Skip to main content

Virtual Patients in Health Professions Education

  • Chapter
  • First Online:
Biomedical Visualisation

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1171))

  • 1388 Accesses

  • 27 Citations

Abstract

Health care professionals must not only have knowledge, but also be able to organise, synthesise and apply this knowledge in such a way that it promotes the development of clinical reasoning. Panels of Virtual patients (VPs) are widely being used in health professions education to facilitate the development of clinical reasoning. VPs can also be used to teach wider educational outcomes such as communication skills, resource utilisation and longitudinal patient care. This chapter will define virtual patients and examine the evidence behind their use in health professions learning and teaching. The chapter will discuss virtual patient design, such as gamification. Finally, the chapter will discuss where this pedagogical innovation is best integrated into assessment and potential barriers to implementation into existing curricula.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+
from $39.99 /Month
  • Starting from 10 chapters or articles per month
  • Access and download chapters and articles from more than 300k books and 2,500 journals
  • Cancel anytime
View plans

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
eBook
USD 84.99
Price excludes VAT (USA)
Softcover Book
USD 109.99
Price excludes VAT (USA)
Hardcover Book
USD 109.99
Price excludes VAT (USA)

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

VP:

Virtual Patient

VPs:

Virtual Patients

References

  • Arya S, Mulla Z, Kupesic Plavsic S (2017) Role of pelvic ultrasound simulation. Clin Teach 15(6):457–461

    Article  PubMed  Google Scholar 

  • Begg M (2010) Virtual patients: practical advice for clinical authors using labyrinth. Clin Teach 7(3):202–205

    Article  PubMed  Google Scholar 

  • Berman A, Biguet G, Stathakarou N et al (2017) Virtual Patients in a behavioral medicine massive open online course (MOOC): a qualitative and quantitative analysis of participants’ perceptions. Acad Psychiatry 41(5):631–641

    Article  PubMed  PubMed Central  Google Scholar 

  • Berman NB, Durning SJ, Fischer MR et al (2016) The role for virtual patients in the future of medical education. Acad Med 91(9):1217–1222

    Article  PubMed  Google Scholar 

  • Berman N, Fall L, Maloney C, Levine D (2006) Computer-assisted instruction in clinical education: a roadmap to increasing CAI implementation. Adv Health Sci Educ 13(3):373–383

    Article  Google Scholar 

  • Berman N, Fall L, Smith S et al (2009) Integration strategies for using virtual Patients in clinical clerkships. Acad Med 84(7):942–949

    Article  PubMed  Google Scholar 

  • Bitzer M (1966) Clinical nursing instruction via the PLATO simulated laboratory. Nurs Res 15(2):144–150

    Article  CAS  PubMed  Google Scholar 

  • Boyle J, Quail N, Loo X, Linn A (2016) Flipping the classroom: is it worth the bother? Clin Teach 14(2):137–138

    Article  PubMed  Google Scholar 

  • Brown JS, Collins A, Duguid P (1989) Situated cognition and the culture of learning. Educ Res 18:32–42

    Article  Google Scholar 

  • Charlin B, Boshuizen HPA, Custers EJ, Feltovich PJ (2007) Scripts and clinical reasoning. Med Educ 241:1178–1184

    Article  Google Scholar 

  • Consorti F, Mancuso R, Nocioni M, Piccolo A (2012) Efficacy of virtual patients in medical education: a meta-analysis of randomized studies. Comput Educ 59(3):1001–1008

    Article  Google Scholar 

  • Cook DA, Triola MM (2009) Virtual patients: a critical literature review and proposed next steps. Med Educ 43:303–311

    Article  PubMed  Google Scholar 

  • Cook DA (2009) The failure of e-learning research to inform educational practice, and what we can do about it. Med Teach 31(2):158–162. https://doi.org/10.1080/01421590802691393

    Article  PubMed  Google Scholar 

  • Cook D, Andriole D, Durning S, Roberts N, Triola M (2010a) Longitudinal research databases in medical education: facilitating the study of educational outcomes over time and across institutions. Acad Med 85(8):1340–1346

    Article  PubMed  Google Scholar 

  • Cook D, Erwin P, Triola M (2010b) Computerized virtual patients in health professions education: a systematic review and meta-analysis. Acad Med 85(10):1589–1602

    Article  PubMed  Google Scholar 

  • Cook D, Friedman C, Greene P et al (2007) Effective use of educational technology in medical education. AAMC Institute for Improving Medical Education. Available via: https://members.aamc.org/eweb/upload/Effective%20Use%20of%20Educational.pdf. Accessed 15 Jan 2019

  • Daniel M, Rencic J, Durning SJ et al (2019) Clinical reasoning assessment methods: a scoping review and practical guidance. Acad Med 94(6):902–912

    Article  PubMed  Google Scholar 

  • Denson P (2018) Challenges and opportunities facing medical education. Trans Am Clin Climatol Assoc 122:48–58

    Google Scholar 

  • Electronic Virtual Patients (2019) Electronic virtual Patients website. Available via https://virtualpatients.eu. Accessed 15 Jan 2019

