A virtual patient-based training program to enhance clinical decision-making competencies in general practice...

Area of Science:

• Medical Education
• General Practice Training
• Clinical Decision-Making

Background:

• Clinical decision-making (CDM) is crucial for general practice (GP) residents.
• Traditional training offers limited deliberate practice for CDM skills.
• Virtual patient (VP) platforms offer risk-free environments for skill development.

Purpose of the Study:

• Evaluate the effectiveness of a structured VP training program for GP residents' CDM competencies.
• Explore residents' perceptions of the VP program's value.
• Identify barriers to developing CDM competencies using VP platforms.

Main Methods:

• Explanatory sequential mixed-methods design: quantitative pre-post assessment followed by qualitative interviews.
• 12-week curriculum: 50 GP residents completed weekly VP cases and facilitated workshops.
• Assessments included OSCEs (history-taking, physical examination, clinical reasoning, medical record writing) and a theoretical test; focus groups explored experiences.

Main Results:

• Significant improvements observed in clinical knowledge (mean increase 6.7 points), history-taking (mean diff.=10.2), and clinical reasoning (mean diff.=11.2).
• No statistically significant improvements in physical examination (mean diff.=2.4) or medical record writing (mean diff.=1.2).
• Residents valued the structured design for diagnostic reasoning and reflective learning; barriers included technological fidelity, documentation, skill transfer, and workshop variability.

Conclusions:

• Structured VP curriculum enhances GP residents' clinical knowledge, history-taking, and clinical reasoning.
• Limited impact on physical examination and medical record writing suggests need for technological advancement.
• Future efforts should focus on enhancing realism, optimizing integration, and assessing long-term competency transfer.