International Journal of Healthcare Simulation

Background:

The COVID-19 pandemic has necessitated a transition from traditional face-to-face teaching to virtual equivalents, sometimes at the expense of teaching quality and student engagement ^[1]. Knowledge and a practical understanding of the management of an acutely unwell patient are essential for safe and effective clinical practice. This involves problem-solving, situational awareness and the ability to deal with uncertainty. To demonstrate these skills virtually, we developed an online, gamified interactive video simulation exemplifying the management of an acutely unwell patient. The simulation was tailored to prospective medical students in secondary school during a virtual work-experience programme. We propose that this approach is potentially translatable across the healthcare profession at both undergraduate and post-graduate levels, thus allowing for teaching to be more engaging, participant-led, and accessible.

Aims:

Our aim was to demonstrate the feasibility of a novel gamified online simulation approach to teaching the management of acutely unwell patients.

Method/design:

Using elements of gamification and interactive film, this virtual session was designed to teach prospective medical students the ‘A to E’ approach of managing an acutely unwell patient. The management of an acutely unwell patient is an iterative and dynamic process that requires one to manage uncertainty and constantly re-evaluate the clinical situation. The session was designed using interactive film, with students given the ability to influence a clinician’s actions and subsequent changes of clinical scenario dictated by student live-vote. This interactive and engaging approach allowed students to reflect-in-action and be active learners, in line with an experiential pedagogy ^[2].

Implementation:

Students attended a live session using a video conferencing service (Zoom) and their responses to clinical scenarios were recorded using an online voting tool (Mentimeter). Students were provided with a case history of an unwell patient and presented with an opening video. The session required video options to be pre-recorded to reflect the numerous potential avenues within the scenario as dictated by the students’ chosen actions. Depending on overall student voting consensus, pre-recorded videos of the clinician’s actions and changes to the clinical scenario were subsequently shown. For example, if the appropriate clinical action was selected, students would progress through the A-E approach. Students effectively guided the clinician to manage the unwell patient, with iterative and real-time feedback provided throughout the scenario. The session was concluded with a debrief, explanation of the case and key learning points.