Plackett, Ruth;
Kassianos, Angelos;
Mylan, Sophie;
Kambouri, Maria;
Raine, Rosalind;
Sheringham, Jessica;
(2022)
The effectiveness of using virtual patient educational tools to improve medical students’ clinical reasoning skills: a systematic review.
BMC Medical Education
10.1186/s12909-022-03410-x.
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Abstract
Background: Use of virtual patient educational tools could fll the current gap in the teaching of clinical reasoning skills. However, there is a limited understanding of their efectiveness. The aim of this study was to synthesise the evidence to understand the efectiveness of virtual patient tools aimed at improving undergraduate medical students’ clinical reasoning skills. Methods: We searched MEDLINE, EMBASE, CINAHL, ERIC, Scopus, Web of Science and PsycINFO from 1990 to January 2022, to identify all experimental articles testing the efectiveness of virtual patient educational tools on medical students’ clinical reasoning skills. Quality of the articles was assessed using an adapted form of the MERSQI and the Newcastle–Ottawa Scale. A narrative synthesis summarised intervention features, how virtual patient tools were evaluated and reported efectiveness. Results: The search revealed 8,186 articles, with 19 articles meeting the inclusion criteria. Average study quality was moderate (M=6.5, SD=2.7), with nearly half not reporting any measurement of validity or reliability for their clinical reasoning outcome measure (8/19, 42%). Eleven articles found a positive efect of virtual patient tools on reasoning (11/19, 58%). Four reported no signifcant efect and four reported mixed efects (4/19, 21%). Several domains of clinical reasoning were evaluated. Data gathering, ideas about diagnosis and patient management were more often found to improve after virtual patient use (34/47 analyses, 72%) than application of knowledge, fexibility in thinking and problem-solving (3/7 analyses, 43%). Conclusions: Using virtual patient tools could efectively complement current teaching especially if opportunities for face-to-face teaching or other methods are limited, as there was some evidence that virtual patient educational tools can improve undergraduate medical students’ clinical reasoning skills. Evaluations that measured more case specifc clinical reasoning domains, such as data gathering, showed more consistent improvement than general measures like problem-solving. Case specifc measures might be more sensitive to change given the context dependent nature of clinical reasoning. Consistent use of validated clinical reasoning measures is needed to enable a metaanalysis to estimate efectiveness.
| Type: | Article |
|---|---|
| Title: | The effectiveness of using virtual patient educational tools to improve medical students’ clinical reasoning skills: a systematic review |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12909-022-03410-x |
| Publisher version: | https://doi.org/10.1186/s12909-022-03410-x |
| Language: | English |
| Additional information: | Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| Keywords: | Computer simulation, Virtual patient, Computer-assisted instruction, Educational technology, Medical education, Clinical decision-making, Clinical reasoning, Clinical skills, Review, Medical students |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10148494 |
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