Improving assessment with virtual patients

Abstract

Assessments should accurately predict future performance in a wide variety of settings yet be feasible to conduct. In medical education a robust and comprehensive system of assessment is essential to protect the public from inadequate professionals. The parameters for devising such an assessment are well-defined, and good practice for writing examinations well-established. However even excellent written assessments are limited in their predictive validity, and limited in sampling, face and construct validity. The increasing availability and power of computing has led to growing interest in computer simulations for use in examinations, creating assessment virtual patients (AVPs). They can potentially test knowledge and data interpretation, incorporate images, sound or video and test decision making. Such AVPs could represent the most comprehensive, integrated assessment possible that is both objective and feasible. This article focuses on AVP design, distinguishing between linear and branched models, choice and consequence driven designs. It reviews the use of AVPs in the context of assessment theory. It presents different AVP designs discussing their benefits and problems. AVPs can become valuable components in high stakes medical exams, particularly in later years of courses. However this requires application of established assessment principles to AVP design.

Virtual Patients for assessment of medical student ability to integrate clinical and laboratory data to develop differential diagnoses: Comparison of results of exams with/without time constraints

“…The use of VPs for assessment is a more recent application and has been described as a possible way to assess clinical reasoning and/or clinical decision-making abilities among students (Courteille et al 2008;Waldmann et al 2008;Gesundheit et al 2009;Round et al 2009;Botezatu et al 2010a, b;Forsberg et al 2010 (Brooks et al 2003) has emphasized that average raw scores of students tested under both timed and untimed conditions vary less than one raw score point. A more recent publication (Lee & Chen 2011) relates that most educational assessments are designed to measure knowledge ( power tests), are usually administered with time constraints, and before the application of computer-based assessment, it was extremely difficult to evaluate cognitive ability.…”

An evaluation of implementing problem-based learning scenarios in an immersive virtual world

“…This is because when using problem-based learning in virtual learning environments the discussion forums result in a linearity in learning which is unhelpful for team work. Using problem-based learning in SL student experience suggests both in this study and other related PREVIEW studies [3][4][5][6][7] , that students value in-world interactive collaboration.…”

“…Further related papers were published elsewhere. [3][4][5][6][7] It is argued here that the current lack of pedagogical underpinning has introduced a number of difficulties, little understanding about which kinds of pedagogies best work in virtual worlds and which do not and what the impact is of using these 3D spaces on student learning and student engagement. It is suggested here that these difficulties might be overcome by using approaches that readily combine pedagogy with technology, thereby shifting from the VLEs to IVWs.…”

Twelve Tips for Utilizing Virtual Patients to Teach Professionalism

“…Using virtual patients as an assessment tool can be more advantageous when compared with more traditional assessment methods (such as multiple choice questions) due to the increased realism incorporated into the cases and the ability to integrate multiple facets of case management into a single scenario (Round et al, 2009;Waldman et al, 2008). Virtual patients also have the advantage that assessors can view student interaction with each case and the steps taken to reach a decision (Cendan & Lok, 2012;McEvoy et al, 2012), which may give insight into the learners level of professional development.…”