Educators' perspectives of adopting virtual patient online learning tools to teach clinical reasoning in medical schools: a qualitative study.
Adoption
Clinical reasoning
Implementation framework
Medical education
Medical students
Online learning
Simulation learning
Virtual patient
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
08 Jun 2023
08 Jun 2023
Historique:
received:
01
06
2022
accepted:
01
06
2023
medline:
12
6
2023
pubmed:
9
6
2023
entrez:
8
6
2023
Statut:
epublish
Résumé
Learning tools using virtual patients can be used to teach clinical reasoning (CR) skills and overcome limitations of using face-to-face methods. However, the adoption of new tools is often challenging. The aim of this study was to explore UK medical educators' perspectives of what influences the adoption of virtual patient learning tools to teach CR. A qualitative research study using semi-structured telephone interviews with medical educators in the UK with control over teaching materials of CR was conducted. The Consolidated Framework for Implementation Research (CFIR), commonly used in healthcare services implementation research was adapted to inform the analysis. Thematic analysis was used to analyse the data. Thirteen medical educators participated in the study. Three themes were identified from the data that influenced adoption: the wider context (outer setting); perceptions about the innovation; and the medical school (inner context). Participants' recognition of situations as opportunities or barriers related to their prior experiences of implementing online learning tools. For example, participants with experience of teaching using online tools viewed limited face-to-face placements as opportunities to introduce innovations using virtual patients. Beliefs that virtual patients may not mirror real-life consultations and perceptions of a lack of evidence for them could be barriers to adoption. Adoption was also influenced by the implementation climate of the setting, including positioning of CR in curricula; relationships between faculty, particularly where faculty were dispersed. By adapting an implementation framework for health services, we were able to identify features of educators, teaching processes and medical schools that may determine the adoption of teaching innovations using virtual patients. These include access to face-to-face teaching opportunities, positioning of clinical reasoning in the curriculum, relationship between educators and institutions and decision-making processes. Framing virtual patient learning tools as additional rather than as a replacement for face-to-face teaching could reduce resistance. Our adapted framework from healthcare implementation science may be useful in future studies of implementation in medical education.
Sections du résumé
BACKGROUND
BACKGROUND
Learning tools using virtual patients can be used to teach clinical reasoning (CR) skills and overcome limitations of using face-to-face methods. However, the adoption of new tools is often challenging. The aim of this study was to explore UK medical educators' perspectives of what influences the adoption of virtual patient learning tools to teach CR.
METHODS
METHODS
A qualitative research study using semi-structured telephone interviews with medical educators in the UK with control over teaching materials of CR was conducted. The Consolidated Framework for Implementation Research (CFIR), commonly used in healthcare services implementation research was adapted to inform the analysis. Thematic analysis was used to analyse the data.
RESULTS
RESULTS
Thirteen medical educators participated in the study. Three themes were identified from the data that influenced adoption: the wider context (outer setting); perceptions about the innovation; and the medical school (inner context). Participants' recognition of situations as opportunities or barriers related to their prior experiences of implementing online learning tools. For example, participants with experience of teaching using online tools viewed limited face-to-face placements as opportunities to introduce innovations using virtual patients. Beliefs that virtual patients may not mirror real-life consultations and perceptions of a lack of evidence for them could be barriers to adoption. Adoption was also influenced by the implementation climate of the setting, including positioning of CR in curricula; relationships between faculty, particularly where faculty were dispersed.
CONCLUSIONS
CONCLUSIONS
By adapting an implementation framework for health services, we were able to identify features of educators, teaching processes and medical schools that may determine the adoption of teaching innovations using virtual patients. These include access to face-to-face teaching opportunities, positioning of clinical reasoning in the curriculum, relationship between educators and institutions and decision-making processes. Framing virtual patient learning tools as additional rather than as a replacement for face-to-face teaching could reduce resistance. Our adapted framework from healthcare implementation science may be useful in future studies of implementation in medical education.
