Virtual patients - what are we talking about? A framework to classify the meanings of the term in healthcare education

Abstract

BackgroundThe term “virtual patients” (VPs) has been used for many years in academic publications, but its meaning varies, leading to confusion. Our aim was to investigate and categorize the use of the term “virtual patient” and then classify its use in healthcare education.MethodsA literature review was conducted to determine all articles using the term “virtual patient” in the title or abstract. These articles were categorized into: Education, Clinical Procedures, Clinical Research and E-Health. All educational articles were further classified based on a framework published by Talbot et al. which was further developed using a deductive content analysis approach.Results536 articles published between 1991 and December 2013 were included in the study. From these, 330 were categorized as educational. Classifying these showed that 37% articles used VPs in the form of Interactive Patient Scenarios. VPs in form of High Fidelity Software Simulations (19%) and Virtual Standardized Patients (16%) were also frequent. Less frequent were other forms, such as VP Games.Analyzing the literature across time shows an overall trend towards the use of Interactive Patient Scenarios as the predominant form of VPs in healthcare education.ConclusionsThe main form of educational VPs in the literature are Interactive Patient Scenarios despite rapid technical advances that would support more complex applications. The adapted classification provides a valuable model for VP developers and researchers in healthcare education to more clearly communicate the type of VP they are addressing avoiding misunderstandings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0296-3) contains supplementary material, which is available to authorized users.

Virtual Pediatric Patient Activities With Randomized Scenarios as an Instructional Tool for Pharmacy Students

“…Based on previously described virtual patient classifications, the VPAs would fall under the classification of interactive patient scenarios seeking to improve clinical reasoning. 6 The VPAs were created using the Qualtrics (Qualtrics, LLC, 2015, Provo, UT) electronic survey program. This program was chosen over others because it was available at the Virginia Commonwealth University School of Pharmacy, had robust data collecting capabilities, incorporated multiple question formats, could create scores based on responses, could randomize questions, and allowed for the use of branched-outcomes based on answers from multiple choice and/or text entry questions.…”

“…The majority of virtual patients described in healthcare professional education involved the use of multimedia systems to promote clinical reasoning skills. 6 There is much variability in the virtual patient scenario design and multimedia system capabilities, which can impact the effectiveness of the teaching method. 6,7 Overall in health science education, virtual patients have made a positive impact on learning compared to no intervention, but the effects in comparison to other instructional methods were small and effects may depend on the type of virtual patients used.…”

“…6 There is much variability in the virtual patient scenario design and multimedia system capabilities, which can impact the effectiveness of the teaching method. 6,7 Overall in health science education, virtual patients have made a positive impact on learning compared to no intervention, but the effects in comparison to other instructional methods were small and effects may depend on the type of virtual patients used. 8 In pharmacy education, computer-aided instruction tools, mannequin-based patient simulations, and virtual patient simulations have been used.…”

“…5 Analyses of virtual patient use in pharmacy schools have usually compared before and after knowledge assessments while comparisons to paper-based scenarios or other teaching methods have also not been done or did not show significant differences. [9][10][11][12] The majority of virtual patient publications in the pharmacy and other healthcare fields have involved adult patient scenarios, [5][6][7] but pediatric patients have unique medication-related needs that would impact the creation and implementation of virtual patients for pharmacy education.…”

Virtual Patients in Clinician’s Education: Theory, Knowledge and Self-efficacy in Anxiety Diagnosis

“…a virtual world type [1]. VPs can be used in teaching and in evaluation to deliver and assess theoretical knowledge competencies, such as clinical reasoning, communication, or examination skills [2].…”