The 2nd Medical Education Forum (MEF) hosted from 4 to 6 May 2021 as a virtual meeting was an opportunity to review and summarise current research outcomes in medical education. It was organised by Jagiellonian University Medical College, McMaster University and Polish Institute for Evidence-Based Medicine. The live event had five speakers from the DID-ACT project (Samuel Edelbring, Inga Hege, Sören Huwendiek, Małgorzata Sudacka & me) and had 110 participants from 24 countries, most of them from Canada, Poland and Ukraine.
During the MEF conference, I took on the task of reviewing the most recent systematic reviews of virtual patients effectiveness. A review of reviews is called an umbrella review. Effectiveness of virtual patients is an important topic for the DID-ACT project because we use this type of education resources as a vehicle to deliver interactive exercises to practice clinical reasoning in the designed DID-ACT curriculum. To see how effectiveness is measured of clinical reasoning outcomes is also important to inform the DID-ACT project pilot evaluations.
I have identified in the recent three years five systematic reviews of virtual patients effectiveness. This included a systematic review I completed with my colleagues from the Digital Health Education collaboration in 2019. For me personally, preparation of the MEF presentation was an interesting exercise that gave an opportunity to see how much the results obtained in our former review align with the outcomes reported in other reviews published afterwards. To check it makes sense as systematic reviews often have unique scopes defined by the selected inclusion criteria, data extraction and synthesis methods and therefore may differ.
The reviews published after 2019 were carried out by international teams from France, New Zealand, South Korea, UK and USA. Only one, similar as we, included all health professions; the remaining focused on particular health professions: nursing, medicine, pharmacy. The studies either included all possible outcomes or selected a particular skill. It was interesting to see that the skill that was in particular in the scope of interest in syntheses in the recent years were communication skills. The conclusions of the studies were consistent across the different professions and topics. The studies reported benefits of application of virtual patients in education with hardly any exceptions. As Lee and colleagues (Med Educ, 54(9), 2020) concluded in their systematic review, the effectiveness of virtual patients can be even more improved when their use is preceded or followed by reflection exercises and human-teacher provided feedback. The technological features of virtual patient platforms were less important.
You may learn more about the result of my umbrella review, presentation of the other DID-ACT project speakers and the follow-up Question & Answers sessions as video recording.
In this blog post we would like to point another Erasmus+ funded project “iCoViP” – International collection of virtual patients. This strategic partnership with participants from Poland, Germany, France, Spain, and Portugal aims to create a well-designed high-quality collection of virtual patients to train clinical reasoning. Other than DID-ACT, iCoViP focuses specifically on the training of medical students by providing opportunities to identify symtpoms and findings, develop differential diagnoses, document tests and treatment options, and decide about the final diagnosis.
The project started in April 2021 and continues until March 2023. As a first stept the consortium develops a blueprint that describes the virtual patients based on key symptoms, final diagnosis, and (virtual) patient-related data, such as age, sexual orientation, disability, profession, etc. This approach ensures that the collection is a realistic representation of a real-world patient collective.
More information about the project can be found at icovip.eu
For the development of the DID-ACT’s online clinical reasoning curriculum we will be following the six step Kern cycle for curriculum development. Kicking off our third and fourth work package in January 2021 signalled the start for detailed planning and development of learning units. As of now, we have started with 4 units, but based on our curricular framework, we will be developing a total of 40 learning units. These units will be aligned with a collection of case scenarios and virtual patients. Together, these will allow for interprofessional and deliberate practice of clinical reasoning.
We started this process by providing an exemplary learning unit (“What is clinical reasoning – an introduction”) and a template for describing a learning unit. We then divided into smaller teams to develop the first four learning units on different clinical reasoning-related theories in parallel. Each team includes partners from different health professions across Europe. Each team has varying levels of expertise, ranging from students to experienced clinicians or educators. The diversity of knowledge and experience are key elements for developing a clinical reasoning curriculum that reflects the various needs of health professions across Europe and beyond.
