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Introduction
Definition of computer-based simulations
Rationale for using ClinicSoft
How ClinicSoft is used
Features/Advantages of ClinicSoft


Introduction

Changes in the healthcare industry have caused problems for many medical education institutions in trying to provide satisfactory educational resources for training students.  The time patients spend in hospitals is decreasing, the gamut of patient encounters is narrowing, and clinicians are spending less time in education initiatives.  This can lead to less opportunities for students to gain knowledge and skills.  ClinicSoft patient simulations offer students the opportunity to increase their knowledge and problem solving skills in a clinical scenario.

What is a computer-based patient simulation?

Computer-based patient simulations are situational experiences that present problem conditions close to real life.  They are used to reinforce principles and practices that are essential to a trade or profession.  In order to be effective, computer based simulations must have four essentials: 1) attempt to imitate life, not duplicate; 2) provide maximum opportunity for the participant to do wrong (and provide effective feedback when necessary); 3) allow participants responses and choices to produce life like consequences 4) provide potentially dangerous situations.  In addition to these, the conditions and participant involvement must pick up where text books leave off.  Participants must be allowed to explore situations of danger, but without the complex and potential life threatening consequences.

Why use a computer-based patient simulation?

Modern simulations allow participants to practice the skills they know, and to establish and practice what they don't know, regardless of the setting, or lack thereof.  Simulations also offer participants exposure to a wide variety of diseases that they may not encounter in a clinical experience and are especially valuable when patient availability is reduced.  Finally, evaluation, assessment, and certification can be accomplished through simulations.

How are computer-based patient simulations being used at medical institutions?

ClinicSoft patient simulations are being implemented within clerkship programs in order to supplement student knowledge.  At one institution, students on a three-week Nephrology ambulatory rotation start a case in the beginning of the week.  While working through a case, participants identify a learning issue and then research and write up a short synopsis week for case "wrap-up" session at the end of the week.

ClinicSoft patient simulations can also be implemented within case-based learning (CBL) small groups.  Group members can work through case in a controlled environment where a facilitator can use "progressive disclosure" of information.  The group can work through history in session, physical exam in another, lab section later, and so forth.

ClinicSoft patient simulations can be used on CD-ROM for in situations where participants are located beyond the institution.  All participant information can be stored on a floppy disk and then handed in when complete.

ClinicSoft Features/Advantages

• ClinicSoft simulates a patient encounter while assisting the student to state the problem correctly, interview and examine the patient, interpret data, formulate and revise competing hypotheses, diagnose and prescribe accurate therapy.
• ClinicSoft assists faculty in evaluating students' clinical reasoning skills in situations where real or simulated patients are not available.  Students can practice patient encounters across a broad range of medical problems.
• A student's diagnostic reasoning ability can be measured through ClinicSoft's assessment algorithm.
• Group statistics are generated for easy viewing of performance across one or many cases.
• ClinicSoft utilizes a medical natural language knowledge base.  This knowledge base minimizes student "cueing" while allowing truly interactive encounters.
• Students use a realistic form to order diagnostic tests that includes complete cost tracking.
• Special procedures (surgery, etc.) and consults can be introduced.
• A high level of realism is achieved via the use of multimedia (video, audio, images, and animation).
• The versatility of ClinicSoft allows development of simulations that can be used for independent self-directed learning, group interaction, assessment purposes, or a combination thereof.
• ClinicSoft can emulate a problem-based learning environment to assist students in becoming active, independent learners and problem solvers.
• ClinicSoft cases can be geared toward multiple learning levels.  ClinicSoft patient simulations can be adapted for multiple learning levels and can therefore be implemented throughout a medical curriculum, residency program, or continuing education.
• ClinicSoft cases cover a variety of fields. ClinicSoft patient simulations can be generated for just about any medical field of study.
• The cases are highly interactive and involving. ClinicSoft is conversational, event driven, and engaging.
• The structure of a case allows for self-pacing. One can learn as they go, and go as quick or as slow as they like.
• Use of these cases foster independence and increased access for participants.  Interactive system like ClinicSoft can provide greater and more equal access to a quality education program that cannot be offered in a textbook or scheduled training time.
• Use of these cases also lead to increased participant motivation and attention.  Interactive systems like ClinicSoft provide feedback and require individual involvement that has proven to be highly motivating.
• A student is assured of privacy and constructive feedback as he or she moves through a case. With ClinicSoft, a student is free to ask questions and explore areas that might otherwise cause embarrassment in group situations.