Virtual patient design: exploring what works and why. A grounded theory study

Area of Science:

• Medical Education Technology
• Health Professions Education Research
• Clinical Reasoning Development

Background:

• Virtual patients (VPs) are widely used online tools for medical education, offering potential for clinical reasoning skill development.
• Existing research lacks evidence on which VP designs are most effective and why.
• International standards facilitate VP creation and sharing across institutions.

Purpose of the Study:

• To investigate the influence of virtual patient design on undergraduate medical students' learning experiences.
• To develop a theoretical model explaining how students learn from virtual patients.

Main Methods:

• A grounded theory study involving 46 medical undergraduates.
• Participants engaged with two custom-designed VPs and participated in focus groups.
• Data analysis employed grounded theory techniques, including open, axial, and selective coding.

Main Results:

• A core phenomenon of 'learning from the VP' was identified, encompassing VP construction, external preconditions, student-VP interaction, and consequences.
• A three-layer model was developed, detailing student preconditions, the VP as an 'encoded object' and 'constructed activity', and resulting cognitive/behavioral changes.

Conclusions:

• This is the first grounded theory study to explore virtual patient design's impact on learning.
• The developed model enhances understanding of how and why VP design influences learning.
• The findings offer practical insights for VP developers, educators, and researchers.