Upon completion of each learning unit, each unit will be reviewed within our team and by associate partners. The units will then be revised accordingly and implemented into Moodle, our learning management system, using available OERs. We will create new resources ourselves, if needed. After a final review, all learning units will be made publicly available to be freely used by students and educators.
We will pilot selected learning units from the student curriculum and the train-the-trainer course within our partner institutions during the summer and fall 2021. The evaluation results of course participants and facilitators will be the basis for further refinements of our clinical reasoning curriculum. For that purpose, we aim to include at least 500 students and 50 educators.
At the end of December 2020, the DID-ACT project consortium welcomed two things: the holidays and the successful completion of Work Package 2. This post aims to provide an update on what that entailed, what we completed, as well as provide a short overview of what we are going to be developing in Work Package 3. To begin, we will provide a brief overview of what we learned using the age-old rhetorical question: “How do you eat an elephant?” To which the answer is, “not in one bite”.
This rhetorical question is often used to illustrate how overcoming large and complex challenges is done by dividing them into smaller chunks. That when broken down into bite size pieces, these challenges are easier to manage. In the case of the DID-ACT project and beyond, every clinician, educator or researcher who has tried to describe the nature of teaching clinical reasoning, has realized this challenge. As a team, we most definitely learned this throughout work package 2 as we represent a collection of diverse professionals with the same ultimate goal, but with different ideas on how to get there.
When broken down further, we explored and learned how teaching clinical reasoning is a challenge that is inherently multifaceted. One facet, for example, is the complexity of a clinical situation, a second, is the need to grasp the nature of the varied competencies required to address the situation at hand, and third is how to support the learning of these competencies effectively.
Developing a clinical reasoning framework
Last fall the DID-ACT consortium developed a clinical reasoning curriculum framework that included clinical reasoning quality criteria. In addition to the above challenges, we emphasized having an interprofessional clinical reasoning curriculum. Our interprofessional framework was conceived with the input from different nations and educational cultures, all conducted online due to the current pandemic. So – similar to a complex clinical situation, we faced a plethora of challenges when producing and describing a clinical reasoning framework. This work led us to the development of two curricula: one directed to health professions students and one for teachers.
What makes a good clinical reasoning curriculum?
When we zoomed out to get a clear idea of the big picture, we noted a few crucial pedagogical aspects: a strong focus on student-centeredness; a perspective in which the student takes responsibility for their own learning process; as well as a strong connection to relevant clinical situations which means that knowledge and competencies were applied to context. We also noted that the philosophy of “constructive alignment” will be used when designing our clinical reasoning learning units. In practice, this means that the intended learning outcome should direct choices when designing learning activities; thereby creating a harmony between the clinical reasoning learning activities and how they are assessed. This means that the intended learning outcomes hold a central position when designing your clinical reasoning learning activities, assessments, and learning units overall. That is why we structured our interprofessional clinical reasoning framework according to ~ 50 learning objectives in an interdisciplinary consensus process.
DID-ACT’s Health Professions Education Framework
Did we eat the metaphorical elephant in this project phase? Yes!
By using our various knowledge and skills collectively, then by dividing the bigger task into parts and iteratively working in small and greater teams, we put parts back together to form a much clearer picture. Building from Work Package 1, we had a framework that is grounded in an interdisciplinary needs analysis directed towards a breadth of European health professions schools to launch from. When taking our learning into WP2, our work entailed bringing forward and evaluating a large amount of open learning resources for clinical reasoning based on our desired learning outcomes. It was essential that these learning resources were accessible and of a strong quality for our online clinical reasoning curriculum. When we tied our learning objectives, outcomes, assessment ideas, and open resources together, we created a well-rounded, interprofessional framework and the beginnings of an actual online clinical reasoning course.
