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A Basis for Electronic Cognitive Simulation: The Heuristic Patient

University of Maryland School of Medicine, MSTF 334, 10 South Pine Street, Baltimore, MD 21201 dmallott{at}clc.umaryland.edu

John Raczek, BA

Craig Skinner, MD

Kevin Jarrell, BS

Mark Shimko, BA

Bruce Jarrell, MD

University of Maryland School of Medicine, Baltimore

Although medical trainees are expected to become expert quickly and safely, limited electronic methods are available to rehearse medical cognition for common outpatient and nonemergent inpatient problems. We conducted a series of formal observational sessions designed to determine what interaction requirements are desirable for student rehearsal of medical management by using an electronic patient. The studies utilized both manual and electronic methods for a student to evaluate and manage patients with medical and surgical problems. We observed the following major requirements for an effective simulation experience: the user must have a trial-anderror experience with the patient; the user must have unconstrained access to query and treat the patient; anatomic and physiologic values in the patient must change appropriately in response to user actions; and the user must be able to control certain time-related aspects of the simulation. When these requirements are implemented within a simulation, userdirected management of an electronic patient, by itself, becomes a strong aid to learning by trial-and-error techniques. We conclude that the heuristic patient is a practical and useful concept. Once fully developed, it would allow rehearsal of patient care decision making, intrinsically demonstrating trainee knowledge deficits, and resulting in self-directed learning.

Surgical Innovation, Vol. 12, No. 1, 43-49 (2005)
DOI: 10.1177/155335060501200107


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