Gamification of Medical Student Pre-Rounding Training
Gamification of Medical Student Pre-Rounding Training
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This project originated from a resident who identified a need to better prepare medical students for pre-rounding during their clinical rotations in the third year of their studies. Pre-rounding includes being prepared to present about a patient to their peers and attending physicians during rotations in a hospital. It also includes being confident and competent in using the hospital's electronic medical record (EMR) system called EPIC. Medical students are under a great deal of pressure when they first enter their clinical rotations, so this training was meant to alleviate some fears and help them being successful on day one.
Project Highlights
Project Highlights
Where it started
Where it started
The resident had already been providing in-person presentations on pre-rounding using a straight-forward slide deck with bullet points and screenshots of the EPIC software. This became our starting point for designing a new, stand-alone training that medical students could access at anytime on their own. The resident wanted the new training to be fast (no more than 30 minutes to complete) and to have a light tone. Some of the original slides are shown below:
The Challenge(s)
The Challenge(s)
Challenge one was to figure out how to transform the didactic content in the slide deck to a more engaging and interactive lesson format for learners. I suggested gamifying the content by writing it into a realistic scenario that would mimic their first day in the hospital. To do this, we reorganized the content into a series of decisions the students would need to make in the typical order they would need to make them during pre-rounding (e.g., What materials would they use to take notes? When should they talk to their patients? What types of notes should they take for presentations?).
I also decided to use photos of hospital settings accompanied by ambient hospital sounds to enhance the realism of the experience. For example, the first slide shows a photo of a hospital entrance. There are sounds of cars and sirens in the background -- what you would expect to hear while standing at the entrance to a hospital. After a second, text appears on the screen, and learners can click to learn more about their senior resident and two patients.
The second challenge was in training learners in the software. For this challenge, I leveraged Articulate Storyline's simulation capabilities. I asked the resident to create screen recordings of herself navigating a learning environment version of the software while talking aloud about what she was doing and what students needed to know. I then logged into the learning environment on my own and mimicked her steps click-by-click using Articulate's screen recorder. This enabled me to create several slides where learners could practice navigating the EPIC software in a controlled, risk-free environment.
I also used those same recordings to create videos in Vyond.com of the senior resident character demonstrating how to use the software. This way, learners could watch and hear the steps first. After watching the demonstration, they are presented with the opportunity to try on their own.
Where it ended
Where it ended
The final product was a robust, 162-slide branching Articulate Storyline training with many opportunities for learners to customize their experience to their specific needs. We left the menu unrestricted and allowed learners to bypass practice opportunities so that they could focus on their specific areas on weakness without getting bogged down by having to go through each slides and interaction. This is important for busy medical students who cannot afford to waste time between their full class schedule and clinical experiences.
Quotables
Quotables
"I wish I would have had this before starting 3rd year! I learned a lot of this through trial and error and with the help of interns/med students/senior residents. I think the incoming 3rd years will find this very useful!"
- Sofia Baena
Third year medical student
The Ohio State University College of Medicin
"I am so impressed with this module and wish I had this before I started. This answers quite literally all the questions that medical students ask on the first days. I think this will significantly improve medical student confidence with showing up to a rotation feeling prepared and less burdensome on residents. I even learned Epic tricks that I had never known before!"
- Alyssa Thompson
Fourth year medical student
The Ohio State University College of Medicine
"When it comes to seeing patients in the hospital , a well-prepared student is the best student. To be well prepared, it is important for a student to be good at the art of pre-rounding, or the ability to glean everything about the patient that you can from the electronic medical record (EMR) before you go to see them. This is often a challenging skill to develop and there currently is no standardized education that students get on how to do this effectively even though it is such a core part of being a doctor. The Pre-rounding 101 training aims to create a simulation that not only teaches students efficient ways to collect this EMR information, but also shows students how to set up their Epic EMR so that they can hit the ground running when they first transition to the clinical setting. Working with Jackie Gish-Lieberman during this process was invaluable, as she was able to use her instructional design skills to create a realistic simulation module that is as close as possible to the real thing."
- Dr. Vignesh Doraiswamy
Assistant Clinical Professor of Internal Medicine and Pediatrics
Associate Program Director, Med-Peds Residency
Division of Hospital Medicine
Ohio State University Hospitals
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