About the Advanced Clinical/Diagnostic Reasoning VIC Cases

Virtual Interactive Cases (VIC) were developed to allow graduate students in the NP Program at the Lawrence S. Bloomberg Faculty of Nursing an opportunity to engage in the deliberate practice of clinical reasoning. Students were presented with a presenting complaint; they were required to assess the patient using a focused health history and physical examination. Students were able to review relevant diagnostic tests and diagnostic imaging related to the presenting complaint and relevant health history and physical examination findings. When students were ready, they formulated a diagnosis and selected an appropriate management plan. Students were provided with feedback about their diagnosis and their management plans, as well as a time and a cost for their assessment. This time and cost score provided incentive to the student to conduct a more focused examination based on the patient's presenting complaint.

Anecdotal feedback from students:

  • The VIC format is great and I especially like that it provides a rationale as to why an action is appropriate or not. Also, I think this format is easier to recall when considering medications, which makes it a bit easier to retain the information.

  • I really like this format. It makes you stop and think about what you are ordering and whether it is really necessary.

  • I think it's great. I had to work through the first case to get used to it, but once I was familiar with the format I found it really helpful in consolidating and applying what I learned to a patient case. It helps me to think through what are the most pertinent physical exams and diagnostic tests I should focus on. It reminds me of how different clinical manifestations help me to differentiate one type of chest pain from another.

  • I love the VICs! I also had to get used to the first case, and now have a basic understanding for the second one and how to go about using VICs. For example, (to save money/time) I would choose one question that would answer my question, instead of the various options listed there that overall point to the same direction. However, if I did that, it would prompt me to actually select all the questions that are related to the dx, even if I got the answer from just asking one of the questions.

  • Going through the cases confirmed what my kids have been telling me for years, I ask too many questions!!! And asking too many questions doesn't necessarily give you the end result you need; one of my take away learnings was to be more focused in my assessment and now that I have completed the cases as well as gone back and learned more about the diagnoses I can see where a lot of my questions were irrelevant. Overall, I think this is a good way to learn as opposed to just reading and discussing.

  • I just finished the interactive case studies, and I have to say, I absolutely loved going through them. I found them intellectually stimulating, challenging and enjoyable! Kindly provide more resources as such. Thank you.

  • I thought the VIC's were awesome. They really challenge you to think about what is relevant and what is not. Many a time I was perhaps asking too many irrelevant questions that took up time and money. This is also an important point to consider in practice. Please provide as many as you can--what a great learning tool!!!

  • I think that this is a great tool to get you thinking outside of the classroom setting and actually applying the theoretical knowledge. A beginning step to bringing knowledge-to-practice. Thanks for putting so much work into making these knowledge-testing tools. It was stressful but helpful.

  • They have helped in determining the best diagnostic and treatment approaches to use. The VIC cases provide an excellent opportunity to apply the theoretical/textbook knowledge that we gain in a controlled setting where it's really ok to make mistakes (and learn from those mistakes). I think it will better prepare us for the real life experience ahead of us. I plan to practice these cases as much as I can, with the thought that this will help to consolidate the theory that is bouncing around in my head! I look forward to more of them. I'm hoping that there will be several VIC cases per module over time.

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