title: Clinical decision making: a pilot e-learning study.
abstract: BACKGROUND
  As many medical schools focus on student-centred learning strategies, e-learning provides a useful approach to foster clinical decision-making skills in a case-based way. We developed an e-learning module based on real patient cases for final-year students as a self-directed studying tool.
  
  
  METHODS
  Ten patient cases were developed from patients treated in the emergency room. Original documents were integrated into the virtual patient system CASUS(®) . In total, 522 students from three different terms of their final year were invited to use the e-learning module. Students filled out a self-assessment questionnaire regarding clinical decision-making skills before and after the module, and were also asked to fill out an evaluation form.
  
  
  RESULTS
  Only 30 per cent of the students invited participated in the e-learning module, and even fewer filled out the questionnaires. Nevertheless, the students participating liked the online cases and valued the relevance of the diseases. An increase in the self-assessment rating of clinical decision-making skills after the e-learning module was only seen for students in the first term of their final year. Additionally, those students showed significantly lower scores in their pre-module clinical decision-making skills compared with students in terms two and three of their final year.
  
  
  CONCLUSIONS
  Even though the overall participation was small, participating students were satisfied with the e-learning module and were motivated to work with the cases. A better integration into the clinical curriculum and a stronger association with an exam might provide an even better learning opportunity for medical students with respect to the acquisition of clinical decision-making skills.
authors.affiliation: Department of Internal Medicine, University Hospital Hamburg-Eppendorf, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Abendroth
authors.forename: Sigrid
authors.initials: S
authors.lastname: Harendza
authors.forename: Martin
authors.initials: M
authors.lastname: Riemer
mesh_terms: D002983:Clinical Competence; D003258:Consumer Behavior; D003657:Decision Making; D020375:Education, Distance / Q000379:methods*; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D020407:Internet; D016544:Patient Simulation; D013337:Students, Medical / Q000523:psychology*; D014584:User-Computer Interface