“…In addition to the above learning contexts and practical aspects, the remaining 18 articles ( 15 , 21 , 24 , 27 , 40 , 41 , 43 , 54 , 73 , 77 , 83 , 87 , 89 , 95 , 100 , 102 , 103 , 105 ) reported the integration of VS into other case-based learning experiences in virtual patient-care settings. Despite the diversity of virtual patient systems and clinical scenarios, these studies generally showed that VS-integrated case-based learning as a feasible teaching approach ( 54 ) could result in students’ learning gains, retention of information, and transfer of knowledge to clinical application ( 89 , 95 , 100 , 102 ), help future physicians improve diagnostic accuracy thus enhance the clinical reasoning teaching ( 15 , 27 , 43 ), extend students’ preparedness level for their future clinical experiences ( 40 , 83 ), facilitate empathy ( 24 ), cultural competence ( 77 ) and comprehensive clinical skills such as communication-based skills ( 21 ), clinical decision-making skills ( 78 ) within undergraduate medical education, and improve students’ confidence in managing clinical scenarios ( 41 ), thus was highly received by students ( 89 , 95 , 105 ).…”