Internal medicine games

Future work should evaluate its impact on educational outcomes. Peer Review reports. Researchers have evaluated a number of strategies to improve the implementation of clinical practice guidelines CPGs.

These strategies include didactic sessions, passive dissemination of information, printed educational materials, audit and feedback, interactive workshops, use of local opinion leaders, and computerized decision support systems. However, the effects of these interventions vary from trivial to moderately large [ 1 ]. Research evidence also suggests a higher efficacy of multifaceted interventions and underlines the importance of tailoring interventions to specific barriers and particular settings [ 1 , 2 ].

An educational game is defined as a competitive activity with a prescribed setting constrained by rules and procedures [ 3 ]. Learning results from peer interaction and feedback in an entertaining and low risk environment.

By allowing active learning experiences, educational games stimulate higher thinking such as analysis, synthesis, and evaluation [ 4 ]. They make the learning process fun and exciting and reduce stress and anxiety, which in turn may increase retention [ 5 ]. They also can generate useful points of departure for discussion [ 6 ]. Thus, educational games represent an educational strategy of growing interest and has the potential to improve adherence to CPGs [ 7 , 8 ].

Indeed, these games could be used in multifaceted interventions, could be tailored to the particular setting of residency training, and would address two of the major barriers to adherence to CPGs [ 9 ]: the lack of awareness of CPGs and the lack of familiarity with their recommendations. Formal and informal discussions with internal medicine residency program directors and chief residents at the national and local level revealed a need for additional strategies for teaching CPGs with an interest in educational games as a potential strategy.

We initially designed the game for teams instead of single users to compete in order to use it in group educational activities e. The approach included 3 steps: 1 developing a comprehensive list of guidelines for potential inclusion; 2 assessing these guidelines for inclusion, including a methodological quality assessment using the Appraisal of Guidelines Research and Evaluation AGREE instrument [ 10 ]; 3 developing questions based on the recommendations of the included guidelines.

Indeed, the pilot testing see below confirmed the need for such tailoring. We conducted four weekly sessions of the game at a hospital training site for the Internal Medicine residency program at the University at Buffalo. A senior resident RM doing an EBM elective run the sessions [ 11 ] and participants consisted of a convenience sample of 30 residents rotating at the training site at that time.

Each session lasted 45 minutes and was followed by 15 minutes qualitative feedback sessions. The feedback consisted of answering in writing open ended questions followed by an open verbal group discussion. We improved each of the three components of the game tool, questions, and rules through an iterative process of pilot testing, feedback and revision. The 15 minutes qualitative feedback sessions included questions about the acceptability of the game in terms of interest in the educational strategy and engagement in the learning process.

We used the results of the evaluation after each session to improve the game prior the following session. Figure 1 shows the tool workflow diagram. The tool uses a Macromedia Flash web application and consists of a manager interface and a user interface compiled by Revolution for Mac and PC.

The manager interface allows the creation and editing of questions using a question editor Figure 2. It also collects data and produces reports about which questions participants selected and what answers they chose. The user interface allows choosing the game settings and running the game. The instructions for the manager interface are available as a users' guide PDF file. The user interface settings include the choice of two game styles with different sets of rules see below , the game length and the question length Figure 3.

Additional features include a soundtrack, the ability to choose the competing teams' names, a countdown clock for the game time, a countdown ticking clock and a timeout sound alert for each question, sounds to indicate whether an answer was correct or incorrect, and automatically calculated and displayed scores.

The instructions for the user interface are imbedded the interface itself in order to make it user friendly. A moderator runs the game on a computer and projects it on a wide screen for participants viewing.

The "main screen" displays 5 columns corresponding to 5 different guidelines Figure 4. Each column has 6 rows corresponding to 6 different questions. The "question screen" presents the question with a number of answer options Figure 5.

After the correct answer is provided, a "rationale screen" provides an explanation for the recommendation e. The "review screen" is available at the end of the game and shows whether a question was answered correctly or incorrectly and by which team Figure 6. It thus gives the moderator the opportunity to review questions and to provide the correct answers and the rationale. The user interface allows choosing from two game styles "Classic" and "Rally" that differ by their rules Additional file 3.

The two styles differ mainly by the timing of the provision of the correct answer to an incorrectly answered question. In the classic strategy, designed for learning purposes, the answer is provided before moving to the next question. Vertigo is mostly caused by inner ear problems. New Year resolutions are usually not complete without losing weight on the list.

Here are simple and easy ways of losing and maintaining a healthy body weight. Evidence Based Medicine combines research evidence with patient values and clinical skills to solve medical problems and improve patient outcome. Show More Related Topics. Disclaimer - All information and content on this site are for information and educational purposes only.

The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer. This site complies with the HONcode standard for trustworthy health information: verify here. Contact Details Dr. Virendra Singh bijnor, uttar pradesh.

We will allow you access once we verify your details. Interactive Map. Premium Listing. The kind pastor who would now be years old selected "Herta" for me—a very fashionable name in Germany in the last century. Lynn E. It is recognition of having excelled and created something of value for the institution, for my colleagues, and for the community of New Haven.

It has also given me the opportunity to build a team, of almost entirely women, who are brilliant and talented and work tirelessly, and without whose efforts and good humor, the work would not happen and we would not enjoy the work as much as we do. I have had the opportunity to create something of value that has only grown in scope and impact over the past decade and that is something I am really proud of.

Herzog is a physician-scientist seeking new treatments for chronic lung diseases. Sponsored by:. Share Facebook. Question 1 Question 2 Results. Question 1 of 6. Internal Medicine Board Review Sample Question 1 A year-old patient presents by referral from the emergency department ED for evaluation of shortness of breath.

Paradoxical vocal cord motion Explanation: This patient has intermittent symptoms most suggestive of upper respiratory tract obstruction. A It is an analog of vasopressin and can cause hypernatremia. B It should not be given chronically to prevent bleeding in patients with moderate von Willebrand disease vWD. C It does not have efficacy in several mild platelet disorders, such as storage pool defect. D It can be used in all causes of vWD. The correct answer is B.

It should not be given chronically to prevent bleeding in patients with moderate von Willebrand disease vWD.