Every project needs evaluation. Even though it might sometimes be considered as cumbersome or stressful for those whose work is evaluated, it is important that the merits and limitations of any given project are clearly laid out. A well-conducted evaluation ideally goes beyond highlighting the particular achievements of a program by delivering ideas for improvement. Furthermore it justifies the need to continue the efforts surrounding the project and its aims. It is commonplace that evaluation and feedback are employed during the last stage of the curriculum development cycle. However, it is well-founded that initiating evaluations in program development should be started as early as possible. The benefits are many with the central reasoning being that evaluating early on maintains and ensures that the chosen tools align with the planned outcome(s).
In terms of evaluation for the DID-ACT project, the Evaluation Work Package is a shared effort of the consortium partners. Jagiellonian University in Kraków, Poland, is responsible for its coordination. Its first year of activities finished in December 2020 with a report published on the project’s website. During the first half of the year, the activities were focused on gauging the needs of potential users by developing a web survey to collect the specific expectations. From the data gathered, the DID-ACT project’s set of learning objectives and curricular framework were developed by another working group of the project. The goal of the second half of the year in terms of the evaluation work package was to propose a set of evaluation and learning analytic tools. Combined, these measure the planned outcome of the DID-ACT student curriculum and train-the-trainer course.
At the time of commencing our evaluation work, the specific set of learning objectives had not yet been set. Thus we first reviewed the literature in search of existing tools that measure participant satisfaction and perceived effectiveness of clinical reasoning training. This brought us the productive advantage and opportunity to reuse the outcomes of former projects. We experience this as an important point that demonstrates continuity and sustainability of research in this area. Our literature review identified a number of studies in which evaluation questionnaires of clinical reasoning learning activities were presented. Based on the analysis of the questions that aimed to measure student satisfaction, we were able to identify seven common themes of interest: course organisation, clear expectations, relevance, quality of group work, feedback, teaching competencies, and support for self-directed learning. We collected plenty of exemplar questions in each of the themes. Additionally, for the self-assessment questions we have assigned the gathered items to the DID-ACT learning goals and objectives.
Surprisingly our literature review did not yield any evaluation questions specific to clinical reasoning that could be used for our train-the-trainer courses. We resolved this challenge by broadening our goal. We adapted our search to include faculty development evaluation questionnaires that focused on honing teaching skills in general (not necessarily exclusively clinical reasoning). There was one evaluation tool from this group that caught our attention in particular: the Stanford Faculty Development Program Model (SFDP-26). We value its wide dissemination in many domains and clearly formulated set of 26 questions grouped in seven dimensions. An additional strength is that it has already been translated and validated in languages other than English, for example, in German.
An interesting discovery for us was a tool that measures the impact of curricular innovation following the Concerns-Based Adoption Model (CBAM). This tool, developed at the University of Texas, proposes an imaginative way of measuring the progress of curriculum innovation. It does so by identifying the types of concerns teachers voice regarding new topics. These concerns can range from disinterest, through concerns about efficiency of teaching of this element, and end with ideas for expanding the idea.
The CBAM model is based on the assumption that certain types of statements are characteristic to particular developmental stages when introducing an innovation into a curriculum. The developmental stage of introducing the innovation is captured effectively by the Stage of Concern (SoC) questionnaire. When collecting the data from a particular school the outcome is a curve that displays the intensity of concerns found within the seven consecutive stages of innovation. The value this brings is that comparing the curves across several institutions can help us visualise any progress implementing the curriculum is having. We find this visualisation to be akin to following how waves traverse the ocean.
As the DID-ACT curriculum is planned to be a blended model of face-to-face and e-learning activities, we intend to use learning analytics in our curriculum evaluation. More specifically we will capture, process and interpret the digital footprints learners leave while using electronic learning environments. It is of course pivotal to be transparent about the purpose and to obtain consent regarding the collection of educational data. Upon receiving consent, computational power can be harnessed to optimise educational processes to the benefit of both learners and teachers. From the perspective of the curriculum developer, it is particularly important to know which activities attracted the most versus least engagement from students.
