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J Surg Educ. 2016 Jul-Aug;73(4):559-66. doi: 10.1016/j.jsurg.2016.02.008. Epub 2016 Apr 30.

A Learner-Created Virtual Patient Curriculum for Surgical Residents: Successes and Failures.

Author information

1
Division of General Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada. Electronic address: katherine.mckendy@mail.mcgill.ca.
2
McGill Molson Medical Informatics, Montreal, Quebec, Canada; McGill University, Montreal, Quebec, Canada.
3
Division of General Surgery, McGill University Health Centre, Montreal, Quebec, Canada; McGill Molson Medical Informatics, Montreal, Quebec, Canada; McGill Molson Medical Informatics, Montreal, Quebec, Canada.
4
Division of General Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada.

Abstract

OBJECTIVE:

To determine the feasibility and effectiveness of a learner-created virtual patient (VP) curriculum for postgraduate year 2 surgical residents.

DESIGN:

Using a social-constructivist model of learning, we designed a learner-created VP curriculum to help postgraduate year 2 residents prepare for their in-training surgical examination. Each resident was assigned to create a VP curriculum based on the learning objectives for this examination, and VP cases were then disseminated to all residents for completion. To measure the learning effects of the curriculum, participants completed 2 simulated in-training examinations, both at the beginning and at the end of the intervention. Study participants also participated in a focus group and completed an online questionnaire about the perceived learning value of the curriculum.

SETTING:

The study was conducted at the McGill University Health Centre, a tertiary care hospital in Montreal, Canada.

PARTICIPANTS:

In total, 24 residents from 7 surgical specialties completed both the pretest and posttest, as well as took part in the creation of a VP curriculum. Of those 24 residents, only 19 residents completed the cases created by their peers, with 7 completing greater than 50% of the cases and 12 completing less than 50%. In all 17 residents responded to the online questionnaire and 11 residents participated in the focus group.

RESULTS:

The VP curriculum failed to improve scores from pretest (59.6%, standard deviation = 8.1) to posttest (55.4%, standard deviation = 6.6; p = 0.01) on the simulated in-training examination. Nonetheless, survey results demonstrated that most residents felt that creating a VP case (89%) and completing cases created by their peers (71%) had educational value. Overall, 71% preferred active participation in a curriculum to traditional didactic teaching. The focus group identified time-related constraints, concern about the quality of the peer-created cases, and questioning of the relationship between the curriculum and the Surgical Foundations examination as barriers to the success of the curriculum.

CONCLUSIONS:

Despite the fact that a learner-created VP curriculum did not improve scores on a mock in training examination, residents viewed this intervention as a valuable educational experience. Although there were barriers to the implementation of a learner-created curriculum, it is nonetheless important to try and integrate pedagogical concepts into the instructional design of curricula for surgical residents.

KEYWORDS:

Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; active learning; constructivism; curriculum design; surgical education; virtual patients

PMID:
27142719
DOI:
10.1016/j.jsurg.2016.02.008
[Indexed for MEDLINE]

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