Use virtual patients to replace passive instruction and train clinical reasoning before bedside learning, without diminishing bedside teaching hours¶

Strategy · All strategies
Evidence · 6 claims (3 for, 3 mixed) · 1 study (1 quant-synthesis), q3 · 1 of 1 report an effect size · 6 claims rest on one study

Description¶

The review recommends deploying virtual patients where they show the greatest benefit: replacing passive forms of traditional education and training clinical reasoning and critical thinking before direct patient contact. The authors state virtual patients "can have greater impact when applied where knowledge is combined with skills and applied in problem solving, and when direct patient contact is not yet possible". They also warn against using the results to justify reduced bedside teaching, which was investigated in only one study without positive outcomes.

Design Implications¶

Context¶

Requirements¶

• Learning needs, not technological objectives, should drive teaching; curriculum time resources should be considered when adding virtual patients

Constraints¶

• Introduction of virtual patients will not always lead to detectable positive outcomes without consideration of needs and implementation details; evidence for replacing bedside teaching is limited to one study

Target Learners¶

• Preregistration health professions students
• Postregistration health professionals

Target Learning Goals¶

• Clinical reasoning
• Problem solving
• Procedural skills

Affordances¶

• Virtual Patient Experiential Learning Theory

Claims¶

• Virtual patients blended with traditional education show moderate positive knowledge effects over traditional education alone (SMD=0.73) [+W]
• Virtual patient blended learning shows a moderate but non-significant pooled skills effect versus traditional education alone (SMD=0.60, CI crossing zero) [~W]
• Virtual patients show larger effects when replacing passive traditional learning (lectures, reading) than active learning (group discussion, mannequin-based) [+W]
• In the few trials comparing them, virtual patients showed no significant knowledge differences versus other digital education, and skills differences in only one of three studies [~W]
• Virtual patients are as effective as traditional education for knowledge outcomes (pooled SMD=0.11) [~W]
• Virtual patients are more effective than traditional education for skills outcomes (pooled SMD=0.90) [+W]

Related Strategies¶

• Simulation Based Medical Training
• Simulation Based Practice
• Simulation Based Training

Examples¶

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Key Sources¶

• Kononowicz A A, Woodham L A, Edelbring S, Stathakarou N, Davies D, Saxena N, Tudor Car L, Carlstedt-Duke J, Car J, Zary N. (2019). Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. Journal of Medical Internet Research. https://doi.org/10.2196/14676