Shadow Health Recommended Use Case. Spring 2016

Transcription

1 Shadow Health Recommended Use Case Spring 2016

2 Purpose Statement The goal of this project is to identify the most effective integration strategy for Shadow Health Digital Clinical Experiences, as supported by current research. The goal of this project is not to restrict the range of choices an instructor can make when integrating a Shadow Health simulation. However it is intended that, as a result of this use case, we restrict the range of options we suggest to faculty in our prepared training materials and support literature.

3 Present Solutions With the validation of the Shadow Health clinical reasoning framework, and introduction of the subsequent Student Performance Index, instructors have an overall score, and a contextualized DCE score, from a set of valid and reliable instruments that they can use for assessment and grading purposes.* Current research also documents the most effective ways to use virtual patient simulations in health professions curriculum. This has allowed for the development of a Shadow Health Recommended Use Case. *However, it should be noted that documentation and self-reflection are currently not scored (and self-reflection never should be), although they are part of the Shadow Health Clinical Reasoning Framework.

4 Creation of the Recommended Use Case The Instructional Design team examined peer-reviewed literature for documented best practices with virtual patients in health professions education, in order to craft an evidence-based integration strategy that highlights benefits of virtual patient simulations, the unique value of the Digital Clinical Experience, and the effectiveness of the Student Performance Index.

5 Literature Review A summary of best integration practices is included in the Recommended Use Case document. The results of this research included: The value of using virtual patients includes critical self-reflection, validated skills development and assessment, and the development of clinical reasoning, clinical decision-making, plan-making, and communication skills, through deliberate practice and repetition of skills within an active learning framework

6 Literature Review (cont.) The learning framework should consist of self-paced formative experiences within in-depth patient cases with a narrative focus, flexible learning with multiple solutions, context for situated cognition, transparency of performance and assessment, multiple scenarios, and the promotion of questioning and rationales The virtual patient assignments themselves should include a pre-brief, initial motivation (e.g., framing from faculty, video with emergency case scenarios), data collection, question-asking, written rationales, practice with prioritization, and instant feedback

7 Introduction of Recommended Use Case After reviewing the research, one evidence-based use case emerged. However, based on current faculty practices, the recommended use case was also altered to produce two modified versions for lab pass and flipped classroom models. The recommended use case is intended for: Health Assessment / Advanced Health Assessment products Theory / Lab curricula Face-to-Face / Online delivery BSN / RN-BSN / All graduate levels Modified Cases Lab Pass Flipped Classroom

8 The Shadow Health Recommended Use Case Faculty provide an introduction to Shadow Health for their students Expectations of performance Grading (e.g., academic weight) Value SH assignments are sequenced After didactic activities Before lab or clinical practicum Correspond to skill-specific content throughout semester (e.g., SH HEENT assignment be assigned in HEENT unit)

9 Recommended Use Case (cont.) SH assignments are used as formative assessment (a formative assessment being defined as assessment of content knowledge and performance informing teaching and student progress in contrast to summative which evaluates outcomes for external accountability) One submission No reopening (unless remediation needed) No findings filtered Focused exams should be used for deliberate practice after their respective system assignments (e.g., Cough Focused Exam with Danny Rivera after Respiratory with Tina Jones) Alternative possible use: All focused exams are used as summative assessment at the end of the semester Comprehensive Assessment is not used Not time-limited

10 Recommended Use Case (cont.) Self-reflection prompts are used With the exception of Hallway, post-exam activities are optional and not encouraged Each assigned simulation is graded Based on normalized score Not pass/fail Documentation is not generally recommended as a graded component Self-reflection should be assessed and commented on, but not graded Instructor feedback should be provided as coaching and remediation both within the SH system, and in class / lab discussions Physical Examination Plus is used for all levels above ADN Information Processing is used SOAP documentation is used by grad until IP is added to all assignments

11 Recommended Use Case: Additional Notes If time is an issue for courses, some modules may be substituted by the focused exams, and post-exam activities except self-reflection be hidden, but findings would not be filtered The time spent in SH virtual patient simulations supports, but does not replace some high fidelity / task trainer simulations

12 Recommended Use Case: Modified Cases Lab Pass Allow reopening to achieve performance expectations Not graded Flipped Classroom Percentage attained or time expectations met earns a Pass Sequenced after didactic activities Textbook content or video lecture Allow reopening to achieve percentage expectations Not graded Percentage attained or time expectations met earns a Pass

13 References Cook, D. A., & Triola, M. M. (2009). Virtual patients: A critical literature review and proposed next steps. Medical Education, 43(4), Forneris, S. G. (2014). Virtual Simulations Piloted. Nursing education perspectives, 35(5), 348. Foronda, C., Liu, S., & Bauman, E. B. (2013). Evaluation of simulation in undergraduate nurse education: An integrative review. Clinical Simulation in Nursing, 9(10), Forsberg, E., Ziegert, K., Hult, H., & Fors, U. (2014). Clinical reasoning in nursing, a think-aloud study using virtual patients A base for an innovative assessment. Nursing Education Today, 34, Georg, C., & Zary, N. (2014). Web-based virtual patients in nursing education: development and validation of theory-anchored design and activity models. Journal of medical Internet research, 16(4). Guise, V., Chambers, M., & Valimaki, M. (2012). What can virtual patient simulation offer mental health nursing education. Journal of Psychiatric Mental Health Nursing, 19,

14 References (cont.) Josephsen, J., & Butt, A. (2014). Virtual multipatient simulation: A case study. Clinical Simulation in Nursing, 10(5), e235-e240. Kalisch, B. J., Aebersold, M., McLaughlin, M., Tschannen, D., & Lane, S. (2014). An intervention to improve nursing teamwork using virtual simulation. Western journal of nursing research, 37(2), Kelley, C. G. (2014). Using a virtual patient in an advanced assessment course. Journal of Nursing Education, 54(4), Kleinheksel, A. J. (2015). Transformative learning through virtual patient simulations: Predicting critical student reflections. Clinical Simulation in Nursing, 10(6), Liaw, S. Y., Wong, L. F., Chan, S. W. C., Ho, J. T. Y., Mordiffi, S. Z., Ang, S. B. L.,... & Ang, E. N. K. (2015). Designing and Evaluating an Interactive Multimedia Web-Based Simulation for Developing Nurses Competencies in Acute Nursing Care: Randomized Controlled Trial. Journal of medical Internet research, 17(1). McCallum, J., Ness, V., Price, T. (2011). Exploring nursing students' decision-making skills whilst in a second life clinical simulation laboratory. Nurse Education Today, 31(7),

15 References (cont.) Oermann, M. H. (2015). Technology and Teaching Innovations in Nursing Education: Engaging the Student. Nurse educator, 40(2), Seropian, M. A., Kimberly Brown, M. S. N., Gavilanes, J. S., & Bonnie Driggers, M. S. (2004). Simulation: not just a manikin. Journal of Nursing Education, 43(4), Sportsman, Puetz, & Billings (2008). The evolution of simulation and its contribution to competency. The Journal of Continuing Education in Nursing, 39(2), 74. Sweigart, L., Burden, M., Carlton, K. H., & Fillwalk, J. (2014). Virtual simulations across curriculum prepare nursing students for patient interviews. Clinical Simulation in Nursing, 10(3), e139-e145. Tilton, K. J., Tiffany, J., & Hoglund, B. A. (2015). Non-Acute-Care Virtual Simulation: Preparing Students to Provide Chronic Illness Care. Nursing education perspectives, 36(6),