  • Ellaway R, Topps D, Lee S, Armson H (2015) Virtual patient activity patterns for clinical learning. Clin Teach 12(4):267–271

    Article  PubMed  Google Scholar 

  • Eva KW (2005) What every teacher needs to know about clinical reasoning. Med Educ 39(1):98–106

    Article  PubMed  Google Scholar 

  • Evans K, Daines W, Tsui J, Strehlow M, Maggio P, Shieh L (2015) Septris: a novel, mobile, online, simulation game that improves sepsis recognition and management. Acad Med 90(2):180–184

    Article  PubMed  PubMed Central  Google Scholar 

  • Feldman L, Shihab H, Thiemann D et al (2013) Impact of providing fee data on laboratory test ordering. JAMA Intern Med 173(10):903–908

    Article  PubMed  Google Scholar 

  • Hardy S, Brown G (2010) Virtual patients and online video resources: useful when patient availability is reduced? Clin Teach 7(4):292–293

    Article  Google Scholar 

  • Harries R, Rashid M, Smitham P et al (2016) What shape do UK trainees want their training to be? Results of a cross-sectional study. BMJ Open 6(10):e010461

    Article  PubMed  PubMed Central  Google Scholar 

  • Hatala R, Brooks L, Norman G (2003) Practice makes perfect: the critical role of mixed practice in the acquisition of ECG interpretation skills. Adv Health Sci Educ 8:17–26

    Article  Google Scholar 

  • Hege I, Kononowicz A, Kiesewetter J, Foster-Johnson L (2018) Uncovering the relation between clinical reasoning and diagnostic accuracy – an analysis of learner’s clinical reasoning processes in virtual patients. PLoS One 13(10):e0204900

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Hege I, Ropp V, Adler M et al (2007) Experiences with different integration strategies of case-based e-learning. Med Teach 29(8):791–797

    Article  PubMed  Google Scholar 

  • Heng N, Anbarasan T (2018) Comments on: “collaborative use of virtual patients after a lecture enhances learning with minimal investment of cognitive load”. Med Teach 41(1):118–119

    Article  PubMed  Google Scholar 

  • Higgs J, Jensen GM (2019) Clinical reasoning. In: Higgs J, Jensen GM, Loftus S, Christensen N (eds) Clinical reasoning in the health professions, 4th edn. Elsevier, Edinburgh

    Google Scholar 

  • Huwendiek S, Duncker C, Reichert F et al (2013) Learner preferences regarding integrating, sequencing and aligning virtual patients with other activities in the undergraduate medical curriculum: a focus group study. Med Teach 35:920–929

    Article  PubMed  Google Scholar 

  • Khan K, Gaunt K, Ramachandran S, Pushkar P (2013) The objective structured clinical examination (OSCE): AMEE guide no. 81. Part II: organisation & administration. Med Teach 35(9):e1447–e1463

    Article  PubMed  Google Scholar 

  • Kleffner R, Flatten J, Leaver-Fay A et al (2017) Foldit standalone: a video game-derived protein structure manipulation interface using Rosetta. Bioinformatics 33(17):2765–2767

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Klein M, Otto B, Fischer M, Stark R (2018) Fostering medical students’ clinical reasoning by learning from errors in clinical case vignettes: effects and conditions of additional prompting procedures to foster self-explanations. Adv Health Sci Educ 24:331–351. https://doi.org/10.1007/s10459-018-09870-5

    Article  Google Scholar 

  • Kolb D (1984) Experiential learning: experience as the source of learning and development. Prentice-Hall, Englewood Cliffs

    Google Scholar 

  • Kononowicz A, Zary N, Edelbring S, Corral J, Hege I (2015) Virtual patients – what are we talking about? A framework to classify the meanings of the term in healthcare education. BMC Med Educ 15(1):11

    Article  PubMed  PubMed Central  Google Scholar 

  • Lave J, Wenger E (1991) Situated learning: legitimate peripheral participation. Cambridge University Press, New York

    Book  Google Scholar 

  • Levinson W, Kallewaard M, Bhatia RS (2015) On behalf of the choosing wisely international working group, et al ‘choosing wisely’: a growing international campaign. BMJ Qual Saf 24:167–174

    Article  PubMed  Google Scholar 

  • Lin C, Chang E, Clinciu D et al (2018) Using modified information delivery to enhance the traditional pharmacy OSCE program at TMU – a pilot study. Comput Methods Prog Biomed 158:147–152

    Article  Google Scholar 

  • Litchfield I, Bentham L, Hill A, McManus R, Lilford R, Greenfield S (2015) Routine failures in the process for blood testing and the communication of results to patients in primary care in the UK: a qualitative exploration of patient and provider perspectives. BMJ Qual Saf 24(11):681–690

    Article  PubMed  PubMed Central  Google Scholar 

  • Marei H, Donkers J, Al-Eraky M, Van Merrienboer J (2018) Collaborative use of virtual patients after a lecture enhances learning with minimal investment of cognitive load. Med Teach 41:332–339. https://doi.org/10.1080/0142159X.2018.1472372

