MONDAY 27TH AUGUST 2018 - AMEE

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MONDAY 27TH AUGUST 2018
                                                                 Reflecting on practice provides meaningful learning; -
4CC: ePosters: Engaging with                                     Prepared learning environment, with instrumental
Learning - game-based, problem-                                  materials for the intervention, facilitates transformations
                                                                 in the work processes; It is crucial that students provide
based & practice-based                                           examples of good practice by disseminating them in their
Location: Kairo 2, Ground Floor, CCB                             services and municipalities.
Date: Monday 27th August
Time: 1400-1530 hrs                                              4CC2 (1736)
                                                                 Using the “Flash Teaching” Model for Prevention of Facial
4CC1 (2363)                                                      Pressure Injuries during Nursing Training and Education
Pedagogical Approach of the Family Health Specialization
Course of the Federal University of Pelotas, Brazil
                                                                 Authors
                                                                 Ching-Uen Huang
Authors                                                          Shun-Cheng Chang
Anaclaudia Gastal Fassa, Federal University of Pelotas,          Fu-Yu Wang
Pelotas, Brazil
Maria Elizabeth Gastal Fassa, Federal University of Pelotas,
                                                                 Presenter: Ching-Uen Huang, Taipei Medical University
Pelotas, Brazil
                                                                 Shuang-Ho Hospital, New Taipei City, Taiwan
Elaine Tomasi, Federal University of Pelotas, Pelotas, Brazil
Luiz Augusto Facchini, Federal University of Pelotas, Pelotas,
                                                                 Background: Facial pressure injury (FPI) is a common and
Brazil
                                                                 difficult clinical problem, especially in chronic and long
                                                                 term patients. Effective protection education is an
Presenter: Anaclaudia Fassa, Federal University of Pelotas,      indispensable part of nursing staff's pressure injury
Brazil                                                           prevention implementation measures. Using 〝Flash
                                                                 teaching〞model to improve the shortcoming of
Background: The strong expansion of the family health
                                                                 traditional teaching method. Clinical staff may memorize
strategy teams in Brazil led to the creation of the Open
                                                                 key points in short period of time, which helps them to
University of SUS, constituted by Public Universities, to
                                                                 implement the use of clinical protection, and reduce the
offer the Specialization Course in Family Health on a large
                                                                 severity of FPI.
scale. The course of the Federal University of Pelotas
                                                                 In the past, due to shift work, hospitals or wards need to
aimed at training the family health professionals of the
                                                                 gather nursing staff for continuous education, which is
SUS, promoting the capacity of management and
                                                                 difficult in practice and the outcomes, promotion and
organization of primary health care services (PHC), the
                                                                 implementation respectively, from the education is often
institutionalization of health monitoring and evaluation,
                                                                 poor. “Flash teaching” is a method, which key teaching
