On the Usage of Health Records for the Teaching of Decision-Making to Students of Medicine

The development of clinical reasoning and decision-making skills in medicine is inextricably linked to experience. Yet students are failing to gain this experience before embarking on their first medical jobs. This is due to several factors, including advances in medical science resulting in patients that are less likely to be hospitalized and more likely to be treated in outpatient departments. This lack of experience within real-world scenarios has resulted in students feeling they are ill prepared for their first medical jobs. One way to counter such a lack of experience is through the use of software simulations such as Virtual Patients. However, simulations are extremely costly to develop, in terms of both financial outlay and the time required to create them. We report here on the development of an iPad-based Virtual Patient simulation system that uses annotated electronic patient data and health records for the creation of cases to enable students to learn critical decision-making skills. By basing these Virtual Patients on abundant patient records, cases can be more quickly and easily created, thus enabling pools of cases to be accumulated—essential for gaining the experience required for the development of sound clinical reasoning skills.