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Simulation in Healthcare : Journal of the Society for Simulation in Healthcare
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Virtual standardized patients (VSPs) offer a promising tool for training high-value care (HVC) by simulating patient encounters. This study shows VSPs can provide valuable insights into resident physician history-taking and diagnostic testing choices.

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Area of Science:

  • Medical Education
  • Health Informatics
  • Clinical Skills Training

Background:

  • High-value care (HVC) emphasizes efficient diagnostic and treatment strategies.
  • Effective history taking and physical examination are crucial for appropriate risk stratification.
  • Virtual standardized patients (VSPs) offer a novel approach to experiential learning in HVC.

Purpose of the Study:

  • To develop and evaluate virtual standardized patient (VSP) cases for training high-value care (HVC).
  • To assess the ability of VSPs to provide experiential learning in diagnostic testing and treatment decisions.

Main Methods:

  • A pilot study utilized natural language processing-based VSPs on the USC Standard Patient platform.
  • Faculty developed VSP cases with defined optimal diagnostic and treatment strategies.
  • First-year resident physicians completed VSP case simulations focusing on history taking, physical examination, and diagnostic/treatment modules.

Main Results:

  • Fourteen learners completed eight VSP cases, with high interrater reliability for scoring (0.87 and 0.83).
  • Learner history-taking scores showed moderate correlation between faculty and platform assessment (ρ=0.80, P=0.02).
  • Learners correctly identified diagnoses 82% of the time but ordered a median of two unnecessary tests and completed 56% of optimal treatments.

Conclusions:

  • VSP simulations provide detailed insights into learner decision-making regarding history taking and diagnostic testing.
  • The developed VSP cases demonstrate potential for enhancing high-value care (HVC) education.
  • Further refinement of VSP platforms can improve their utility in clinical skills training.