Electronic assessment of clinical reasoning in clerkships: A mixed-methods comparison of long-menu key-feature problems with context-rich single best answer questions.

Background: It remains unclear which item format would best suit the assessment of clinical reasoning: context-rich single best answer questions (crSBAs) or key-feature problems (KFPs). This study compared KFPs and crSBAs with respect to students' acceptance, their educational impact, and psychometric characteristics when used in a summative end-of-clinical-clerkship pediatric exam.

Methods: Fifth-year medical students (n = 377) took a computer-based exam that included 6-9 KFPs and 9-20 crSBAs which assessed their clinical reasoning skills, in addition to an objective structured clinical exam (OSCE) that assessed their clinical skills.

Exploring the validity and reliability of a questionnaire for evaluating virtual patient design with a special emphasis on fostering clinical reasoning.

Background: Virtual patients (VPs) are increasingly used to train clinical reasoning. So far, no validated evaluation instruments for VP design are available.

Aims: We examined the validity of an instrument for assessing the perception of VP design by learners.

Learner preferences regarding integrating, sequencing and aligning virtual patients with other activities in the undergraduate medical curriculum: A focus group study.

Context: E-learning resources, such as virtual patients (VPs), can be more effective when they are integrated in the curriculum. To gain insights that can inform guidelines for the curricular integration of VPs, we explored students' perceptions of scenarios with integrated and non-integrated VPs aimed at promoting clinical reasoning skills.

Methods: During their paediatric clerkship, 116 fifth-year medical students were given at least ten VPs embedded in eight integrated scenarios and as non-integrated add-ons.

Computer supported collaborative learning in a clerkship: an exploratory study on the relation of discussion activity and revision of critical appraisal papers.

Background: Medical students in clerkship are continuously confronted with real and relevant patient problems. To support clinical problem solving skills, students perform a Critical Appraisal of a Topic (CAT) task, often resulting in a paper. Because such a paper may contain errors, students could profit from discussion with peers, leading to paper revision.

Towards a typology of virtual patients.

Introduction: Although on-screen "virtual patients (VPs)" have been around for decades it is only now that they are entering the mainstream, and as such they are new to most of the medical education community. There is significant variety in the form, function, and efficacy of different VPs and there is, therefore, a growing need to clarify and distinguish between them. This article seeks to clarify VP concepts and approaches using a typology of VP designs.

Design principles for virtual patients: a focus group study among students.

Objectives: This study aimed to examine what students perceive as the ideal features of virtual patient (VP) design in order to foster learning with a special focus on clinical reasoning.

Methods: A total of 104 Year 5 medical students worked through at least eight VPs representing four different designs during their paediatric clerkship. The VPs were presented in two modes and differed in terms of the authenticity of the user interface (with or without graphics support), predominant question type (long- versus short-menu questions) and freedom of navigation (relatively free versus predetermined).

The effect of face-to-face collaborative learning on the elaboration of computer-based simulated cases.

Introduction: This study investigates the effects of working face to face in small groups on the processes that occur when students elaborate on computer-based simulated cases.

Methods: We performed a randomized controlled experiment that was designed to measure the effect of "social context" (triads versus individuals) on students' perceptions of the elaboration process and on the time spent on the different parts of the computer case. We sought students' perceptions using a questionnaire that was administered to all participating students (N = 47) and we examined the actions of the students working in triads (N = 12) and individually (N = 11) by analyzing the log files of the computer case.

Student perceptions of a virtual learning environment for a problem-based learning undergraduate medical curriculum.

Objective: To investigate the effects of a virtual learning environment (VLE) on group interaction and consultation of information resources during the preliminary phase, self-study phase and reporting phase of the problem-based learning process in an undergraduate medical curriculum.

Methods: A questionnaire was administered to 355 medical students in Years 1 and 2 to ask them about the perceived usefulness of a virtual learning environment that was created with Blackboard for group interaction and the use of learning resources.

Results: The students indicated that the VLE supported face-to-face interaction in the preliminary discussion and in the reporting phase but did not stimulate computer-mediated distance interaction during the self-study phase.

Analysis of verbal interactions in tutorial groups: a process study.

Introduction: Collaborative learning, including problem-based learning (PBL), is a powerful learning method. Group interaction plays a crucial role in stimulating student learning. However, few studies on learning processes in medical education have examined group interactions.