citizenship and social participation and the qualification of
                                                                 points are made into pictures, by using these pictures,
clinical practice
                                                                 learners memories are enhanced. Teachers go to wards,
The course is structured around an intervention in the
                                                                 give a 15-minute teach section between shift-change.
service, focusing on the improvement of the work process
                                                                 Teaching materials are transferred into PDF, uploaded to
and clinical practice. Based on the strategic planning, the
                                                                 intranet on each ward for reminder learning. Furthermore,
student identifies the problems of his health unit, prepares
                                                                 training seed staff in each ward to perform Flash Teaching
an intervention project on a programmatic action typical
                                                                 regularly can reinforce the memories.
of PHC, develops the intervention and evaluates it. The
                                                                 “Flash Teaching” was held on wards which needed to face
course requires only one face-to-face meeting for the
                                                                 FPI on daily practice, there were total 213 staff and seed
presentation of the final paper and the activities are
                                                                 staff trained. The average pre-education test score was 65,
asynchronous, valuing the distance learning strategy, the
                                                                 the post score was 90, the average satisfactory score was
professional's link with the service and promoting
                                                                 4.65. The FPI incidence (2013-2015) dropped from 5.1% to
reflection on the practice.
                                                                 2.9%, the injury severity also improved from Grade 3 to 1.
2300 health professionals were trained over a 5-year
                                                                 Teaching method has great impact on learning outcome.
period throughout Brazil. Collective health materials for
                                                                 Through innovative “Flash Teaching”, the traditional
intervention were developed as questionnaires for
                                                                 group teaching was embarrassed, the new method not
situational analysis; sheets with aims, goals, indicators and
                                                                 only utilizes limited time period but also gives nursing staff
actions for the planning of interventions; clinical forms and
                                                                 clear images; seed staff have provided consistent clinical
automated spreadsheets for individual and population
                                                                 teaching and assistance, FPI incidence and severity have
monitoring and interactive clinical cases. The interaction
                                                                 been reduced effectively.
with the colleagues and the personalized attention of the
                                                                 Understanding the basic problems and difficulties; with
supervisor made possible the deepening of the themes
                                                                 imagination, teaching is unrestricted by time and space,
and the exchange of experiences. The materials provided
                                                                 yet it is innovative and effective.
great autonomy for the student.
This pedagogical approach focused on the training of the
professional through the transformation of the service,
improving the quality of attention and, in many situations,
spreading the ideas to the team and even other health
services of the municipality.

