A penny for your thoughts!

BADGER (Browser-based Assessment of Decision-making skills using virtual patients (VPs) Generated by Expert peer-Review) is the latest tongue-twisting addition to the BDRA Media Zoo (www.le.ac.uk/badger).

Virtual Ward is a software which facilitates the creation of virtual patients using web-based simulation. The software has been developed by the University Hospitals of Leicester NHS Trust, East Midlands Healthcare Workforce Deanery and OCB Media. A collaboration with the Beyond Distance Research Alliance has culminated in the BADGER project.

The decision making skills of medical students at Leicester is being explored using the Virtual Ward software. The project aims to characterise how students and health care professional learn using VPs created by web-based simulation. The project is in its infancy and more information about the findings will be reported in the coming weeks.

Ronald Harden coined the term ‘medicide’ to describe the systematic killing of the love of medicine and work as a doctor in his last blog on MedWorld (http://goo.gl/1FIj0). He read a recently published book ‘Readicide’ which described the systematic killing of the love of reading, often by mind numbing practices found in schools.

My observations lead me to believe there is an element of truth in his proposal. I entered the hospital ward last week and began my ward round with my junior doctors. I was joined by two medical students, who seemed more preoccupied with last night’s events, than learning from the round. I received little attention from the students despite making deliberate eye contact and inviting questions from them.

I took a new approach to teaching clinical medicine after reading Harden’s blog post, and with the BADGER project in mind. I keep an electronic stethoscope and netbook in the hospital to collect multimedia for the VP cases. I replaced my usual stethoscope with the electric version for my last ward round.

A swarm of medical students gathered around my recording equipment after I found patients willing to contribute their sounds for the BADGER project. Seizing this moment of enthusiasm, I turned the student interest into a teaching exercise.

The Foundation Year doctors and I entered individual cubicles after gaining consent from three patients willing to be examined for teaching purposes. The students listened to the heart and breath sounds from three patients in turn. They submitted their findings to us, before receiving feedback on their answers and examination findings. The sounds were recorded for use during the feedback. The sounds would also be used for formative assessment over the coming days.

The students seemed to enjoy the experience. Repeatedly challenging them with sounds captured by multimedia may help in the development of clinical skills. The students can repeatedly listen and learn from sounds, which they may otherwise have only listened on one occasion. The sounds can now be shared with other students to increase the learning experience of the entire cohort on the rotation.

Cees van der Vleuten has described the need for an assessment programme based on a systems approach (1). He advocates assessment for learning and not of learning. Anecdotal evidence during the feedback session for this teaching suggest students prefer such an approach to learning and assessment.

The perception of ‘medicide’ appears to be present amongst Foundation Doctors and medical students. Technology could help to minimise this belief, improve the attitude of students towards assessment, but perhaps most importantly, potentially minimise the intrusion upon our patients made by teaching.

Dr Rakesh Patel

Principal investigator and case editor on BADGER
Specialist Registrar in Nephrology/Honorary Clinical Education Fellow
Department of Nephrology
Leicester General Hospital

1 Dijkstra J. Van der Vleuten CP. Schuwirth LW. ‘Advances in Health Sciences Education 2010’; 15(3):379-93

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1 Comment

  1. Ali Ewing

     /  February 1, 2011

    It is concerning that medical students are alredy experiencing ‘medicide’ yet I do think there is a real challenge to educators especially in traditional health settings to engage with different approaches to learning.

    If we can engage in assessment as a positive activity and they make the link between what they are doing and meeting learning outcomes I think this is a win win situation for educators and learners.


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