Virtual patients reflecting the clinical reality of primary care – a useful tool to improve cultural competence

Abstract

Background Virtual patients are educational tools that may be described as case-based interactive computer simulations of clinical scenarios. In terms of learning outcomes, improved clinical reasoning skills and knowledge acquisition have been shown. For further exploring the role of virtual patients in medical education, a greater focus on context-specific cases, combined with suitable educational activities, has been suggested. A knowledge gap has been identified in cultural competence in primary care. As primary care physicians are often the main medical providers for patients with refugee backgrounds, they would probably benefit from improved training focusing on how to apply cultural competence in everyday work. Using virtual patient cases, as a complement to clinical training, may be one way forward. The aim of this study was therefore to explore a learner perspective on the educational use of a virtual patient system designed to contribute to training in cultural competence in a primary care context. Methods Three virtual patient cases portraying patients with refugee backgrounds were developed. The cases addressed various issues and symptoms common in primary care consultations, while also incorporating intercultural aspects. The system also provided the informants with individualized feedback. Primary care physicians and medical students were invited to test the cases and participate in an interview about their experience. Data was analyzed using qualitative content analysis. Results The analysis generated the theme Virtual patients might help improve cultural competence in physicians and medical students by complementing knowledge gained through the informal curriculum. Informants at different educational levels found it suitable as a tool for introducing the topic and for reflecting on one’s own consultations. It could also compensate for the predominant informal manner of learning cultural competence, described by the informants. Conclusions Virtual patients could be useful for gaining cultural competence in a primary care context. Advantages that could benefit learners at both pre- and post-graduate levels are decreased dependence on the informal curriculum and being presented with an illustrative way of how cultural competence may be applied in the consultation.

Virtual Simulation in Undergraduate Medical Education: A Scoping Review of Recent Practice

“…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 ).…”

Underprepared: influences of U.S. medical students’ self-assessed confidence in immigrant and refugee health care

“…More rigorous analysis and evaluation of teaching methods in this arena are imperative [ 25 , 35 ]. Some effective strategies can include opportunities for self-reflection [ 36 ], the use of virtual patients, partnering with interpretation services, paid community members as cultural mentors [ 37 , 38 ], peer education, and experiential learning opportunities [ 39 ].…”