 AMEE 2018 ABSTRACT BOOK                                                                                                  1
MONDAY 27TH AUGUST 2018
4CC3 (2457)                                                     4CC4 (1149)
Photo Challenge: An Educational Innovation to Stimulate         Pedagotchi 2.0 – a playful learning concept to train
Effective Learning in Ophthalmology                             clinical decision making

Authors                                                         Authors
Sakchai Vongkittirux, Thammasat University, Pathum Thani,       Lorenz Grigull, Medical University Hannover, Germany
Thailand                                                        Urs Mücke, Medical University Hannover, Germany
Tayakorn Kupakanjana, Thammasat University, Pathum              Ralf Schmidt, gamespired, Uplengen, Germany
Thani, Thailand
Picha Thunpimon, Thammasat University, Pathum Thani,            Presenter: Lorenz Grigull, Medical University, Hannover,
Thailand                                                        Germany

Presenter: Sakchai Vongkittirux, Department of                  Background: Children learn whilst playing. For adults,
Ophthalmology, Faculty of Medicine, Thammasat                   work and play have been segregated. Recently, the terms
University, Pathum Thani, Thailand                              playful learning or serious gaming (SG) have been
                                                                introduced. Both describe forms of learning with games or
Background: The learning process in Ophthalmology               by concepts derived from the game world. In medical
emphasizes visual disease manifestations, which can be          education, SG is not very common yet despite its potential
traced to aspects such as epidemiology, pathophysiology,        to provide engaging learning experiences. To train the
clinical manifestations and management. However,                important clinical decision making we developed a SG for
contemporary teaching methods of lecturing are often            medical students embedded in a blended learning
insufficient for facilitating learning. Additionally,           concept.
instructors find it difficult to evaluate the knowledge and     After focus group discussions we scripted the screenplay
understanding of students after lectures.                       for the game. For students, a game should increase
To stimulate effective learning, Ophthalmology residents        knowledge, competence, and include challenges. Besides,
from the Faculty of Medicine, Thammasat University,             rewards and feedback should be provided. From the
invented an activity called Photo Challenge. Fifteen            educator point of view the system should be easy-to
residents from three years of training were randomized          manage, technically flexible and open for a range of
and divided into five groups to compete in a quiz and           medical subspecialties. Likewise, master-characters for
discuss different aspects of the disease depicted in the        patients (various age-groups and diseases) were created
photo. Qualified ophthalmologist instructors score the          and an excel-based platform for authors developed. The
team’s performance on quality and completion of                 game was settled in the emergency department. On
discussion and provide feedback on the conformity,              smartphones or tablets students chose a case, explore the
rationale and omissions of the discussion as a team.            past medical history, perform a clinical exam and order
Ophthalmology residents participating in Photo Challenges       blood tests, sonography or X-ray. Finally, the student (-
favored the activity and benefited from engaging in the         player) is requested to word a diagnosis and possible
learning experiences as well as being given opportunities       differentials before deciding upon the clinical placement,
to practice clinical thinking processes by verbally             e.g. hospital admission or ambulatory care.
approaching the clinical diagnosis from important findings      Despite broad knowledge base, many students express
and management of the disease. Instructors are able to          difficulties to judge clinically upon a scenario. Therefore,
assess their students’ degree of success in learning            they appreciate the playful opportunity of a blended-
outcomes and provide instant feedback.                          learning concept to improve decision making. Our SG
Photo-Challenge activities, unlike the traditional photo        offers the opportunity to transform students into active
quiz, are engaging for learners and enable them to              learners within a game world that provides various media
demonstrate knowledge and skill in clinical thinking,           content and instant feedback. From the teachers’
applicable to everyday practice and, in addition, evaluate      perspective, important diseases and classical clinical
themselves after the quiz. Instructors are able to              presentations can be taught and knowledge gaps can be
emphasize knowledge and guide clinical thinking relevant        identified.
to the learning outcomes after each session. It can be          SG offers the opportunity to expand the way we teach
noted that the Photo Challenge is evidently more suitable       clinical decision making in medical education. Embedded
for producing intended results than traditional photo quiz      in a blended-learning concept it might improve the
in Ophthalmology studies.                                       students’ understanding for clinical decision making. For
The Photo-Challenge’s success demonstrates a                    medical teacher, SG offers opportunities of interaction
counterpart of a teaching method that emphases visual           with the students and transparency of the learning
detection of clinical signs and clinical thinking as learning   process.
outcomes, in context of Ophthalmology learning.                 Games are fun and instructive. Serious gaming works to
Photo Challenge is an educational innovation is suitable for    teach clinical reasoning.
Ophthalmology learning and is effective for students to
achieve learning outcomes as well as gain straightforward
assessment from instructors. This teaching method can
also be applicable to other studies where photographs are
an important element in the learning process.