    Article  PubMed  Google Scholar 

  • Marquet O, Alberico C, Adlakha D, Hipp J (2017) Examining motivations to play Pokémon GO and their influence on perceived outcomes and physical activity. JMIR Serious Games 5(4):e21

    Article  PubMed  PubMed Central  Google Scholar 

  • McCoy L, Lewis J, Dalton D (2016) Gamification and multimedia for medical education: a landscape review. J Am Osteopath Assoc 116(1):22–34

    Article  PubMed  Google Scholar 

  • Moro C, Štromberga Z, Raikos A, Stirling A (2017) The effectiveness of virtual and augmented reality in health sciences and medical anatomy. Anat Sci Educ 10(6):549–559

    Article  PubMed  Google Scholar 

  • Motz P, Gray M, Sawyer T et al (2018) Virtual antenatal encounter and standardized simulation assessment (VANESSA): pilot study. JMIR Serious Games 6(2):e8

    Article  PubMed  PubMed Central  Google Scholar 

  • Muller D, Ornstein K (2007) Perceptions of and attitudes towards medical errors among medical trainees. Med Educ 41(7):645–652

    Article  PubMed  Google Scholar 

  • Noonan Z, Boyle J, Pope L, Ditchfield C, Leach J, McDowall S (2018) Quarantining the OSCE: reflections on the Glasgow experience. Clin Teach. https://doi.org/10.1111/tct.12993

  • Norman GR, Eva KW (2010) Diagnostic error and clinical reasoning. Med Educ 44(1):94–100

    Article  PubMed  Google Scholar 

  • Norman G (2014) Research challenges in digital education. Perspect Med Educ 3(4):260–265

    Article  PubMed  PubMed Central  Google Scholar 

  • Pantelidis P, Chorti A, Papagiouvanni I et al (2018) Virtual and augmented reality in medical education. In: Tsoulfas G (ed) Medical and surgical education – past, present and future. IntechOpen, London, pp 77–97

    Google Scholar 

  • Posel N, Mcgee J, Fleiszer D (2014) Twelve tips to support the development of clinical reasoning skills using virtual patient cases. Med Teach 37(9):813–818

    Article  PubMed  Google Scholar 

  • Quail N, Holmes K, Linn A, Rea P, Livingstone D, Boyle J (2018) Serious digital games using virtual Patients and digital chalk-talk videos: a novel approach to teaching acute diabetes Care in the Undergraduate Medical Curriculum. Diabet Med 35(S1):112–135

    Google Scholar 

  • Satava R (2006) Assessing surgery skills through simulation. Clin Teach 3(2):107–111

    Article  Google Scholar 

  • Schmidt HG, Rikers RMJP (2007) How expertise develops in medicine: knowledge encapsulation and illness script formation. Med Educ 41:1133–1139

    PubMed  Google Scholar 

  • Seewoonarain S, Barrett M (2017) The technological evolution in surgical skills. Clin Teach 14(5):370–371

    Article  PubMed  Google Scholar 

  • Singh H, Onakpoya I, Thompson M (2016) Diagnostic errors. World Health Organization. Available via: http://apps.who.int/iris/bitstream/handle/10665/252410/9789241511636-eng.pdf;jsessionid=9BC584CFD622CF7ADC54D6BD7C9D915D?sequence=1. Accessed 15 Jan 2019

  • Sperl-Hillen J, O’Connor P, Ekstrom H et al (2013) Using simulation technology to teach diabetes care management skills to resident physicians. J Diabetes Sci Technol 7(5):1243–1254

    Article  PubMed  PubMed Central  Google Scholar 

  • Talbot T, Sagae K, John B, Rizzo A (2012) Sorting out the virtual patient. Int J Gaming Comput-Mediated Simul 4(3):1–19

    Article  Google Scholar 

  • Urresti-Gundlach M, Tolks D, Kiessling C, Wagner-Menghin M, Härtl A, Hege I (2017) Do virtual patients prepare medical students for the real world? Development and application of a framework to compare a virtual patient collection with population data. BMC Med Educ 17(1):174

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Van Bruggen L, Manrique-van Woudenbergh M, Spierenburg E, Vos J (2012) Preferred question types for computer-based assessment of clinical reasoning: a literature study. Perspect Med Educ 1(4):162–171

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhou L, Tait G, Sandhu S, Steiman A, Lake S (2018) Online virtual cases to teach resource stewardship. Clin Teach 16:220–225. https://doi.org/10.1111/tct.12804

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James Graham Boyle .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Quail, N.P.A., Boyle, J.G. (2019). Virtual Patients in Health Professions Education. In: Rea, P. (eds) Biomedical Visualisation. Advances in Experimental Medicine and Biology, vol 1171. Springer, Cham. https://doi.org/10.1007/978-3-030-24281-7_3

Download citation

Keywords

Publish with us

Policies and ethics