This information, when triangulated with other data evaluation sources, e.g. from questionnaires or interviews, allows us to identify elements of the curriculum that are particularly challenging, attractive or in need of promotion or better alignment. The learning analytics dashboards are viewed for our purposes a bit like a car’s dashboard where our fuel, odometers, speedometer display key information; for DID-ACT, analytics present a clear range of visualised progress indicators in one place.
We selected then analysed two electronic tools that will be used to implement the technical side of the DID-ACT curriculum: “Moodle” (a learning management system) and “Casus” (a virtual patient platform). Our goal was to look for the relevant learner data that could be collected. In addition, we intended to determine how it is visualised when following learner progress and trajectories. To systematise the process, we have produced a table we dubbed the ‘Learning Analytic Matrix’ that shows how engagement in attaining individual DID-ACT learning goals and objectives is captured by these electronic tools. Logs of such activities, like the opening of learning resources, time spent on activities, number and quality of posts in discussion boards, or success rate in formative questions, will enable us to map what is happening in the learning units developed by the DID-ACT consortium.
This is augmented by recording traces of some learning events which are characteristic to the clinical reasoning process. These events can be qualified as success rates in making the right diagnoses in virtual patient cases, student use of formal medical terminology in summary statements, or making reasonable connections in clinical reasoning concept maps. We also inspected the ways the captured data are presented graphically, identifying at the moment a predominance in tabular views. We foresee the possibility of extending the functionality of learning analytic tools available in the electronic learning environment by introducing a more diverse way of visualising evaluation results in learning clinical reasoning.
The collection and interpretation of all that data related to the enactment of the DID-ACT curriculum using the described tools is something we are looking forward to pursuing in the two upcoming years of the DID-ACT project.
Generally, clinical reasoning refers to a health professional’s thinking and decision-making process. It guides practical actions, implying a process limited to the cognitive activities of health professionals. In more elaborated definitions of clinical reasoning, we may also find concepts such as collaboration and context. These imply a broader view of the reasoning process where the client and situational factors also come into play. The number of definitions of clinical reasoning are innumerable. Variations within and between different professional disciplines are equally as many. There is no established singular definition of the nature, relevant components or boundaries of a health professional’s clinical reasoning. The co-existence of multiple definitions leads to a plethora of variation in clinicians’ view(s) of clinical reasoning. These variations in turn influence their consistent and uniform application of reasoning in practice.
My name is Maria Elvén, I’m a lecturer and researcher in physiotherapy. In my PhD-work, focusing on clinical reasoning in physiotherapy, clinical reasoning was studied from a biopsychosocial and person-centred perspective. As such, clinical reasoning in relation to health and illness are dependent on biomedical, psychological and social aspects. Accordingly, to be in ‘good health’ represents different realities for different individuals. This variation emphasizes the need to grasp the persons’ individual perceptions. We must understand their own definitions of health and life situation in tandem, with their mental and bodily status from a health care perspective in the clinical reasoning process. Person-centredness, e.g., that the clinician considers the unique needs and specific health concerns of the person, and treats the individual as competent to make decisions about their own care, is a way to empower clients to take an active part in the clinical reasoning process.
Let’s pause here and reflect! Based on your view/definition of clinical reasoning, what is the goal of the clinical reasoning process? A correct diagnostic decision? A well-performed analytical thought process? A well-founded treatment decision? A satisfied clinician? A satisfied client?
If I ask myself these questions, the ultimate goal of effective clinical reasoning is that the client achieves their own goal(s) related to their current health problem. To be able to reach this goal, the clinical reasoning process cannot be confined to the mind of the clinician, the process needs to be articulated and shared with the client. To make full use of the client as an active partner in the clinical process, shared treatment decisions are not sufficient. The client needs to be aided in supporting their role as an important contributor to the analysis of the problem as well. This process also involves selecting and prioritizing among various treatments and management strategies that fit their actual life situation, as well as continuously evaluate their effectiveness.