 AMEE 2018 ABSTRACT BOOK                                                                                                2
MONDAY 27TH AUGUST 2018
4CC5 (1912)
The Pitch for ‘QUITCH’: Harnessing Mobile Technology to          4CC6 (226)
Improve Patient Safety                                           The Application of Gamification in Clinical Teaching -
                                                                 Courses of Quality Management
Authors
Shereen Ng, Department of General Medicine Tan Tock Seng         Authors
Hospital, Singapore                                              Jia-Min Wu, Tungs' Taichung MetroHarbor Hospital,
Christine Balibadlan, Department of General Medicine Tan         Taichung, Taiwan
Tock Seng Hospital, Singapore                                    Zhi-Quan Hsu, Tungs' Taichung MetroHarbor Hospital,
Kalpana Vijakumar, Department of General Medicine Tan            Taichung, Taiwan
Tock Seng Hospital, Singapore                                    Hui-Jen Chen, Tungs' Taichung MetroHarbor Hospital,
Ranjana Acharya, Department of General Medicine Tan Tock         Taichung, Taiwan
Seng Hospital, Singapore                                         Chen-Jung Yen, Tungs' Taichung MetroHarbor Hospital,
Nihar Pandit, Department of General Medicine Tan Tock            Taichung, Taiwan
Seng Hospital, Singapore                                         Ching-Shiang Chi, Tungs' Taichung MetroHarbor Hospital,
Ung Peck Houy, Department of General Medicine Tan Tock           Taichung, Taiwan
Seng Hospital, Singapore
                                                                 Presenter: Ching-Shiang Chi, Tungs' Taichung
Presenter: Shereen Ng, Department of General Medicine            MetroHarbor Hospital, Taichung, Taiwan
Tan Tock Seng Hospital, Singapore
                                                                 Background: It is important for medical staffs to use
Background: Multiple batches of fresh medical graduates          scientific management tools to improve patient safety.
rotate through the Department of General Medicine with           However, medical staffs often felt very difficult on the
very little knowledge of hospital safety protocols. The          operation and application of quality management. The
ongoing challenge is to ensure the timely delivery of            purpose of this project was to apply gamification in clinical
hospital specific patient safety knowledge upfront so            courses.
patient care errors are minimized. As mobile applications        Quality management and education team made e-learning
and games are now ubiquitous and attractive, we                  materials on the hospital platform and Youtube, so
developed a web-based game on a mobile application               learners can learn anytime, anywhere. Teachers have
(‘QUITCH’) to teach patient safety. However, does this           adapted teaching videos into short and interesting videos.
translate to effective patient care?                             Staffs must complete the online learning and homework
A list of must-know information on daily ward duties and         before the class. In the classroom, teachers implemented
hospital-based safety policies has been translated into a        the game using staged descriptions, demonstrations,
series of 80 multiple-choice questions on the application        exercises, and confirmations. Team competition, group
with a gaming element. All new rotating residents will be        discussion and brainstorming were conducted. Through
enrolled with access to the game on their mobile devices.        designed question, members understood how to make the
Each set of 8-10 time-sensitive questions are ‘pushed’ daily     process more effective in solving problems and
for the first 14 days of their rotation. Residents compete       internalized quality control practices from the process.
against their peers to reap attractive rewards, such as          After the course, FB was used to conduct the follow-up
badges and points, to get on the ‘QUITCH Leaderboard’.           discussion which provided further self-learning
Relevant bite sized explanations and material are linked to      suggestions to staffs.
the questions. The faculty reviews the progress and              Before implementing gamification, the willingness to learn
reinforces important concepts with the residents in a face       was only 45%. After conducting 3 gamification courses
to face session after the game.                                  continuously, the willingness was raised to 91%. Members
Quantitative and qualitative data are collected on               actively formed 12 interprofessional teams. Medical staffs
reception, perception and engagement towards learning            applied the acquired skills to their daily work and got 9
through mobile gaming. The results will be triangulated to       awards through teamwork and improvement tools in
see whether this translates to better patient care.              external quality competitions in 2017.
Prescription errors from High-Alert Medications (insulin,        Gamification was a method rather than a goal. Games
opioids) are being collected in an ongoing Clinical Practice     which need to be designed according to different staffs
Improvement Program (CPIP) . We will compare the                 were used to increase interpersonal communication,
medication error rates before and after the                      deepen the depth of the courses and enhance team
implementation of this project.                                  cohesion. Immediate feedback from clinical teachers
Data collection has being ongoing from Jan 2018 till Jan         engaged learners in setting specific goals and
2019 for each batch for 40 learners ( approx. 240                expectations. Medical staffs involved in improving medical
learners). We look forward to the data which will be             quality and patient safety could reduce medical risks. We
available by August 2018.                                        reformed teaching methods to enhance the professional
Harnessing technology with mobile learning and                   competence and confidence of staffs in quality
constantly innovating our teaching methods are key to            management. Through well-designed games, staffs
sustaining the attention of the busy resident, and               understood the meaning and purpose of the work by
ultimately to improve the care to our patients. It is our firm   solving problems and internalized the skills of quality
belief that learning through gaming via ‘QUITCH’ will            management.
enable us to do this.

