BACKGROUND: Medical education, in general, is undergoing a significant shift from traditional methods. It becomes very difficult to discover effective teaching methods within the limited possibilities in patient hands-on education, especially as seen in anesthesiology and intensive care medicine (AIM) teaching. Motivation-based teaching is very popular in all other aspects of education, but it has received scant attention in medical education literature, even though it can make a real difference for both students and physicians. OBJECTIVE: The primary aim of this retrospective audit was to find out if proper motivation-based teaching of students via the development of AKUTNE.CZ's serious games can help retain graduates of the Faculty of Medicine of Masaryk University (FMMU) for the AIM specialty. METHODS: Motivation-based teaching and the learning-by-doing concept were applied to a subject called Individual Project. Our topic, The Development of the Multimedia Educational Portal, AKUTNE.CZ, has been offered since 2010. The objective has been the development of supportive material in the form of interactive algorithms, serious games, and virtual patients for problem-based learning or team-based learning lectures aimed at acute medicine. We performed a retrospective questionnaire evaluation of all participants from the 2010-2017 period, focusing on their choice of medical specialty in 2017. The data were reported descriptively. RESULTS: We evaluated 142 students who passed Individual Project with topic The Development of the Multimedia Educational Portal, AKUTNE.CZ during 2010 to 2017. In this period, they developed up to 77 electronic serious games in the form of interactive multimedia algorithms. Out of 139 students in general medicine, 108 students (77.7%) had already graduated and 37 graduates (34.3%) worked in the AIM specialty. Furthermore, 57 graduates (52.8%) chose the same specialty after graduation, matching the topic of their algorithm, and 37 (65%) of these graduates decided to pursue AIM. CONCLUSIONS: Motivation-based teaching and the concept of learning-by-doing by the algorithm/serious game development led to the significant retention of FMMU graduates in the AIM specialty. This concept could be considered successful, and as the concept itself can also be well integrated into the teaching of other medical specialties, the potential of motivation-based teaching should be used more broadly within medical education.

Department of Anesthesiology and Intensive Care Medicine University Hospital Pilsen Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic

Department of Pediatric Anesthesiology and Intensive Care Medicine University Hospital Brno Faculty of Medicine Masaryk University Brno Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

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Poulton T, Balasubramaniam C. Virtual patients: a year of change. Med Teach. 2011 Jan;33(11):933–7. doi: 10.3109/0142159X.2011.613501. PubMed DOI

Robison DG, Bridges-Catalano J, Matson CC. The role for virtual patients in the future of medical education. Acad Med. 2017 Dec;92(1):9. doi: 10.1097/ACM.0000000000001493.00001888-201701000-00003 PubMed DOI

Edelbring S, Dastmalchi M, Hult H, Lundberg IE, Dahlgren LO. Experiencing virtual patients in clinical learning: a phenomenological study. Adv Health Sci Educ Theory Pract. 2011 Aug;16(3):331–45. doi: 10.1007/s10459-010-9265-0. PubMed DOI

Salminen H, Zary N, Björklund K, Toth-Pal E, Leanderson C. Virtual patients in primary care: developing a reusable model that fosters reflective practice and clinical reasoning. J Med Internet Res. 2014;16(1):e3. doi: 10.2196/jmir.2616. v16i1e3 PubMed DOI PMC

Poulton T, Ellaway RH, Round J, Jivram T, Kavia S, Hilton S. Exploring the efficacy of replacing linear paper-based patient cases in problem-based learning with dynamic web-based virtual patients: randomized controlled trial. J Med Internet Res. 2014 Nov;16(11):e240. doi: 10.2196/jmir.3748. v16i11e240 PubMed DOI PMC

Bateman J, Allen M, Samani D, Kidd J, Davies D. Virtual patient design: exploring what works and why. A grounded theory study. Med Educ. 2013 Jun;47(6):595–606. doi: 10.1111/medu.12151. doi: 10.1111/medu.12151. PubMed DOI PMC

Bateman J, Allen ME, Kidd J, Parsons N, Davies D. Virtual patients design and its effect on clinical reasoning and student experience: a protocol for a randomised factorial multi-centre study. BMC Med Educ. 2012 Aug 1;12:62. doi: 10.1186/1472-6920-12-62. 1472-6920-12-62 PubMed DOI PMC

Jin J, Bridges SM. Educational technologies in problem-based learning in health sciences education: a systematic review. J Med Internet Res. 2014;16(12):e251. doi: 10.2196/jmir.3240. v16i12e251 PubMed DOI PMC

Koh GC, Khoo HE, Wong ML, Koh D. The effects of problem-based learning during medical school on physician competency: a systematic review. CMAJ. 2008 Jan 1;178(1):34–41. doi: 10.1503/cmaj.070565. 178/1/34 PubMed DOI PMC

Dolmans D, Michaelsen L, van Merriënboer J, van der Vleuten C. Should we choose between problem-based learning and team-based learning? No, combine the best of both worlds! Med Teach. 2015 Apr;37(4):354–9. doi: 10.3109/0142159X.2014.948828. PubMed DOI

Walker A, Leary H. A Problem Based Learning Meta Analysis: Differences Across Problem Types, Implementation Types, Disciplines, and Assessment Levels. Interdisciplinary Journal of Problem-Based Learning. 2009 Mar 24;3(1) doi: 10.7771/1541-5015.1061. DOI

