Evaluating Student Preferences in Medical Case Simulations: Aquifer vs. Traditional "Paper Cases".

Introduction: This study compares the value of web-based interactive case simulations (specifically, Aquifer) with paper-based case simulations among first-year physician assistant students working in small groups.

Methods: Forty-three first-year physician assistant (PA) students in the gastroenterology module preassigned to physical examination practice groups of 3 or 4 were randomly assigned to work through 2 cases in a crossover study. Roughly half the students were assigned to do a pancreatitis case on Aquifer while the other half worked through a pancreatitis case in a paper-based symptom-to-diagnosis simulation. The groups then switched so that each group changed to the other modality to work through a diverticulitis case. Students were surveyed at the conclusion of both exercises about the value of each modality for learning and for reinforcing learning and asked which modality they preferred.

Results: Forty completed surveys were returned. Nearly 75% of students preferred the manual symptom-to-diagnosis simulation, particularly for small group work, and the most cited reason was that it was "more realistic."

Discussion: Alhough many students found the wealth of information they could read about on Aquifer beneficial, especially when studying alone, students felt that they learned more from the group discussion during the traditional symptom-to-diagnosis case, had more fun learning, and preferred this type of exercise when working in small groups.