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Real-world virtual patient simulation to improve diagnostic performance through deliberate practice: a prospective
Susrutha Kotwal1,2, Mehdi Fanai2,3, Wei Fu4
1Department of Medicine, Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Diagnosis (Berlin, Germany)
|March 6, 2021
Summary
Novice clinicians achieved diagnostic proficiency in dizziness after just 9 hours of virtual patient training. This targeted approach significantly improved diagnostic accuracy and appropriate testing compared to traditional residency education.
Area of Science:
- Medical Education
- Clinical Reasoning
- Diagnostic Accuracy
Background:
- Diagnostic errors are common, often stemming from clinical reasoning failures.
- Nonspecific symptoms like dizziness present diagnostic challenges.
- Virtual patients offer a novel training modality for complex cases.
Purpose of the Study:
- To evaluate if novice clinicians can achieve diagnostic proficiency in dizziness using virtual patients.
- To compare the effectiveness of virtual patient training against traditional residency experience.
Main Methods:
- A prospective, quasi-experimental study compared internal medicine interns (intervention) to residents (control).
- Training involved brief lectures and 9 hours of supervised deliberate practice with virtual patients (VIPER approach).
- Both groups completed pretests and posttests assessing diagnostic accuracy and appropriate imaging.
Main Results:
- Posttest diagnostic accuracy significantly improved for interns (50%) versus residents (20%) (p=0.001).
- Posttest appropriateness of imaging also significantly improved for interns (65%) versus residents (25%) (p<0.001).
- Pretest scores showed no significant difference between groups.
Conclusions:
- Nine hours of deliberate practice with virtual patients enhanced interns' diagnostic skills more than 1.7 years of residency.
- Condensed educational experiences like VIPER can improve diagnostic education and patient care.
- Virtual patient training is effective for improving diagnostic skills in complex presentations.
