Abstract 8
Instructional Design for virtual patients for clinical reasoning: a systematic review
Robert Jay (Faculty of Health, Edge Hill University, UK);Â Rakesh Patel (School of Medicine, University of Nottingham, UK);Emma Wilson (School of Medicine, University of Nottingham, UK);
Jeremy Brown (Faculty of Health, Edge Hill University, UK);John Sanders (Faculty of Health, Edge Hill University, UK)
Background:
Technology-enhanced education is associated with increased knowledge and skills development among medical students. Virtual patients (VPs) are digital learning technologies that simulate real-life clinical cases, and have facilitated student learning during the Covid-19 pandemic in the face of restricted access to the workplace. Although evidence suggests VPs are effective for developing clinical reasoning, little is known about the most effective instructional design for VPs, and the extent to which VPs develop various components of clinical reasoning including self-regulated learning (SRL) behaviours.
Methods:
A systematic review was undertaken to identify effective VP designs, components of clinical reasoning and SRL behaviours developed by VPs as well as the most effective methods for giving feedback after students complete VP cases. A search strategy was developed in partnership with information librarians. Database searching Medline, Embase, CINHAL, Scopus, Eric and ProQuest identified 4776 articles. Empirical studies undertaken in a medical or healthcare professions education context were identified describing the instructional design of the VP; clinical reasoning components developed; and specific feedback protocol for delivering information about student performance on the VP.
Results:
70 articles were identified. Non-branching and branching designs were commonplace, with few enabling global navigation. Feedback information comprised: correctness of diagnosis and appropriate analytical pathways through the case; exemplar problem representations and relevant clinical knowledge. Little feedback was given around SRL behaviours or exploration of non-analytical cognitive processes during tasks. Greater development of SRL behaviours and cognitive processes during clinical reasoning tasks using VPs permitting global navigation may improve performance and learning over time.
