Development and Evaluation of a Mobile Application to Strengthen Clinical Reasoning Skills among General Medical Students in the Field of Internal Medicine

Abstract

Introduction: Computer-based technologies, particularly mobile-based simulation technologies, play a significant role in advancing learning objectives and strengthening clinical reasoning. Objective: This study aimed to develop and evaluate a mobile application to enhance clinical reasoning in general medical students in the field of internal medicine at Tabriz University of Medical Sciences. Methodology: This study employed multiple methods, including a systematic review of articles and information technology-based applications, focus group discussions, an expert panel, conceptual program design, content and feature definition, coding, and program evaluation. Findings: Through analysis of 18 articles and 43 electronic tools, the researchers extracted the requirements and functionalities to define virtual patient scenarios and approaches for presenting them in the software. Based on the findings of this stage, focus group discussions and an expert panel finalized content of the application, including scenarios, the required databases, multimedia, and the content of pretest and posttest. Then software was designed in four modules of training, pretest, practice, and posttest. The practice section encompassed the four main stages of clinical reasoning with possibility of changing, deleting, and adding scenarios, as well as reflection along with peer-to-peer group discussions and instructor support. Following software development and a 3-month follow-up period, the average student and faculty satisfaction score were obtained 4.3 and 4.1 out of 5 respectively. A significant increase was observed in the average scores of clinical reasoning test. Conclusion: The virtual patient program can enhance the clinical reasoning skills of medical students, enabling them to act with greater preparedness at clinical settings. Keywords: Clinical Reasoning, Internal Medicine, Simulation, Virtual Patient, Medical Education