May 4, 2012 8:00 AM – 9:30am
Manon M Schladen EdS, MedStar Health Research Institute
Cynthia Pineda, MD FAAPMR, National Rehabilitation Hospital
Brenda Tsai, BS, MedStar Health Research Institute
Miriam Philmon, BS, MedStar Health Research Institute
Standardized patients and mannequin simulators allow learners to practice clinical skills in naturalistic patient care contexts. Face-to-face simulations, however, are also extremely time and resource intensive. Further, the degree of realism provided may be extraneous to the development of certain competencies, for example, clinical reasoning. Virtual patients, purely electronic simulations, may in certain situations be preferable to less agile, face-to-face simulation strategies. Using a case study approach, we analyzed learner activity in a hybrid, standardized patient/mannequin simulator learning module designed to teach PGY-2 residents how to diagnose and manage autonomic dysreflexia (AD), a potentially life-threatening condition in persons with spinal cord injuries. We decomposed residents' activities in the hybrid module into a hierarchy of clinical tasks and rated them as essential or nonessential to the module's specific objective, learning to diagnose and manage AD. The hierarchy of essential tasks served as the basis for re-authoring the hybrid module into a branching virtual patient exposing the learner, as did the hybrid module, to the three principal causes of AD and their successful resolution. We describe the process of translating the face-to-face AD simulation module to a virtual patient and formative review of the new AD virtual patient by residents who had previously experienced the hybrid learning module.