The project for the application of the Practicum Script Clinical Reasoning Simulator to medical students will be presented at the AMEE 2019 conference

The Practicum Script Clinical Reasoning Simulator project for medical students will be presented at the AMEE 2019 conference, which will take place in Vienna between August 24 and 28. The experiment, coordinated by the European Board of Medical Assessors, will consist of the simulation of 20 real clinical Internal Medicine cases during the upcoming academic year. Dr. Amir H. Sam, scientific director of EBMA and Head of Curriculum and Assessment at Imperial College London (ICL), will be in charge of the presentation of the abstract, which is co-authored by Drs. Eduardo Pleguezuelos, Carlos Collares, Eduardo Hornos, Adrian Freeman, and Cees Van der Vleuten, all of whom are members of the Practicum Institute (Madrid, Spain) and EBMA.

This multicenter pilot study aims to investigate the effectiveness of Practicum Script as a standardized educational resource integrated into the medical school curriculum to enhance clinical reasoning and problem-solving skills among senior medical students. In short, Practicum Script (http://www.practicumscript.education) is an online simulation-based program aimed at introducing the concept of uncertainty in decision making. The platform will be tested in more than 15 European medical schools (including ICL, Oxford, Sapienza [Rome], and Charité [Berlin], among others). Top medical schools in other countries, including Harvard (USA) and the University of São Paulo (Brazil), will also implement the tool.

With the editorial stage already finalized by a board at ICL, the cases are currently under revision by a panel of referees comprised by internists, and the next move will be the compilation of their answers as part of the feedback for the participants. Practicum Script presents challenges in dilemmatic contexts. For each clinical scenario, final year medical students will be asked to generate hypotheses and justify them by identifying pertinent positive and negative findings in the case. Subsequently, they will be required to report, in five different clinical scenarios, how new data may affect their original hypotheses. The students will be able to observe the agreement between their responses and those of the experts, along with literature-based clinical evidence. This tool allows users to self-assess clinical reasoning in real-life situations, boosting confidence in decision making.

The project is ongoing and the plan is to obtain psychometric results by the end of 2020. There is a strong need for effective approaches tailored to the development of clinical reasoning skills, and Practicum Script could contribute meaningfully to this goal. In fact, Practicum Script has been applied as a CPD/CME tool and in residency training for more than 10 years. Also, a recent research published in Medical Education concluded that “even when their beliefs remain unchanged, by knowing about controversies, the examinees may calibrate their certainty and apply more diverse thinking going forward”. The investigation, conducted by a group of researchers from the Practicum Foundation and the University of Illinois at Chicago, revealed the usefulness of this pedagogic model in medical education.

Both, the international project for medical students and the experts’ response process validity investigation, will be presented at the AMEE conference 2019 by the Practicum Foundation in two forms: a poster about the Practicum Script application project for medical students and a short communication about the article recently published in Medical Education about the script concordance test methodology. Check them all below:

“Piloting Practicum Script, a clinical reasoning simulator, in a multi-centre European study” is a project coordinated by the European Board of Medical Assessors (EBMA)

#5LL Posters – Clinical Reasoning & Decision Making
5LL01 (3383) Date of Presentation:  Monday, 26 August 2019. Time of Session:  1600-1730. Location of Presentation:  Hall/Foyer F, Level 0.

Piloting Practicum Script, a clinical reasoning simulator, in a multi-centre European study
AUTHOR(S):  Amir Sam, Imperial College London, UK (Presenter), Eduardo M Pleguezuelos, Practicum Institute of Applied Research in Health Sciences Education, Spain, Carlos Collares, Maastricht University, The Netherlands, Adrian Freeman, University of Exeter, UK, Eduardo Hornos, Practicum Institute of Applied Research in Health Sciences Education, Spain, Cees van der Vleuten, Maastricht University, The Netherlands.

#7I Short Communications – Assessment: Written and Progress Test
7I2 (1480) Date of Presentation:  Tuesday, August 27, 2019. Time of Presentation: 10:30-10:45. Location of Presentation:  Room L2, Level 1.

Experts’ responses in script concordance tests: A response process validity investigation
AUTHOR(S): Matthew Lineberry, University of Kansas Medical Center and Health System, USA (Presenter); Eduardo Hornos, Practicum Institute of Applied Research in Health Sciences Education, Spain; Eduardo Pleguezuelos, Practicum Institute of Applied Research in Health Sciences Education, Spain; Jose Mella, Practicum Institute of Applied Research in Health Sciences Education, Spain; Carlos Brailovsky, College of Family Physicians of Canada, Canada; Georges Bordage, University of Illinois at Chicago, USA