Second Life and Classroom Environments: Comparing Small Group Teaching and Learning in Developing Clinical Reasoning Process Skills

Abstract

Medical education and clinical practice support the development of clinical reasoning competency. Traditionally, the process of clinical reasoning is taught through small group discussions in pre-clinical and clinical medical training, and the need exists to explore further teaching and learning approaches that develop clinical reasoning. This study compared teaching and learning the clinical reasoning process through the virtual platform of Second Life (SL) with the traditional classroom setting. Participants were first semester veterinary students; 34 participated virtually through SL, and 41 experienced traditional classroom interactions. Students and one facilitator engaged in three small group meetings to process a clinical case. A seven-item clinical reasoning rubric guided the teaching, learning, and assessment. Clinical reasoning assignments were scored on a grading scale from 0 to 4 with a maximum result of 28. Descriptive statistics for clinical reasoning assignment scores were (m = 14.0; SD = 2.6) and (m = 12.2; SD = 2.6) in SL and classroom interaction, respectively. Results indicated positive associations for all participants between the rubric item score of gathering historical information with (1) gathering physical examination information (p < 0.01) and (2) prioritizing patient's problems (p = 0.003). Additionally, the rubric item score of gathering physical examination information was positively associated with the rubric item score for prioritizing patient's problems (p = 0.02). Specifically for the SL cohort, results demonstrated that rubric item scores were significantly higher for gathering historical information (p = 0.03), gathering physical examination information (p < 0.01), and prioritizing patient's problems (p = 0.02). Small group interaction using SL and traditional classroom environments offers a comparable educational platform for developing clinical reasoning process skills.

Keywords: Clinical reasoning assessment; Clinical reasoning process; Second life; Veterinary education; Virtual learning.