Development and Assessment of a Web-Based Patient Simulation Program

Background and Purpose. The development of clinical-reasoning skills is dependant on substantial exposure to realistic patient experiences. Academic programs are constrained by several factors, including the the amount of time they can expose students to real patient cases. Typically, text cases and standardized patient experiences are used to increase student exposure; however, both of these methods have limitations. Computer-simulated patients may be an alternative or supplemental pedagogy that can be used to expose students to realistic patient cases with greater frequency. Method/Model Description and Evaluation. Existing computer-simulated cases used to teach clinical reasoning to medical studients were modified to include the Guide to Physical Therapist Practice to add examination and interventions used by physical therapists. First, 5 faculty and second-year students performed a usability analysis. Second, they conducted a feasibility study to determine if the software could be integrated into a specific class. Third, a pilot study was conducted that compared the effectiveness and efficiency of the a Web-based simulation compared to a traditional small-group discussion. Outcomes for the pilot study included the health science reasoning test (HSRT) and implementation costs. Outcomes. The outcome of this project was the design and testing of a computerized patient simulation program that can be used to teach clinical reasoning to physical therapy students. Discussion and Conclusion. Existing clinical-reasoning software was modified for use by physical therapist students. Incorporating software into a physcial therapy class was proved to be feasible. When compared to a traditional teaching group, the Web-based simulated group had signficant improvements in some aspects of clinical reasoning and cost less to implement. However, the software requires further changes for greater congruency with physical therapist clinical reasoning. Additionally, questions of dosing and integration into a physical therapist education curriculum rather than a discrete class need to be addressed.