We have covered a lot of ground surrounding the clinician’s inner process. The next step is to look beyond the cognitive processes of the clinician and to further elaborate on what meaningful client participation and involvement implies in the reasoning process. As suggested in my definition of clinical reasoning in physiotherapy, clinical reasoning is a process performed in partnership between the client and the clinician; ultimately stressing their shared responsibilities and equal values (Elvén, 2019). Performance of such reasoning may need training and competence development for clinicians to be able to support clients in their role as clinical reasoning partners.
That brings us to where we are today and what I am hoping to bring into the DID-ACT project. In the DID-ACT project, the client perspective in clinical reasoning is clearly in focus. This is done by the inclusion of learning objectives related to client participation and shared decision-making. These learning objectives will influence learning activities and assessments in the forthcoming clinical reasoning curriculum development. The aim is that the client-perspective will play an increasingly important role in the learning and teaching of clinical reasoning in this project.
I’m looking forward to contributing to a strengthened role for the client or patient in general health care, and, more specifically, clinical reasoning and I hope you’ll join me!
Elvén, M. (2019) Clinical reasoning focused on clients’ behaviour change in physiotherapy: Development and evaluation of the Reasoning 4 Change instrument. Doctoral dissertation. Mälardalen University. Västerås.
The goal of this deliverable was to provide our curricular framework with teaching/ assessment methods for the student curriculum and the train-the-trainer course.
Having already established our initial needs assessment and definition of goals and objectives (Deliverable 2.1), we have reached the exciting point of providing educational strategies in terms of a curriculum framework for clinical reasoning. We followed the constructive alignment theory to ensure an optimal alignment of learning objectives, teaching, and assessment. We have employed a theme-based approach. We plan to continue using a blended-learning format to help ensure flexibility for our learners while also utilizing an optimal match of teaching and assessment.
Blended learning combines online activities, such as virtual patients and interactive videos, with face-to-face methods such as bedside teaching. We aim for our courses to have the learner at the centre, meaning that the student is actively engaged in their learning. In this set up, the teacher is more to support and facilitate learning.
Some of our biggest wins in this work package have been:
Defining 35 general learning objectives in D2.1 and aligned them in 14 themes/ categories to describe the DID-ACT student curriculum and the train-the-trainer course.
We have defined four different learner levels: Novice, Intermediate, Advanced, and Teacher.
Our list of suitable learning and assessment methods that align with our previously defined categories.
A breakdown of our teaching and learning assessment strategies for clinical reasoning clearly defined.
Overarching curricular outline for the categories, theories, errors, and aspects of patient participation related to the clinical reasoning process. These outlines include the specific learning objectives, teaching and learning activities, as well as assessments, both summative and formative, for our courses.
Our most recent deliverable is a big step as it establishes the framework for the next steps in our curriculum development process. Our team is both multi-professional international; thereby reflecting the needs of the different health profession curricula and curricular formats of the partner schools. Due to the current COVID-19 pandemic, we could not organize as originally planned in a face-to-face meeting to discuss the framework. However, we were able to organize the work in small groups across professions and contexts who worked asynchronously and met online according to their needs. In addition, we held a series of online meetings to discuss specific aspects and make decisions in consensus.
What’s next? Coming later in December 2020 will be our “Collection of available Open Educational Resources (OER)”, “Publication of recommendations for learning objectives of a clinical reasoning curriculum”, and our “Set of evaluation and analysis tools”
You can keep track of what is upcoming in the project on our Results page, or by clicking here.
Hello! I’m Ada, a junior doctor from Cracow, Poland. I would like to describe how teaching clinical reasoning looks like from a student’s perspective – I just graduated university in June, so my memories are still fresh. Let’s get on with it!
At Jagiellonian University in Cracow, clinical reasoining (CR) teaching started at the second year, with the course Introduction to the Clinical Sciences and Laboratory Training in Clinical Skills.
