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

Teaching of clinical decision-making is an important component of health professions education. Patient case examples are widely used in didactic coursework to teach this material, but engaging all learners in large, lecture-based courses remains a challenge. Interactive fiction (IF), a digital choose-your-own-adventure media, provides an accessible way for students to individually explore the narrative of a patient-case in a safe environment. Here, we report the development of interactive, digital patient-cases (eCases) using Twine, a free IF development platform. Fourteen eCases were developed in collaboration with 11 faculty members and were used in seven different PharmD courses over three semesters. eCase content was developed by faculty members for their respective instructional topics and accessed via Web browsers on students' personal electronic devices. eCases were received positively by students, with > 90% of students reporting that eCases were easy to use, helped them learn the material at their own pace, and gave them an opportunity to learn from mistakes. Student self-perceived confidence also increased significantly after eCase use. Faculty reported that eCases took more time to develop than conventional cases, but were easier to deliver and provided better student engagement. IF is an accessible media for creating and delivering low-fidelity interactive patient cases that can engage all students in a large class. eCases allow students to apply their knowledge, practice clinical decision-making, and safely learn from their mistakes. eCases are versatile and well suited for both in-person and virtual teaching across a variety of health professions programs to teach clinical decision-making.

The online version contains supplementary material available at 10.1007/s40670-021-01245-7.