Transcultural adaptation of the virtual patient integration rating scale: a factor analysis

Using Virtual Patients (VPs) in medical education has gained popularity, especially during the SARS-CoV-2 pandemic, which restricted traditional clinical training. VPs provide a learning platform for students to refine their clinical reasoning and decision-making skills in a risk-free environment. Although the educational benefits of VPs are well known, there is still a need for validated tools to assess student perceptions, which are key to optimizing learning outcomes. The Virtual Patient Integration Rating Scale (VPIRS) has made a valuable contribution in this regard, having been established in English-speaking contexts, but its applicability in Ibero-American countries remains poorly explored. This study aimed to fill this gap by transculturally validating VPIRS for Spanish-speaking medical education environments, ensuring it reflects cultural nuances.

We conducted a two-phase transcultural validation of the VPIRS on medical students at the Universidad del Rosario. First, we translated and culturally adapted the VPIRS, using the modified Delphi method for face validation. Second, we assessed the construct validity, internal consistency, reproducibility, and reliability of the scale through a test-retest approach with 153 participants, using descriptive statistics, factor analysis, and reliability testing in SPSS.

The VPIRS was successfully adapted and validated for transcultural use in Spanish (VPIRS-E). The exploratory and factor analyses maintained the original scale's four-dimensional structure, explaining 61.8% of the total variance, with an overall Cronbach's alpha of 0.826. Test-retest reliability demonstrated robust intraclass correlation coefficients ranging from 0.8 to 0.9.

The VPIRS-E is a reliable and valid instrument that has maintained the structural integrity of the original scale and has demonstrated strong internal consistency across all of its domains. These results demonstrate the suitability of the VPIRS-E to assess medical students' perceptions of the use of VPs in Spanish-speaking learning contexts. The successful validation of this instrument also opens avenues for expanded international comparative studies, allowing fora deeper understanding of the effective integration of VPs in different medical education curricula.