The first course lasted a whole year. We were divided into 9-person groups, each supervised by a teacher and served with patient’s cases. The aim was for each group to manage a case to the best of their abilities – gather information, outline which lab and imaging tests would be needed, and finally how to treat the patient. We were allowed to use any books and websites we deemed necessary as this was only the second year of our studies, and all we knew were basic sciences – anatomy, physiology, biochemistry etc. The teacher was more a moderator of our discussion, trying not to impose his views and solutions on us. At the end of each class, we summarized the most important issues about each case, and where we lacked knowledge the most. At the next class, volunteers gathered necessary information about the issues and delivered a short presentation to the rest of the group. I remember this course as a nice brainstorming experience, where every idea was valid and counted.
The second course lasted four years – till the end of our studies. We were learning how to gather information from patients, be it adult, pediatric or a “poor historian”. We also were taught how to examine a patient and how to suture wounds and even the basics of laparoscopy. There was a particular emphasis placed on an ability to communicate with a patient effectively, for example how to make sure they understand us and how to deliver difficult news. During this course we also had to solve virtual patients’ cases in the CASUS system. We were evaluated by OSCE on the third and last year of our studies.
At 4th, 5th and 6th years high fidelity simulations took place. This meant we were divided into 5-person teams, with one leader, and had to take care of a simulated patient or a mannequin. We mostly dealt with emergency cases there, and the ability to see how our actions affected, for example, the patient’s blood pressure or consciousness was irreplaceable. It once more evaluated our efficacy of gathering information, but for the first time we were able to test our ability to act promptly. On the 6th year we also had an occasion to work with a nurse as a part of our team, which bettered our interdisciplinary communication. After each case we analysed our steps with the supervising teacher – what was done right and what could be done better next time.
Above all, since the 3rd year we had clinical rotations, and while the aforementioned courses really added to my knowledge, the rotations really varied in quality. Of course, there were talented teachers, and going to their classes was an enlightening experience – but there were also teachers who acted as if they lacked ideas about how to make a student an active participant in classes or at least be heard. I don’t doubt their knowledge was vast – it’s just that sometimes it was hard for them to describe their reasoning process or they didn’t feel the need to do so to us – “it’s just done like that” or “it’s in the guidelines”; not to mention that many of them didn’t even know that clinical reasoning is something that can be actively taught. This way I feel that many opportunities to learn clinical reasoning in rotations were lost.
This is why I joined the DID-ACT project – I experienced from the first-person perspective on how much could be done to better the quality of teaching at medical universities. I’m also keen on teaching myself – and when I’ll become a teacher, I want to do it the best way possible. I’ve experienced classes where the topic didn’t seem too interesting, but the teacher transformed it into something fascinating and inspiring.
With all the professionals involved and great ideas created in the DID-ACT project, I think that it’s the best place to begin a change in teaching clinical reasoning.
The Association for Medical Education in Europe (AMEE) is one of the biggest organisations focused on excellence and research in health professions education. It has been organising annual conferences for scholars engaged in this topic for close to 50 years. The interest in these meetings is rising and has reached the level of around 4000 participants last year. The DID-ACT consortium decided to disseminate its outcomes at AMEE by submitting an abstract informing about the results of the project’s needs analysis.
This year’s conference was originally planned to be held in Glasgow, United Kingdom, however, changes had to be made due to the ongoing COVID-19 pandemic; AMEE’s traditionally face-to-face format was adapted to be a virtual conference that rose to the challenge and exceeded expectations. Rather than following suit to mainstream reliance on primarily traditional audio-video teleconferencing tools, AMEE took on the challenge to host the conference in a virtual world. The virtual venue encompassed a group of interconnected locations with different purposes. A palm tree grown lobby with information booths led to several lecture theatres, exhibition halls, networking areas and poster rooms. The participants, prior to joining the conference, designed their own avatar and then navigated it through the locations meeting on the way avatars of other participants. The meetings enabled interactions either by typing in a chat window or an audio conversation. Participation in the events held in parallel conference communications could be interactive as well, enabling the audience to applaud, raise hands, and talk to the next-sited neighbour.
