Development of a Web based Immersive Patient Simulator as a curricular tool for OSCE preparation in surgery

Background: OSCE (Objective Structured Clinical Examination) is a standard method of testing declarative and process knowledge in clinical core competencies. It is desirable that students undergo OSCE training before participating in the exam. However, establishing OSCE training is resource intensive and often limited in practice time. Web-based immersive patient simulators like ALICE (Artificial Learning Interface of Clinical Education) can possibly fill this gap as they allow the training of complex medical procedures at the user’s individual pace and with an adaptable number of repetitions at home. ALICE is known to positively influence knowledge gain and motivation. Aim: Therefore, the aim of this study was the development of a simulator-based curriculum that teaches declarative and process knowledge and prepares for a real OSCE station. Furthermore, we wanted to test influence in knowledge gain and student motivation. Methods: A specific curriculum was developed in order to implement the relevant medical content of two surgical OSCE Stations into the “ALICE” simulator framework. A total of 190 medical students were included in the study. 130 students participated in the study and were compared to 60 students in a control group. Students’ knowledge gain and motivation was tested at different points in time. Results: The curriculum was developed according to the Kern cycle. Identification of the target group reveals that students, teachers, patients and the faculty possibly benefit from integrating ALICE into the curriculum. Seven virtual clinical cases were implemented with different teaching methods (structured feedback, keynote speech, group discussion and debriefing by a real instructor) in order to consolidate declarative and process knowledge. ALICE puts students in an active learner role as it uses constructive and interactive methods in order to promote knowledge gain and influences students’ intrinsic motivation. Working with ALICE had significant impact on declarative knowledge gain and OSCE performance. ALICE had no significant long-term effect when used as an additional training tool together with traditional sources. Students showed high levels of motivation and enjoyed working with ALICE. Conclusion: ALICE offers web-based training for OSCE preparation and can be used as a selective didactic intervention as it has positive effect on knowledge gain and student motivation.