication skills, and for faculty to provide assessment. Specific teaching strategies are needed to improve students’ OP skills.

Objective

To compare the effectiveness of Virtual Coaching (VC) to Small Group (SG) discussion or Traditional Feedback (TF/control) in improving clinical reasoning during OP, using a validated PBEAR (Problem Representation, Background Evidence, Analysis, Recommendation) tool.

Design/Methods

Students from two medical schools were randomly assigned to three groups during their inpatient pediatric clerkship. All completed an eLearning module about using illness scripts to promote clinical reasoning and presenting in the PBEAR format. TF/control students completed online “Aquifer” cases; VC students recorded abstracted data from the same cases with on-line faculty feedback and self-reflection; SG students attended faculty facilitated discussions of the same cases. Students were video recorded presenting pre- and post-curriculum cases. Reviewers blinded to assignment groups rated pre and post videos with the PBEAR OP tool.

Results

The overall score and sub-scale scores improved for all groups. VC students significantly improved in the Analysis subscale compared to SG or controls. Students rated the SG teaching sessions as more enjoyable and effective in improving their clinical reasoning and presentation skills.

Conclusions

A blended learning curriculum using VC significantly improved students’ clinical reasoning as assessed by the Analysis subscale.

Recommended Citation

Akar-Ghibril, Nicole MD; Carter, Cristina MD; Dixon, Gabrina MD, MEd; Goldman, Ellen MEd, MBA; and Ottolini, Mary C. MD, MPH, MEd (2020) "Virtual Coaching and Deliberate Practice to Enhance Medical Students' Clinical Reasoning during Oral Case Presentations," Journal of Maine Medical Center: Vol. 2 : Iss. 1 , Article 4.
Available at: https://doi.org/10.46804/2641-2225.1033