ENHANCING MEDICAL EDUCATION IN HEMATOLOGY: COMPLEX CLINICAL CASE SIMULATOR WITH DECISION TREE

• Published in: Hematology, Transfusion and Cell Therapy Vol. 45; p. S204
• Main Authors: KAM Martins, FHB Souza, LP Campos, EOO Menino, JVP Guimarães, MFG Fernandes, AS Soares, LO Rocha, SS Leal, RC Santiago
• Format: Journal Article
• Language: English
• Published: Elsevier 01-10-2023
• ISSN: 2531-1379
• DOI: 10.1016/j.htct.2023.09.431

Objectives: In order to provide better training and knowledge to healthcare professionals without causing tangible harm to human subjects, the use of a virtual simulator proves to be efficient in digitally illustrating real-life scenarios. This work aims to present the implementation of a clinical case simulator in hematology, with a focus on a specific case of Chronic Myeloid Leukemia (CML). The simulator aims to offer medical students and hematology residents a detailed and realistic experience in diagnosing CML, encompassing the steps of clinical evaluation, laboratory examination analysis, and result interpretation, with the intention of enhancing their competencies in managing this complex pathology. Methods: A lighter and faster-processing clinical case simulator was developed through bibliographic reviews. The decision tree was selected as a decisive tool for clinical case simulation, as it represents an action and its possible implications, allowing for various outcomes. The simulated clinical case is that of a 55-year-old male patient with no prior comorbidities, presenting with progressive fatigue, unintentional weight loss, night sweats, and upper left quadrant abdominal discomfort. During the anamnesis, the physician discovers a history of recurrent infections without apparent cause. Results: The simulator was successfully developed to simulate the clinical case with precision, and the implementation of a decision tree provides a simulated environment with greater realism, offering the possibility of unfavorable outcomes based on user decisions. The capability of the prototype to be updated at any time according to each country's protocols or specific clinical cases requested by the user is a significant advantage for medical simulation. Discussion: The simulation encompassed the steps of clinical evaluation, laboratory examination analysis, and result interpretation. During the clinical evaluation, the patient exhibited cutaneous-mucosal pallor and a palpable spleen enlargement. The history of recurrent infections raised suspicions of a hematological disorder. The user also investigated the presence of other symptoms such as fever, night sweats, and weight loss, suggestive of a possible hematological neoplasm. The hemogram revealed significant leukocytosis with a predominance of immature granulocytes. Analysis of myeloid cells suggested CML, which was confirmed through a myelogram showing granulocytic hyperplasia. Cytogenetic testing identified the Philadelphia chromosome, solidifying the diagnosis of CML. Conclusion: Simulation in the clinical setting, in conjunction with fast-processing, editable, and up-to-date decision tree-based simulators, is an increasingly valued learning strategy in medical schools and post-graduate education. This approach will significantly impact medical education, fostering clinical reasoning and decision-making based on the latest updates.