The DID-ACT submission was accepted for AMEE 2020 as a virtual poster. This presentation format involves constructing a digital “stack” of multimedia resources which could be presented either in a smartphone app or in a web browser. The content is organised in nested sections depicted as rectangular tiles, each containing resources as text entries, images, web links. Each conference presenter was encouraged to incorporate in the poster a short video showing a voice-over PowerPoint presentation giving an overview of the most important content. In addition it was required to prepare a one page digital print-out of the poster including a QR-code for easy access by smartphones from the real world. The DID-ACT poster was prepared by Andrzej Kononowicz, Małgorzata Sudacka, Felicitas L. Wagner, Samuel Edelbring, Inga Hege and Sören Huwendiek on behalf of the consortium. In the image below we present the poster print-out. The content is available via this link https://api.ltb.io/show/BWPMF.
The virtual conference was held from 7th until 9th September. Several DID-ACT members participated in the conference events and networked with fellow researchers. In particular there were several conference presentations around the topic of clinical reasoning. By the end of conference the participants form DID-ACT project decided to gather virtually in one of the exhibition hall for a virtual group selfie:
The conference contributions presented at the virtual AMEE conference will be available at least throughout the next year and by that enable playback of the presentations and sustainable project dissemination. Participation in the conference was a memorable event, impressive by its innovation and showing how far virtualisation of education and research can nowadays go. Despite the many benefits of the virtual conference, and thankful it was possible to be held in these troubled pandemic times, we hope we will be able to meet up at the face-to-face conference next year at AMEE 2021 in real world Glasgow to present the community more news around the DID-ACT project.
Summer term 2020 was special. Most universities start their summer term in April and thus, with the onset of the Corona outbreak in March, their preparation time given the circumstances was reduced drastically. One of the major challenges was that face-to-face lectures had to be planned online. In a very short amount of time, new online conference systems were established, and the necessary technical support was partially organized with the help of student tutors. Even though people who work on international projects are already used to video conferencing solutions, the amount of potential technical difficulties is still high and bandwidth issues can destroy all previous efforts.
Instruct, as an e-learning provider, observed a strong increase in online lectures and virtual patient usage in our system. Even institutions that already use our system CASUS and offer numerous online courses outperformed their previous numbers (Graphic 1).
The peak in July is the result of exam preparation. We also registered slightly more support requests, however, these were still easily manageable.
In the media, both researchers and newspapers made online learning one of their central themes, especially regarding possibilities on how the current circumstances will impact e-learning in the future. Their findings are not necessarily novel, as can be seen in an article from the New York Times (https://www.nytimes.com/2020/06/13/health/school-learning-online-education.html?smid=em-share), “[…] students tend to learn less efficiently than usual in online courses […]. But if they have a facilitator or mentor on hand, someone to help with the technology and focus their attention — an approach sometimes called blended learning — they perform about as well in many virtual classes, and sometimes better.”
In an article from the German newspaper, Sueddeutsche Zeitung, called „Schluss mit dem Digitalgejammer!“ (“Stop complaining about Digitalization!”) (https://www.sueddeutsche.de/bildung/hochschulen-und-corona-schluss-mit-dem-digitalgejammer-1.4985116 ), the author highlights the discrepancy between educators moaning about a lack of personal interaction, exchange and dialogue in e-learning, while in reality seminars and lectures are quite often overcrowded permitting no interactivity whatsoever, not to mention dialogues and conversations are rarely feasible. The author states that students might miss pre-Corona campus life, but educators believe and hope that various other reasons also play into this.
It’s exciting to see how this transformation will shape the future, and it seems as though we have a special winter term in store for us, too – this time we will have slightly longer to prepare. One thing is for sure: it’s time for more and better blended learning solutions.