The Online Deteriorating Patient: An Adaptive Simulation to Foster Expertise in Emergency Decision-Making

Introduction Designing an ITS to support teaching and learning in emergency medicine requires special consideration of the high-pressure nature of the live clinical environment. Here we present the design of an online version of a simulation-based activity for medical education called the Deteriorating Patient Activity (DPA) [1]. The objective of the DPA is to help medical students learn how to apply a framework to stabilize a patient with symptoms and vital signs that worsen as the simulation continues. In a live DPA activity, a medical expert plays the role of the deteriorating patient and simulates the positive/negative evolution of his or her status according to medical actions suggested by students. If no action is taken, the patient naturally deteriorates after a certain period of time.