Using Interactive Fiction to Teach Clinical Decision-Making in a PharmD Curriculum

Area of Science:

• Health Professions Education
• Medical Simulation
• Digital Learning Tools

Background:

• Clinical decision-making is crucial in health professions education.
• Engaging all learners in large lecture-based courses presents a significant challenge.
• Patient case examples are a common but often limited teaching method.

Purpose of the Study:

• To develop and evaluate interactive, digital patient cases (eCases) using Interactive Fiction (IF) for teaching clinical decision-making.
• To assess student engagement, learning experience, and self-perceived confidence.
• To evaluate faculty perceptions of eCase development and delivery.

Main Methods:

• Developed 14 eCases using Twine, a free IF platform, in collaboration with 11 faculty members.
• Integrated eCases into seven PharmD courses over three semesters, accessed via web browsers.
• Collected student feedback on usability, learning pace, and mistake-based learning, and measured changes in self-perceived confidence.

Main Results:

• Over 90% of students found eCases easy to use, facilitating self-paced learning and learning from mistakes.
• Significant increase in student self-perceived confidence after using eCases.
• Faculty reported eCases were easier to deliver and improved student engagement, despite increased development time.

Conclusions:

• Interactive fiction (IF) provides an accessible medium for creating engaging, low-fidelity interactive patient cases.
• eCases enable students to apply knowledge, practice clinical decision-making, and learn from errors in a safe environment.
• eCases are versatile for in-person and virtual teaching across health professions programs to enhance clinical decision-making skills.