 AMEE 2018 ABSTRACT BOOK                                                                                                  3
MONDAY 27TH AUGUST 2018
Using multiple teaching methods and diverse approaches          4CC8 (3027)
to promote learning, staffs can be active, cooperative and      Educational or professional competences. The perception
studious. Gamification made clinical teaching more              of professors of the Clinical department of the Faculty of
interesting and meaningful.                                     Medical Sciences of the National University of Littoral

4CC7 (1985)                                                     Authors
Use illness script theory to teach clinical reasoning skills    Miguel Hernán Vicco, Faculty of Medical Sciences, National
to nurse practitioners- a pilot study                           University of Littoral, Argentina
                                                                Luz María Rodeles, Faculty of Medical Sciencies, National
Authors                                                         University of Littoral, Argentina
Ching-Hsuan Ho                                                  Larisa Carrera, Faculty of Medical Sciencies, National
Hsin-Yuan Fang                                                  University of Littoral, Argentina
Hung Yao Chen
                                                                Presenter: Miguel Hernán Vicco, Faculty of Medical
Presenter: Hung Yao Chen, China Medical University              Sciencies, National University of Littoral, Santa Fe,
Hospital, Taichung, Taiwan                                      Argentina

Background: The clinical reasoning is an essential ability      Background: Several educators criticize the professional
of caring patients for nurse practitioners (NP).                competence learning approach referring that it implies an
So we developed a case- based approach for developing           utilitarian focus as the students are trained according to
NP’s clinical skills by using illness script theory and         the reference skills that they will need to perform in their
conducted a randomized control trial to determine if this       future workplace. From this view, they could not be able
method was effective.                                           to achieve correctly the process of appropriation of
A total of 42 trainees were enrolled in this study in 2017      knowledge by thinking and interpreting the doing
and divided randomly as experimental, and control               (educational competences).
group, 21 trainees in each group. Five trainees in the          The Faculty of Medical Sciences of the National University
experimental group dropped out because of their personal        of Littoral use a problem-based learning curriculum
event. For the experimental group, the clinical reasoning       encouraging educational training through the
skills, and illness script theory were introduced first, and    development of educational competences. Considering
then start to discuss clinical cases, following a sequence of   this, we performed an evaluation of the competences
chief complaints, medical history, and physical                 learning implementation by the professors of the clinical
examination. The trainees formed their own clinical             department.
hypothesis first and then asked the information from the        We interviewed 7 tutors, who coordinate 2 student groups
tutor. Finally, the trainees wrote down their differential      each (10 to 12 students/group). All of them were clinicians,
diagnoses and tried to order the relevant laboratory and        and received mandatory courses about problem-based
image study to confirm the diagnosis. Simultaneously, the       and competence-based learning. They were asked about
control group underwent traditional class-based training        their way of teaching, the concept of competence they
program. The effectiveness of intervention was assessed         manage, strategies to encourage educational training and
using the Diagnostic Thinking Inventory (DTI) and Objetive      the development of competences.
Standardized Clinical Exams.(OSCE).                             Only 1 teacher refers to plan ahead the contents to
There was no statistically significant difference on total      develop in the meeting and try to promote the discussion
DTI scores between these two groups , but the total DTI         between the students about the case problem,
scores of experimental group increased 6 points after           encouraging them to pose an adequate clinical approach.
training. Trainees in the experimental group had higher         The rest of the professors consider that the students
flexibility in thinking (86.15 vs 80 ) , and similar in the     should obtain the necessary knowledge to practice, so
memory structure scores ( 77.92 vs 75.88).The total OSCE        they passively pass on information by solving the problem
scores of these two groups after training were close. (         situation pointing the main concepts the students must
63.31 vs 61.12 ) But the trainees in the experimental group     retain as future professionals. Between their reasons, they
had better performance in disease diagnosis (8.13 vs 5.17),     refer that they can dedicate a few time to the lessons due
and clinical management (4.23 vs 2.98).                         to their professional medical practice. Also, most of them,
Although there was no prominent performance in the              despite the training in problem-based and competence-
experimental group, the ability of disease diagnosis and        based learning, ponder that during the career, the student
management in this group slightly empowered after the           should learn what they consider useful to practice
case-based training program. This implied that this             medicine as a clinician.
approach might work but there was inadequate training           Despite the policy of the Faculty of promoting the
time (only 12 hours).                                           development of educational competences, a considerable
The new teaching method is better than traditional class-       number of professors are still centered in the traditional
based training program for developing clinical reasoning        concept of professional competence without considering
skills. Adequate training hours is important.                   its limitation.
                                                                Learning and evaluation approach based on educational
                                                                competences require to be encouraged through specific
                                                                training activities directed to professors of our institution.

 AMEE 2018 ABSTRACT BOOK                                                                                                 4
MONDAY 27TH AUGUST 2018
4CC9 (2479)                                                    4CC10 (3405)
Analysis of Verbal Interactions in Case Mapping Phase of       The correlation between demographic variables and
Problem-Based Learning                                         virtual patient integration in the medical curriculum

