Effectiveness of Virtual Patient Simulation Training for First-Year Au.D. Students
Poster Number
3
Introduction/Abstract
Clinical audiometry training has traditionally required hands-on experience from real patient interaction to acquire practice and advance clinical skills. This has proven limitations due constraints such as number of patients to practice upon. Otis the Virtual Patient (Otis) Program is a patient simulation program designed to provide audiology students with practice by simulating a variety of hearing impairment cases on a computer interface, thus eliminating the need for a real patient for practice. Students can access the program at any time for unlimited practice, and progress through levels of difficulty as they complete self-tests. The program features an audiometer panel, real-life patient responses, and instant feedback to guide the student during a simulated audiological evaluation. Although well-received, the effectiveness of the program on improving audiology student clinic skills has not been measured and is therefore not well understood.
Purpose
The purpose of this study is to evaluate the level of improvement Otis use has the on the clinical skills of first year audiology students. Knowledge from this study will provide a greater understanding of the value of patient simulation program use in clinical medical training, specifically clinical audiometry training.
Method
23 first-year Doctor of Audiology (Au.D.) students at the University of the Pacific were participants in this study. Consent for participation was obtained in accordance with U.O.P. IRB. TRAINING PROCEDURE: Otis-the virtual patient simulates a range of hearing defects so that correct audiometry can be administered without having to burden a patient. The software simulates the behavior of the patient and detects possible user errors immediately. The program guides the learner through the exercises at several levels of difficulty and provides useful help. Students performed weekly exercises that increased in difficulty throughout the first semester. TRAINING ASSESSMENT: A questionnaire was given the next semester to assess their self-perceived Otis use effect. This piece is a self-assessment of knowledge or skills gained and the students' expected application of learning. This was assessed using 5-point value questions from “Strongly Agree” to “Disagree” that probed three out of Four of Donald Kirkpatrick’s Training Evaluation Model: Reaction, Learning and Behavior Reaction was measured by how students Valued the Patient Simulation Training (VAL), Learning was measured by questions on perceived Knowledge of Clinical Audiometry (KNW), and Behavior was measured by perceived Confidence in performing audiometric procedures (CNF). The fourth dimension, Results, was measured by Otis and Practical Scores. RESULTS ASSESMENT: Three final Otis test exercises were evaluated at the end of the semester (Self Test 41, 51, 61). Although all outputs of Otis were assessed, only user error of “Average Deviation from Hearing Threshold” (ADHT) and “Maximum Deviation from Hearing Threshold” (MDHT) varied with student performance. ADHT and MDHT measures student deviation from correct simulated patient Hearing Threshold. CLINICAL PERFORMANCE ASSESSMENT: Student clinical performance was measured by student score on University of the Pacific’s Midterm and Final Practical Score. DATA ANALYSIS: To determine whether Otis user error and student value/performance varied together, Pearson’s R correlations were performed among all measures. No significant correlations were observed, suggesting a discontinuous relationship. Upon observation, bivariate distributions were observed with the KNO and CON variables, suggesting a difference between students who felt Otis improved their performance and those who didn’t. Subsequent analysis was performed on students separated into High and Low KNW and CNF groups based on > or < 3 (3=neutral score).
Results
Results revealed that virtual patient simulation training increases both student Confidence and Knowledge of audiometric procedures, which leads to improved performance on their Final Practical examinations. Audiology students find the idea of patient simulation training useful and interesting in their clinical training. Students also appreciate instant feedback when performing audiometric procedures. It is also most useful in improving the threshold searching skills. Au.D. programs may benefit from virtual patient simulation training under controlled conditions, as it is an easily accessible and effective resource for students to strengthen their developing skills, particularly during their first semester. However, the relationship of Otis output measures to Student performance in Clinic is still unclear, and would require further studies.
Significance
Measured benefits will assist with integrating Otis the Virtual Patient Program into a Doctor of Audiology program to more effectively and efficiently train Audiology students, and also strengthen existing clinical skills. The potential benefits include an understanding of how simulation programs can support clinical training that require patient responses. This information can be used to integrate patient simulation programs into other clinic-based program curriculums. This will reduce the time spent training student audiologists and students in similar clinic-based healthcare programs.
Location
DUC Ballroom A&B
Format
Poster Presentation
Poster Session
Afternoon
Effectiveness of Virtual Patient Simulation Training for First-Year Au.D. Students
DUC Ballroom A&B
Clinical audiometry training has traditionally required hands-on experience from real patient interaction to acquire practice and advance clinical skills. This has proven limitations due constraints such as number of patients to practice upon. Otis the Virtual Patient (Otis) Program is a patient simulation program designed to provide audiology students with practice by simulating a variety of hearing impairment cases on a computer interface, thus eliminating the need for a real patient for practice. Students can access the program at any time for unlimited practice, and progress through levels of difficulty as they complete self-tests. The program features an audiometer panel, real-life patient responses, and instant feedback to guide the student during a simulated audiological evaluation. Although well-received, the effectiveness of the program on improving audiology student clinic skills has not been measured and is therefore not well understood.
