Visualizing Multi-Step Decision-Making at a Glance: Pairing Choose Your Own Adventure Style Simulated Cases with a Novel Mapping Framework
Caitlin D. Hanlon, Harry R. Goldberg, Stacy L. Cooper

TL;DR
This study combines interactive adventure-style medical cases with visual mapping to better assess and understand clinical decision-making in medical education.
Contribution
A novel framework that pairs CYOA-style cases with dynamic mapping to visualize and evaluate multi-step clinical reasoning.
Findings
25.9% of users achieved expert-level decision-making in the simulated cases.
51.9% of users made at least one incorrect decision leading to adverse outcomes.
Visualizations enabled rapid comparison of decision patterns across different cohorts.
Abstract
Clinical reasoning is a critical component of medical education, yet assessing decision-making in real-world scenarios remains challenging. Traditional assessment methods, such as multiple-choice questions, fail to replicate the dynamic nature of clinical problem-solving, where decisions build upon one another over time. Choose Your Own Adventure (CYOA) Case studies offer a promising alternative by simulating non-linear, multi-step decision-making. This study aimed to pair CYOA-style clinical cases with dynamic mapping tools to visualize user decision-making patterns and Evaluate their effectiveness as a pedagogical tool. We developed CYOA branched narrative case studies to simulate clinical decision-making in the management of high-dose methotrexate treatment for patients with pediatric leukemia. Following completion of the case study, user decision-making was mapped using R-based…
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Taxonomy
TopicsClinical Reasoning and Diagnostic Skills · Innovations in Medical Education · Empathy and Medical Education
