Learning activities around VPs
- What should be the tasks students are supposed to do around virtual patients?
Virtual patients are a great tool to learn clinical reasoning. During the design and integration process different types of activities should be taken into consideration, to allow a meaningful and engaging learning process.
Ellaway and Davies distinguish the following learning activities around the VPs: read unfolding narrative, select appropriate history questions, select management options, make diagnosis, learn underlying medical science through guided discovery (optional), view report and debrief (if logged in) [Ellaway 2011]. Other tasks could be writing a summary statement, creating a concept map, creating a case (learning by teaching strategy), solving a case in an interprofessional team and group discussion.
For example in the CASUS system students are asked to fill in a summary statement, a short presentation of a patient of usually one to three sentences length. It is a synopsis of findings from history taking and physical examination. The ability to present a patient in such a concise way is a good indicator for clinical reasoning skills, because the student has to summarize and synthesize a patient’s information [Bowen 2006]. This also provides a chance to practice clinical semantics. Summary statements can be required any time during the case, but they are particularly relevant for case completion. If the author includes examples of expert summary statements as model examples for students, these can be used to scaffold learning, isolate gaps in domain knowledge and as a powerful tool for formative or summative assessment [Posel 2015].
Important element of VPs are concept maps created by students during the process of working on the case. A concept map is a graphical tool for organizing knowledge and it results in a visible representation of the students’ clinical reasoning on a case, which permits them to identify learning gaps [Penuela-Epalza 2019]. Learning with a use of concept maps creation allows combining lower order concepts with higher order concepts, which then can lead to formation of a hierarchy of knowledge and understanding [Daley 2016].
Another activity to be used around the VPs is to involve students in the creation of the cases. Learners show a positive and highly motivated attitude towards this teaching strategy. In a paper by Hege et al. motivation was attributed in 67% of the students to the interest in case-based training and the effectiveness of this strategy [Hege 2007].
VPs can be also used in activities of interprofessional groups of students. Such solution allow better understanding of the other profession’s scope of practice, tasks and responsibilities. Furthermore, it provides a holistic patient’s perspective through the complementary professional view [Edelbring 2022]. Solving VPs in mixed teams promotes interprofessional teamwork and collaboration. They can share their ideas, decision making and responsibility, which in overall prepares them to work in such clinical teams in real life [Martini19].
As noted by researchers one of the tasks could be also a discussion, where students are comparing two VPs with common differential diagnoses or a combination of similar, but contrasting VPs, where the students are encouraged to consider alternative diagnoses and reflect on key features of each of the VP cases. This improved students’ understanding of disease and helped reflect on differential diagnoses [Cendan 2012, Huwendiek 2013].
– Add a summary statement as a task allows students to learn how to present a patient in a concise manner as a good indicator of clinical reasoning.
– Provide learning with the use of concept map creation to give students the opportunity to organize information.
– Try out other activities, such as the creation of the VPs by students, working on VPs in interprofessional teams, and discussion on similar but contrasting VPs.