Training of clinical reasoning with a Serious Game versus small-group problem-based learning: A prospective study

• Published in: PloS one 2018-09, Vol.13 (9), p.e0203851-e0203851
• Main Authors: Middeke, Angélina, Anders, Sven, Schuelper, Madita, Raupach, Tobias, Schuelper, Nikolai
• Format: Article
• Language: English
• Subjects: Analysis; Asthma; Biology and Life Sciences; Cognition & reasoning; College students; Computer & video games; Curriculum development; Education; Educational psychology; Educational software; Emergency medical services; Games; Health education; Hematology; Knowledge acquisition; Learning; Legal medicine; Medical education; Medical students; Medicine and Health Sciences; Methods; Patients; Pattern recognition; People and Places; Planning; Problem based learning; Reasoning; Social Sciences; Students; Teaching; Technology application; Therapeutic applications; Training
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0203851

Serious Games are increasingly being used in undergraduate medical education. They are usually intended to enhance learning with a focus on knowledge acquisition and skills development. According to the current literature, few studies have assessed their effectiveness regarding clinical reasoning (CR). The aim of this prospective study was to compare a Serious Game, the virtual Accident & Emergency department 'EMERGE' to small-group problem-based learning (PBL) regarding student learning outcome on clinical reasoning in the short term. A total of 112 final-year medical students self-selected to participate in ten 90-minute sessions of either small-group PBL or playing EMERGE. CR was assessed in a formative examination consisting of six key feature cases and a final 45-minute EMERGE session. Overall, the EMERGE group (n = 78) scored significantly higher than the PBL group (n = 34) in the key feature examination (62.5 (IQR: 17.7)% vs. 54.2 (IQR: 21.9)%; p = 0.015). There was no significant difference in performance levels between groups regarding those cases which had been discussed in both instructional formats during the training phase. In the final EMERGE session, the EMERGE group achieved significantly better results than the PBL group in all four cases regarding the total score as well as in three of four cases regarding the final diagnosis and the correct therapeutic interventions. EMERGE can be used effectively for CR training in undergraduate medical education. The difference in key feature exam scores was driven by additional exposure to more cases in EMERGE compared to PBL despite identical learning time in both instructional formats. EMERGE is a potential alternative to intensive small-group teaching. Further work is needed to establish how Serious Games enhance CR most effectively.