Identifiants
pubmed: 37291557
doi: 10.1186/s12909-023-04422-x
pii: 10.1186/s12909-023-04422-x
pmc: PMC10248983
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
424Subventions
Organisme : National Institute for Health Research (NIHR) Policy Research Programme
ID : PR-PRU-1217-21601
Organisme : National Institute for Health Research (NIHR) Policy Research Programme
ID : PR-PRU-1217-21601
Organisme : National Institute for Health Research (NIHR) Policy Research Programme
ID : PR-PRU-1217-21601
Organisme : National Institute for Health Research (NIHR) Policy Research Programme
ID : PR-PRU-1217-21601
Informations de copyright
© 2023. The Author(s).
Références
Acad Med. 2018 Sep;93(9):1415
pubmed: 29847325
Acad Med. 2018 Jul;93(7):990-995
pubmed: 29369086
Med Educ. 2010 Jan;44(1):50-63
pubmed: 20078756
Lancet Infect Dis. 2020 Jul;20(7):777-778
pubmed: 32213335
J Med Internet Res. 2021 Jun 4;23(6):e24723
pubmed: 34085940
Acad Med. 2010 Jul;85(7):1118-24
pubmed: 20603909
BMC Health Serv Res. 2019 Mar 25;19(1):189
pubmed: 30909897
Cureus. 2018 Dec 20;10(12):e3754
pubmed: 30820374
N Engl J Med. 2006 Nov 23;355(21):2217-25
pubmed: 17124019
Med Educ. 2015 Oct;49(10):961-73
pubmed: 26383068
BMC Med Educ. 2020 Jul 31;20(1):245
pubmed: 32736583
Med Educ Online. 2015 Apr 23;20:27003
pubmed: 25911282
JAMA Intern Med. 2013 Sep 23;173(17):1639-43
pubmed: 23857567
JAMA. 2020 Jun 2;323(21):2131-2132
pubmed: 32232420
Surg Today. 2017 Jul;47(7):777-782
pubmed: 28004190
Br J Gen Pract. 2015 Jun;65(635):e409-17
pubmed: 26009536
Implement Sci. 2015 Apr 21;10:53
pubmed: 25895742
Adv Physiol Educ. 2018 Mar 1;42(1):15-20
pubmed: 29341815
Med Teach. 2013 Oct;35(10):e1511-30
pubmed: 23941678
BMJ Simul Technol Enhanc Learn. 2020 Jul;6(4):241-242
pubmed: 32832102
BMC Med. 2020 Apr 9;18(1):100
pubmed: 32268900
J Gen Intern Med. 2021 Sep;36(9):2745-2754
pubmed: 34159542
Implement Sci. 2019 Apr 29;14(1):42
pubmed: 31036028
BMC Med Educ. 2015 Feb 01;15:11
pubmed: 25638167
Fam Pract. 2008 Dec;25(6):400-13
pubmed: 18842618
Can Med Educ J. 2023 Mar 21;14(1):58-62
pubmed: 36998494
Am J Community Psychol. 2008 Jun;41(3-4):327-50
pubmed: 18322790
BMC Med Educ. 2018 Sep 17;18(1):213
pubmed: 30223825
BMJ. 2020 Aug 27;370:m3358
pubmed: 32855150
Med Care Res Rev. 2007 Jun;64(3):235-78
pubmed: 17507458
BMC Med Educ. 2022 May 13;22(1):365
pubmed: 35550085
BMC Med Educ. 2020 Apr 7;20(1):107
pubmed: 32264895
Med Teach. 2021 Feb;43(2):152-159
pubmed: 33205693
Adm Policy Ment Health. 2011 Mar;38(2):65-76
pubmed: 20957426
Med Educ. 2016 Oct;50(10):986-91
pubmed: 27628715
Clin Teach. 2013 Oct;10(5):308-12
pubmed: 24015736
Med Educ. 2011 Jan;45(1):60-8
pubmed: 21155869
Health Res Policy Syst. 2017 Feb 23;15(1):15
pubmed: 28231801
Acad Med. 2010 Oct;85(10):1589-602
pubmed: 20703150