Online medical history taking course: Opportunities and limitations in comparison to traditional bedside teaching.
Silvan Lange, Nils Krüger, Maximilian Warm, Mark Op den Winkel, Johanna Buechel, Johanna Huber, Orsolya Genzel-Boroviczény, Martin R Fischer, Konstantinos Dimitriadis
Author Information
Silvan Lange: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany.
Nils Krüger: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany.
Maximilian Warm: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany.
Mark Op den Winkel: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Department of Internal Medicine II, Munich, Germany.
Johanna Buechel: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Department of Gynecology and Obstetrics, Munich, Germany.
Johanna Huber: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany.
Orsolya Genzel-Boroviczény: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Dr. von Hauner Children's Hospital, Division of Neonatology Campus Innenstadt, Munich, Germany.
Martin R Fischer: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany.
Konstantinos Dimitriadis: University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany.
Objective: Obtaining a systematic medical history (MH) from a patient is a core competency in medical education and plays a vital role in the diagnosis of diseases. At the Faculty of Medicine at LMU Munich, students have their first course in MH taking during their second year. Due to the COVID-19 pandemic, the traditional bedside MH taking course had to be transformed into an online course (OC). Our objectives were to implement an online MH taking course, to evaluate its feasibility and to compare the evaluation results to a historic cohort that had undertaken the traditional bedside teaching course (BTC). Methods: 874 second-year students participated in the OC (BTC=827). After teaching the theoretical background via asynchronous online lectures, students participated in a practical exercise with fellow students using the video communication platform Zoom where they were able to practice taking a MH on the basis of fictitious, text-based patient cases. Students were then asked to evaluate the course through a standardized online survey with 31 questions on teaching quality and self-perceived learning success, which had also been used in previous years. The survey results were compared to the results of the historic cohort using the Mann-Whitney U test. Results: A total of n=162 students (18.5%) evaluated the OC. In the historic cohort, n=252 (30.5%) completed the survey. 85.3% of the OC respondents thought that the atmosphere during the practical exercise was productive and 83.0% greatly appreciated the flexibility in terms of time management. Moreover, they appreciated the online resources as well as having the opportunity to undertake a MH taking course during the COVID-19 pandemic. 27.7% of the respondents thought that traditional BTCs should be supplemented through more online activities in the future. With respect to the ability of independently taking a MH upon completion of the course, the OC was rated significantly lower relative to the BTC (mean OC=2.4, SD=±1.1 vs. mean BTC=1.9, SD=±1.1 (1=strongly agree; 5=strongly disagree); p<0.0001). Conclusion: OCs are a feasible format and seem to convey the theory and practical implementation in a peer-exercise format of MH taking to medical students. The theoretical background can be acquired with great flexibility. Nevertheless, the students' self-appraisal suggested that the traditional teaching format was more effective at teaching MH taking skills. Thus, we propose a blended learning concept, combining elements of both formats. In this context, we suggest prospective, randomized trials to evaluate blended learning approaches.
