背景:学习的游戏化增加了学生的享受,以及学习任务的动机和参与度。这项研究调查了使用决策卡(DMC)进行游戏化对案例场景的诊断决策和成本的影响。
方法:30名临床实习医学生参加,随机分为14个小组,每组2-3名医学生。使用DMC将决策游戏化,并将临床信息标题和医疗费用放在首位,和背面的临床信息细节。首先,向每个团队提供了关于病例情景的简短临床信息.随后,根据情况将DMC分发给每个团队,团队成员一次选择一张卡片,直到他们对病例进行诊断。然后根据抽取的卡片的数量和内容对总医疗费用进行评分。进行了四种情况。定量结果包括对有效临床决策的信心,学习诊断决策的动机,在我们的游戏化之前和之后,通过使用7点Likert量表进行自我评估来衡量对医疗费用的认识。定性部分包括对使用DMC学习临床推理的益处的内容分析。
结果:对有效临床决策的信心,学习诊断决策的动机,游戏化后,对医疗成本的认识明显更高。此外,将最后解决的临床病例方案与首先解决的临床病例方案进行比较,学生提取的所有卡的平均医疗费用从11,921日元大幅下降至8,895日元。在内容分析中,提取了与临床推理成分相对应的七个优势类别的DMC(信息收集,假设生成,问题表示,鉴别诊断,领导或工作诊断,诊断理由,以及管理和治疗)。
结论:使用DMC教授医学生临床推理可以提高临床决策信心和学习动机,并在临床病例中降低医疗成本。此外,它可以帮助学生获得实践知识,加深了他们对临床推理的理解,并确定了几种重要的临床推理技能,包括诊断决策和对医疗成本的认识。使用DMC的游戏化是一种有效的教学方法,可以改善医学生的诊断决策并降低成本。
BACKGROUND: The gamification of learning increases student enjoyment, and motivation and engagement in learning tasks. This
study investigated the effects of gamification using decision-making cards (DMCs) on diagnostic decision-making and cost using case scenarios.
METHODS: Thirty medical students in clinical clerkship participated and were randomly assigned to 14 small groups of 2-3 medical students each. Decision-making was gamified using DMCs with a clinical information heading and medical cost on the front, and clinical information details on the back. First, each team was provided with brief clinical information on case scenarios. Subsequently, DMCs depending on the case were distributed to each team, and team members chose cards one at a time until they reached a diagnosis of the case. The total medical cost was then scored based on the number and contents of cards drawn. Four case scenarios were conducted. The quantitative outcomes including confidence in effective clinical decision-making, motivation to learn diagnostic decision-making, and awareness of medical costs were measured before and after our gamification by self-evaluation using a 7-point Likert scale. The qualitative component consisted of a content analysis on the benefits of learning clinical reasoning using DMCs.
RESULTS: Confidence in effective clinical decision-making, motivation to learn diagnostic decision-making, and awareness of medical cost were significantly higher after the gamification. Furthermore, comparing the clinical case scenario tackled last with the one tackled first, the average medical cost of all cards drawn by students decreased significantly from 11,921 to 8,895 Japanese yen. In the content analysis, seven advantage categories of DMCs corresponding to clinical reasoning components were extracted (information gathering, hypothesis generation, problem representation, differential diagnosis, leading or working diagnosis, diagnostic justification, and management and treatment).
CONCLUSIONS: Teaching medical students clinical reasoning using DMCs can improve clinical decision-making confidence and learning motivation, and reduces medical cost in clinical case scenarios. In addition, it can help students to acquire practical knowledge, deepens their understanding of clinical reasoning, and identifies several important clinical reasoning skills including diagnostic decision-making and awareness of medical costs. Gamification using DMCs can be an effective teaching method for improving medical students\' diagnostic decision-making and reducing costs.