Impact of Required Versus Self-Directed Use of Virtual Patient Cases on Clerkship Performance: A Mixed-Methods Study

Area of Science:

• Medical Education
• Digital Health Technology
• Clinical Simulation

Background:

• Virtual patient cases (VPCs) offer a supplementary tool for medical students to encounter diverse clinical scenarios.
• Understanding student utilization and benefits of VPCs is crucial for effective integration into curricula.

Purpose of the Study:

• To investigate how medical students utilize virtual patient cases (VPCs) and assess their perceived and actual learning benefits.
• To compare outcomes between core required use (CRU) and self-directed use (SU) of VPCs in clerkship settings.

Main Methods:

• Two cohorts of students in pediatrics, family medicine, and internal medicine clerkships were assigned to CRU or SU of VPCs.
• Outcomes measured included case completion rates, time spent, student perceptions, National Board of Medical Examiners (NBME) scores, and clinical ratings.
• Focus groups and t-tests were used for data collection and analysis.

Main Results:

• Students in the CRU group completed significantly more VPCs across all clerkships compared to the SU group.
• Perceived value of VPCs was similar between groups, with students noting their utility for rare conditions.
• No significant differences were found in NBME subject examination scores or summative clinical ratings between the CRU and SU groups.

Conclusions:

• VPCs are beneficial for exposing students to clinical conditions infrequently encountered in person.
• The optimal pedagogical strategy for integrating VPCs into medical clerkships requires further investigation.
• Current findings suggest that while CRU increases engagement, it does not necessarily enhance measurable learning outcomes compared to SU.