Authors                                                        Authors
Bong H. Chang                                                  Eleni Dafli, School of Medicine, Aristotle University of
Sang H. Yeo                                                    Thessaloniki, Thessaloniki, Greece
Jang S. Suh                                                    Ioannis Fountoukidis, School of Economics, Aristotle
Jong M. Lee                                                    University of Thessaloniki, Thessaloniki, Greece
Jung M. Kim                                                    Panagiotis D Bamidis, School of Medicine, Aristotle
                                                               University of Thessaloniki, Greece
Presenter: Sanghee Yeo, Kyungpook National University
School of Medicine, Daegu, South Korea                         Presenter: Eleni Dafli, School of Medicine, Aristotle
                                                               University of Thessaloniki, Greece
Background: Problem-based learning (PBL) has goals
which includes clinical reasoning, cooperation, and            Background: The opportunities Virtual Patients (VPs)
patient-based integration of knowledge. The case               provide in modern medical education led to a wide trend
mapping in the PBL is an important stage of an integration     towards VP creation and use among academic institutions.
of knowledge as relevant to the patient's case through         Aristotle University of Thessaloniki in an effort for a
collaboration and group interactions. The purpose of this      comprehensive evaluation of various parameters of the VP
study is to investigate the verbal interactions in PBL case    integration process aimed to add meaningful knowledge
mapping phase.                                                 considering the full adoption of VPs.
The case mapping phases of the randomly selected two           The study included the collection of quantitative and
PBL groups in second-year of the Kyungpook National            qualitative data, using on line available questionnaires, for
University School of Medicine were videotaped and              the medical students’ evaluation (n=219). Descriptive
analysed. The verbal interactions in the case mapping          statistical analysis and factor analysis were performed.
were analysed by using the following coding scheme of          A correlation of age, sex and year of study with the
the utterances: learning-oriented interactions (exploratory    evaluation of the medical students’ clinical experience
questioning, cumulative reasoning, and handling conflicts      with VPs was observed. Male young students of the pre-
about knowledge), procedural interactions, and irrelevant      clinical years showed a significant preference in VPs.
interactions. In the second-year of the curriculum, there is   Generally, students of the pre-clinical years show a high
one tutorial group meeting per week. In the first meeting,     preference in the adoption of VPs as learning activities. A
students identify the problem and generate hypotheses          decrease of interest for VPs’ curricular adoption in the
and learning issues with the guidance of the tutor. In the     next years of study was observed, something that was
second session, they report what they have studied in the      reversed again in the last (6th) year of study.
presence of the tutor and do the case mapping on their         The preferences of medical students concerning the type
own without a tutor. Each group consisted of 7 students        of use and integration of VPs in the medical curriculum are
and worked on the case of the 'Panic disorder'.                presented, sorted according sex, age and year of study.
Learning-oriented interactions, procedural interactions        The virtual clinical encounters used in this study appear to
and irrelevant interactions accounted for 82%, 10%, and 8%     be particularly well suited for learning and assessment for
of the interactions, respectively. Exploratory questioning,    medical students of pre-clinical years of studies, who have
cumulative reasoning, and handling conflicts about             had limited clinical contact.
knowledge accounted for 22%, 50%, and 10% of the
learning-oriented interactions, respectively.
The task involvement of the students in PBL case mapping
session without a tutor was comparatively high.

 AMEE 2018 ABSTRACT BOOK                                                                                                  5
MONDAY 27TH AUGUST 2018
4CC11 (3514)                                                   4CC12 (2497)
Virtual patients in training against medical error: does       Problem-based Learning with Virtual Patients: Outcome
group dynamics influence outcome?                              Evaluations

Authors                                                        Authors
Gulmira Abakassova, Karaganda State Medical University,        Chin-Ru Ker, Department of Gynecology and Obstetrics,
Karaganda, Kazakhstan                                          Kaohsiung Medical University Hospital, Kaohsiung Medical
Viktor Riklefs, Karaganda State Medical University,            University, Kaohsiung, Taiwan
Karaganda, Kazakhstan                                          Jong-Rung Tsai, Department of Respiratory Department,
Sholpan Kaliyeva, Karaganda State Medical University,          Kaohsiung Medical University, Kaohsiung, Taiwan
Karaganda, Kazakhstan                                          Ching-Ju Shen, Department of Gynecology and Obstetrics,
Alma Muratova, Karaganda State Medical University,             Kaohsiung Medical University Hospital, Kaohsiung Medical
Karaganda, Kazakhstan                                          University, Kaohsiung, Taiwan

