Goal in the curriculum
- Why should I have VPs in the medical curriculum?
- For what purpose should I be using VPs?
- What are the pros and cons of integrating VP into the curriculum?
All medical schools should strive to have virtual patients (VPs) in their curriculum, as these are important tools for students on their way to become health professionals, offering them an authentic, comparable, interactive, patient-centered, and safe learning experience.
VPs are employed as a tool for curricular integration that requires the students to combine and apply knowledge from several disciplines in one activity. At the curricular level, VPs offer greater consistency and reliability in the delivery of learning experiences. In a blended learning curricular model, the virtual curriculum runs alongside the existing face-to-face curriculum, giving educators the flexibility in selecting methods to meet the learning objectives. [Tworek 2010].
The versatility of skills that can be taught with VPs encourages many educators to try to embed this teaching method into the medical education curriculum for several purposes. [Sobocan 2017]. Virtual patient panels are being used in health professions education to facilitate the development of clinical reasoning abilities, resource utilization, and longitudinal patient care, as well as knowledge acquisition, teamwork, and clinical skills training. [Hege 2016, Kononowicz 2015, Quail 2019]. Exposure to VPs also can help students to develop non-technical skills such as decision-making, teamwork, communication skills, but also self-awareness and self-confidence. It is especially common to see a recommendation to apply VPs in support of clinical reasoning training [Cook 2009, Plackett 2022], because VPs are giving the students an opportunity for deliberate practice of patient diagnostic and management skills. Using virtual patient panels, students compare and contrast similar clinical findings and have to weigh different options based on the relative probability of each diagnosis and the typicality of findings [Mayer 2022].
VPs also provide clinical and contextual diversity in collections [Bowden 2021]. The coverage of various subjects and possible situations that can appear in real-life medical activities is an important factor in the expected effect of VP training [Doloca 2016]. VPs allow efficient presentation of multiple patient visits, and in accelerated time-perspective how diseases change over time and interact with several factors including genetic background, psychosocial context and comorbidities [Smith 2007]. VPs unlike the textbooks or most lectures are interactive, in addition provide access to multimedia materials, possibility to check reference sources, reflect in the decision-making process and to make mistakes and learn from them [Botezatu 2010]. VPs allow students to safely apply obtained knowledge without putting at risk either themselves or patients [Edelbring 2011, Kulasegaram 2018].
VPs act as a link between students’ factual knowledge and the clinical environment [Ellaway 2015]. This provides students with an opportunity for productive struggle within the context of authentic clinical situations. VPs help students to discover new concepts, structure and then apply their knowledge in face of the ambiguity, complexity or uncertainty of medical practice [Kulasegaram 2018].
You should consider VPs as an opportunity for your students, if you are looking for a tool to increase their exposure to patient cases beyond what is possible in the clinic. VPs give the students the possibility to be confronted with a wide variety of diseases, symptoms, and clinical scenarios, permitting to
- overcome limitations in exposure to real patients (e.g., lack of contact with rare diseases or presentations or differences across groups of students on the types of patients they meet) [Cederberg 2012, Posel 2012]
- meet institutional or national curricular objectives [Hege 2016]
- offer an authentic experience in early stages of the medical curriculum free of ethical concerns [Washburn 2020].
It is fair to say that VPs in the curriculum are not a silver bullet to solve all problems and they also have drawbacks when misused. VPs should not limit access to real patients as this is the gold standard in medical education. Consider for instance the limitation of VPs in terms of physical examination or history taking. Some types of VPs may deteriorate soft skills of students (e.g. showing empathy), when students focus too much on finding the right diagnosis and forget the human-aspects of patient care. Finally, it is tempting for some teachers to trust that VPs will replace them in the role of teachers in assessment or providing feedback and by that save their time. However, VPs, as many other educational technologies, are just tools to aid the educator, but without good support students will feel lost in their education or learn to game the system.
– VPs are great for curricular integration, that requires the students to combine and apply knowledge from several disciplines in one activity.
– Versatility of skills can be taught with VPs, choose how you can utilize them.
– VPs act as a link between students’ factual knowledge and the clinical environment.
– Utilize VPs to address knowledge gaps, to ensure more
comprehensive learning experiences, to provide otherwise unavailable clinical experiences and to guarantee availability of standardized material.
The three questions raised are answered in a comprehensive and attractive way on the basis of scientific contributions in recent years.