In May, the Brazilian Federal University of Minas Gerais (UFMG) started implementing Practicum Script as a formative activity in years 5 and 6 of the medical degree. The public leader institution in education and scientific research has adopted this online clinical reasoning training and assessment platform, using real-life clinical cases, to prepare its medical students for the clinical stage in a safe-to-fail environment. For the coordinator of the simulation laboratory, Prof. Maria do Carmo Barros de Melo, “Practicum Script helps students practice clinical reasoning. Its use in the last three years of the medical course in a longitudinal manner is interesting and relevant, allowing content to be added gradually.”
Belo Horizonte, 17th June 2024. According to a survey published by the Institute of Supplementary Health Studies of UFMG, almost 55,000 people die each year in Brazil due to medical errors (the equivalent of six per hour!). Prof. Barros de Melo is aware that most of these medical errors are not due to inadequate knowledge, but to cognitive failures, mainly in uncertain situations. The point for the university, when they took the decision to apply Practicum Script in the clinical cycle, was to provide students with an opportunity to test their clinical judgment in high-fidelity healthcare settings in internal medicine in order to preserve patient safety and reinforce clinical competence at an early stage.
For this purpose, UFMG has signed an agreement with the Practicum Foundation (Madrid, Spain) to conduct a two-year pilot experience, in which Practicum Script is expected to foster the students’ cognitive skills and autonomy for clinical decision-making, through repetition, immediate feedback and reflection on actions. The longitudinal standardised approach, applicable to Y4, Y5 and Y6, helps to identify errors and reduce bias, while assimilating relevant knowledge and know-how, in relation to scientific evidence and experience-based medicine.
In short, Prof. Barros de Melo trusts that this methodology will reinforce clinical maturation among students by offering genuine challenges of daily practice. The medical contents for this experience, which aims to evaluate the educational impact of Practicum Script, as well as the level of satisfaction with the methodology among the teaching staff and the students, have been validated by local experts and recently audited by staff of UFMG to ensure its relevance in Brazil. The results of the study will be published in an international medical education journal.
Furthermore, UFMG has planned a calendar of post-simulation clinical debriefings to complement this self-regulated learning. The main goal of these sessions is to encourage students to think critically and improve their retention by learning through the discussion of events and mentor guidance. To do this, a group of selected teachers is using Practicum Mentoring, a digital solution for the development of clinical debates, using maieutic methods, with special attention to the deconstruction of errors.
Proficiency increases with practice
Virtual patients offer an excellent way to accelerate the learning curve in medical education. By interacting with life-like cases based on real records, where they must order tests, treat and diagnose by formulating their own hypotheses in free text, learners build the skills necessary to care for encounters in the flesh. Novices can exercise problem-solving skills, make mistakes and learn from them in a controlled manner. Also, the exposure to a wide range of clinical conditions and complex scenarios helps students better prepare for the real-world, where statistical patients, book cases and single algorithmic solutions are not that common.
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