Presenter: Gulmira Abakassova, Karaganda State Medical         Presenter: Chin-Ru Ker, Department of Gynecology and
University, Karaganda, Kazakhstan                              Obstetrics, Kaohsiung Medical University Hospital,
                                                               Kaohsiung Medical University, Kaohsiung, Taiwan
Background: Erasmus+ CBHE project “Training against
medical error” (TAME) aimed to use virtual patients (VP)       Background: Problem-based learning (PBL) has been
scenarios for clinical PBL with senior year students to help   widely adopted in medical education curricula for junior
them gain expertise in prevention of medical errors. We        students in Taiwan. Students are given pieces of
looked into how group dynamics influence student               information pertaining to a certain clinical scenario, from
perceived ability and experience after exposure to             which they develop medical reasoning, inquiries, self-
branched General Practice VP cases with medical errors. In     directed learning and knowledge exchange in group
the first phase of the project covering linear and branched    discussions. The learning model aims to increase students’
paediatric cases, we showed that outcomes of branched          motivations and skills to acquire knowledge. However,
cases could not be explained by case structure only.           PBL in this pre-clinical setting is dissociated from clinical
Medical teachers created clinical decision-making VP cases     reality. It is difficult for students to apply what they
using open access platform OpenLabirynth. Team of GP           practiced in PBL years before to real patients when they
teachers carefully analysed possible medical errors in their   later advanced to clinical works. Furthermore, students
practice and designed the VP cases. The responses were         lack the opportunities to practice hand-on skills because
collected from 60 students gathered into 7 groups after        clinical cues are delivered passively.
each case using non-anonymous online questionnaire. The        We designed a modified learning strategy—PBL with
survey aimed evaluating personal experience, perceived         virtual patients (PBL-VP) to improve s clinical attachments
abilities, mental effort and emotional reactions. The factor   that was missing in the conventional PBL. The tested new
analysis confirmed the presence of 5 factors with              learning model was implemented into the curriculum of
emotional reactions divided into positive and negative         100 senior medical students. Basic gynecology/obstetric
ones. MANOVA of factor scores produced no significant          clerkship curricula were maintained, but some core
differences between cases, but there were significance         lectures were replaced by PBL-VP in a four-week program.
differences between groups of students.                        Students acquire relevant medical history from virtual
Cluster analysis revealed 5 reaction modes to cases: more      patients vial online learning platform in their first
than 50% of responses showed high positive experience,         encounter, after which they participate PBL group
perceived ability and mental effort against low emotional      discussions for composing their next steps. Further
reaction; in 30%, there were high emotionality, positive       laboratory or imaging study results were offered by the
experience and mental effort, but low perceived ability; in    virtual patients in the second encounter. Learning
MONDAY 27TH AUGUST 2018
4CC13 (3413)
Strategy of medical education in home care using
immersive Virtual Reality

Authors
Alessandra Dahmer, UNA-SUS/UFCSPA, Porto Alegre, Brazil
Rodrigo Alves Tubelo, UNA-SUS/UFCSPA, Porto Alegre, Brazil
Eduardo José Zanatta, UNA-SUS/UFCSPA, Porto Alegre, Brazil
Juliano Machado Padilha, UNA-SUS/UFCSPA, Porto Alegre,
Brazil
Fulvia Spohr, UNA-SUS/UFCSPA, Porto Alegre, Brazil
Maria Eugênia Bresolin Pinto, UNA-SUS/UFCSPA, Porto
Alegre, Brazil

Presenter: Alessandra Dahmer, UNA-SUS/UFCSPA, Porto
Alegre, Brazil

Background: The use of Immersive Virtual Reality (IVR) in
medical education remains a challenge for educators. The
process to create educational resources applying this
technology requires pedagogical knowledge as well
comprehension regarding the digital resources provided
by IVR. Therefore, the purpose of this work was to
develop a teaching strategy using an Immersive Virtual
Reality Game directed towards home care teaching for
undergraduate medical students.
Firstly, a survey of all existing educational contents in
regard to home care medicine has been carried out. The
topics that proved to be the most difficult ones to be
developed in the classroom have been selected. A
physician selected the topics and those were discussed
along with educators, designers, and game developers.
The educational topics addressed refer to home
cleanliness, psychological care of the caretakers, special
care for bed-ridden patients and orientations for feeding
patients in the home environment. The educational
resource was available by wearing IVR goggles.
The transformation of a traditional educational topic into a
serious game requires a multi-disciplinary team, which
ought to include health professionals, educators, and
computer experts. The discussions were held in order to
achieve learning goals and simultaneously turn the game
into a pleasant experience for users, resulting in the
exchange of experiences among professionals, which may
lead to an educational resource with a higher level of
quality.
The IVR game developed may be used as a supplementary
tool in the teaching-learning process involving
undergraduate medical students with regard to practical
activities in Home Care.
The use of technology in healthcare education must be
encouraged among healthcare educators. The current
generation tends to transcend traditional teaching
resources, and IVR is suitable for learning contents in
which the environment interferes the clinical conduct.

 AMEE 2018 ABSTRACT BOOK                                        7
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