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USING HIGH-FIDELITY MEDICAL SIMULATION TO ASSESS CRITICAL THINKING IN MEDICAL STUDENTS by Lynda Daniel-Underwood Chair: Robson Marinho ABSTRACT OF GRADUATE STUDENT RESEARCH DissertationOF GRADUATE STUDENT RESEARCH Dissertation Andrews University School of Education Title: USING HIGH-FIDELITY MEDICAL SIMULATION TO ASSESS CRITICAL THINKING IN MEDICAL STUDENTS Name of researcher: Lynda Daniel-Underwood Name and degree of faculty chair: Robson Marinho, Ph.D. Date completed: February 2016 Problem Graduating competent physicians is an imperative societal need. The development of critical thinking skills during medical school is important to meet this societal need and for the care of ill patients. Research shows this skill is key in decreasing medical errors, which in turn decreases cost. (Norman and Eva, 2010) Missing from the literature is a method to assess critical thinking in the setting of caring for the critically ill patient. This instrumental case study tests medical simulation as a method of assessing critical thinking, which incorporates all six competency domains, by looking at the assessment environment, summative patient experience, and participant’s reflection on the case and environment. Method A qualitative instrumental case study design was used to evaluate twelve senior medical students’ critical thinking skills in the setting of identified competency domains. A single simulation patient encounter was administered to each student and data collected from the videotape of the encounter, their written documentation, and oral presentation of the case, mimicking the real-life scenario. The participants were also asked five questions regarding this case. These data were analyzed and presented in narrative format. Results The analysis revealed six major themes: assessment environment, coalescence of knowledge and skills, decision-making and deep thinking/reasoning, integrative experience, lack of depth in thought process, and safe environment. This research identified gaps in the students’ knowledge, skill, and behaviors of competency domains as they apply to critical thinking. Despite all students successfully completing medical school, errors were made in their individual care of the simulated patient. Four cases ended in “death” of the patient. The documentation of their patient encounter also lacked sufficient detail to allow other medical professionals to understand the issues during the case. The students’ opinion of the patient encounter was positive. Several students noted they had not had similar encounters as the sole provider of patient care. The experience gave them the opportunity to apply what they had learned and reflect on their

Using High-fidelity Medical Simulation to Assess Critical Thinking in Medical Students