Georg C, Zary N. Web-based virtual patients in nursing education: development and validation of theory-anchored design and activity models. J Med Internet Res. 2014;16(4):e105. doi: 10.2196/jmir.2556. v16i4e105 PubMed DOI PMC

Hege I, Kononowicz AA, Adler M. A clinical reasoning tool for virtual patients: design-based research study. JMIR Med Educ. 2017 Nov 2;3(2):e21. doi: 10.2196/mededu.8100. v3i2e21 PubMed DOI PMC

Kononowicz A, Woodham L, Georg C, Edelbring S, Stathakarou N, Davies D. Virtual patient simulations for health professional education. Cochrane Database Syst Rev. 2016 doi: 10.1002/14651858.CD012194. DOI

Edelbring S, Parodis I, Lundberg IE. Increasing reasoning awareness: video analysis of students' two party virtual patient interactions. JMIR Med Educ. 2018 Feb 27;4(1):e4. doi: 10.2196/mededu.9137. v4i1e4 PubMed DOI PMC

Subramanian A, Timberlake M, Mittakanti H, Lara M, Brandt ML. Novel educational approach for medical students: improved retention rates using interactive medical software compared with traditional lecture-based format. J Surg Educ. 2012;69(2):253–6. doi: 10.1016/j.jsurg.2011.12.007.S1931-7204(11)00358-8 PubMed DOI

Norman G. Problem-based learning makes a difference. But why? CMAJ. 2008 Jan 1;178(1):61–2. doi: 10.1503/cmaj.071590. 178/1/61 PubMed DOI PMC

Woodham LA, Ellaway RH, Round J, Vaughan S, Poulton T, Zary N. Medical student and tutor perceptions of video versus text in an interactive online virtual patient for problem-based learning: a pilot study. J Med Internet Res. 2015 Jun 18;17(6):e151. doi: 10.2196/jmir.3922. v17i6e151 PubMed DOI PMC

Hayat AA, Salehi A, Kojuri J. Medical student's academic performance: the role of academic emotions and motivation. J Adv Med Educ Prof. 2018 Oct;6(4):168–75. PubMed PMC

Hanrahan J, Sideris M, Tsitsopoulos PP, Bimpis A, Pasha T, Whitfield PC, Papalois AE. Increasing motivation and engagement in neurosurgery for medical students through practical simulation-based learning. Ann Med Surg (Lond) 2018 Oct;34:75–9. doi: 10.1016/j.amsu.2018.08.002. S2049-0801(18)30136-5 PubMed DOI PMC

Sobral D. What kind of motivation drives medical students' learning quests? Med Educ. 2004 Sep;38(9):950–7. doi: 10.1111/j.1365-2929.2004.01913.x.MED1913 PubMed DOI

Pothiawala S, Lateef F. Simulation training in emergency medicine (STEM): an integral component of residency curriculum. Hong Kong J Emerg Med. 2017 Dec 11;19(1):41–5. doi: 10.1177/102490791201900107. DOI

Posel N, Mcgee JB, Fleiszer DM. Twelve tips to support the development of clinical reasoning skills using virtual patient cases. Med Teach. 2015;37(9):813–8. doi: 10.3109/0142159X.2014.993951. PubMed DOI

Kannan J, Kurup V. Blended learning in anesthesia education: current state and future model. Curr Opin Anaesthesiol. 2012 Dec;25(6):692–8. doi: 10.1097/ACO.0b013e32835a1c2a.00001503-201212000-00012 PubMed DOI

Sajeva M. E-learning: web-based education. Curr Opin Anaesthesiol. 2006 Dec;19(6):645–9. doi: 10.1097/ACO.0b013e328010bec8.00001503-200612000-00012 PubMed DOI

AKUTNE.CZ. 2018. [2018-02-10]. http://www.akutne.cz/index-en.php .

Schwarz D, Štourač P, Komenda M, Harazim H, Kosinová M, Gregor J, Hůlek R, Smékalová O, Křikava I, Štoudek R, Dušek L. Interactive algorithms for teaching and learning acute medicine in the network of medical faculties MEFANET. J Med Internet Res. 2013 Jul 8;15(7):e135. doi: 10.2196/jmir.2590. v15i7e135 PubMed DOI PMC

Štourač P, Harazim H, Schwarz D, Křikava I, Komenda M, Štoudek R, Smékalová O, Kosinová M, Hůlek R, Maláska J, Šustr R, Šnábl I, Dušek L, Gál R. MEFANET Journal. 2013. [2019-03-13]. AKUTNE.CZ algorithms and SEPSIS-Q scenarios as interactive tools for problem-based learning sessions in medical education http://mj.mefanet.cz/mj-02130330 . PubMed PMC

Harazim H, Stourac P, Kosinová M, Smékalová O, Stoudek R, Schwarz D. Use of interactive education in undergraduate teaching of acute medicine: The virtual and standardised patient, operating theatre broadcasting. Anaesthesiology and Intensive Care Medicine. 2015;26(4):202–12.

Bowen JL. Educational strategies to promote clinical diagnostic reasoning. N Engl J Med. 2006 Nov 23;355(21):2217–25. doi: 10.1056/NEJMra054782.355/21/2217 PubMed DOI

Cook DA, Blachman MJ, Price DW, West CP, Baasch TB, Berger RA, Wittich CM. Educational technologies for physician continuous professional development: a national survey. Acad Med. 2018 Jan;93(1):104–12. doi: 10.1097/ACM.0000000000001817. PubMed DOI