Decision making is the most difficult part of practicing medicine. For healthcare professionals, knowing the exact decision they need to make when faced with specific clinical situation is vital. A single mistake in judgment or dosing could often have fatal consequences.
This is why it's important that providers stay on top of the medical information, which is literally impossible without an aid of various resources and tools.
Many providers still rely on traditional resources such as textbooks. However, advent of mobile technologies brought many of these resources and tools at the providers' fingertips, making their workflow and decision-making process a bit easier.
A lot of medical apps are designed to provide answers to clinical questions in rapid and simple manner. Some of the apps, however, use game theory and gamification to make some parts of medical education more fun and easier to comprehend, particularly the parts related to making decisions.
Sri Lankan company Medical Joyworks claimed that current medical education is boring, which they're trying to fix with their mobile medical apps that apply gamification concept.
We already reviewed their Prognosis: Your Diagnosis app, the one of several gamified medical apps they made. Actually, we reviewed Prognosis: Your Diagnosis app twice, both times giving it a favorable rating.
Medical Joyworks are also responsible for making Clinical Sense, a free app for Android and iPhone we review today. This app also applies gamification principles, allowing users to plays the role of a physician faced with various challenging clinical scenarios.
This way, users can take a role of physician, surgeon, Ob/Gyn, oncologist or other specialties, and test their knowledge about a wide range of conditions, including obstetrical emergencies, diabetes, cardiovascular conditions, and many more.
The app opens to a main menu from which users can access cases, edit profile (if they decided to create one), invite friends to use the app and set the language (the app is multilingual). You'll have to rotate your phone/device horizontally, in order to use the app. This could be a nuisance on smaller screens.
The main feature of the app, of course, is clinical cases part. There are an impressive number of 75 cases covering different scenarios across various specialties.
Each case needs to be downloaded, which isn't a big deal because they download very quickly, in just couple of seconds. However, be sure to turn on WiFi to avoid potential costs of using your cellular data. Once downloaded, the cases don't require Internet access.
Some cases are only week old, while other are created three years ago. Each scenario can be completed within a couple of minutes, which depends upon how quickly you judge the given situation and make your clinical decisions. Each case provides the supplemental information, which is well referenced.
For this review, I went through obstetrical emergencies. I expected I'll be asked questions in straightforward format and supposed to make my decisions based on the choices provided. However, I was pleasantly surprised because each case contains a narrative that helps you get into the story. The narrative is supported by illustrations, which are more mature looking than cartoony drawings in Prognosis app.
The case introduces a patient with specific symptoms, providing you with minimal history, some vitals and exam data, which all depend on the case and scenario you're going through. You're not allowed to ask additional questions or perform exam, just follow the directions given by the app creators. Some may find this part problematic, because it makes the app looks like textual adventure or interactive fiction game.
However, I found this approach useful, because it makes you carefully read all necessary data about patient's history, previous exams or lab findings before you're faced with multiple choice type questions about what shall you do next.
If you make a wrong decision, the case immediately ends, usually in disastrous way, explaining it was because of your mistake. It provides you with an explanation of what you did incorrectly, referencing the resources. There are no branch points and consequences like in Prognosis app that would be more realistic.
If you provide correct answer the case doesn't end, but continues with the next scenario, imitating the real shift in the ward. There are multiple scenarios within the case, and each starts after the previous is completed successfully. Also, each scenario follows the same pattern, sometimes adding unnecessary complications and drama. However, I didn't find this part annoying, because it requires you to gather all details and information carefully in order to learn more about particular cases.
There's an interesting 'twist' after you made certain decisions. The app first gives you a hint that you've made a good decision, and then in the following screen notifies you about "urgent night call" explaining that your decision was actually a mistake, ending the case.
However, there's no option to start again only scenario you failed. You need to go through the whole case and answer all the questions again, until you reach the desired part.
Clinical Sense app is primarily an educational tool, not the decision making support tool for direct bedside patient care. It allows you to challenge yourself with different clinical scenarios, thus helping you to learn more about them. This is why Clinical Sense is more suitable for medical students and interns, than experienced physicians, although they could find it useful as well.
Benefit: The learning nature of the app makes it perfect for medical students, interns and residents, although more seasoned providers could also find it beneficial.