Linear virtual patients versus student role-plays in teaching patient-centeredness: a mixed-method study

This study is aimed to assess differences in patient-centered attitudes between students using linear virtual patients focused on the patient's perspective and those participating in role-play, compare satisfaction with the methods, and explore students' perceptions.

A mixed-methods study was conducted among third-year medical students attending a communication course. Students were randomly allocated to either the virtual patient or the role-play group. In total, 122 students participated. Patient-centered attitudes were assessed before and after the intervention using the Patient-Practitioner Orientation Scale. Satisfaction was measured using a 7-point questionnaire. Six students participated in semi-structured interviews. Quantitative data were analyzed using nonparametric tests and equivalence testing, while qualitative were analyzed using thematic analysis.

No differences were observed between the groups in patient-centered attitudes either before or after the intervention. Equivalence testing indicated that outcomes for both teaching methods fell within a predefined equivalence margin of 0.5 points on the Patient-Practitioner Orientation Scale. Students in the role-play group reported higher satisfaction (role-play: median 5.65, IQR = 5.00-6.09; virtual patients: median 5.06, IQR = 4.24-5.62; p = .001). Qualitative interviews revealed that students valued role-play for interpersonal engagement, virtual patients were appreciated for reducing stress and supporting reflective learning.

Methods produced equivalent effects on patient-centered attitudes. Although students expressed a preference for role-play due to its realism, they recognized the reflective and low-stress advantages of virtual patients. Future research should explore hybrid approaches.