Clinical decision making: a pilot e-learning study

BACKGROUND: As many medical schools focus on student-centred learning strategies, e-learning provides a useful approach to foster clinical decision-making skills in a case-based way. We developed an e-learning module based on real patient cases for final-year students as a self-directed studying tool.

METHODS: Ten patient cases were developed from patients treated in the emergency room. Original documents were integrated into the virtual patient system CASUS(®) . In total, 522 students from three different terms of their final year were invited to use the e-learning module. Students filled out a self-assessment questionnaire regarding clinical decision-making skills before and after the module, and were also asked to fill out an evaluation form.

RESULTS: Only 30 per cent of the students invited participated in the e-learning module, and even fewer filled out the questionnaires. Nevertheless, the students participating liked the online cases and valued the relevance of the diseases. An increase in the self-assessment rating of clinical decision-making skills after the e-learning module was only seen for students in the first term of their final year. Additionally, those students showed significantly lower scores in their pre-module clinical decision-making skills compared with students in terms two and three of their final year.

DISCUSSION:   Even though the overall participation was small, participating students were satisfied with the e-learning module and were motivated to work with the cases. A better integration into the clinical curriculum and a stronger association with an exam might provide an even better learning opportunity for medical students with respect to the acquisition of clinical decision-making skills.