Virtual patients: a critical literature review and proposed next steps

Cook, David A; Triola, Marc M

doi:10.1111/j.1365-2923.2008.03286.x

Cited by 624Simulation-Based Education in HealthcareClinical Reasoning and Diagnostic SkillsInnovations in Medical Education

Virtual patients: a critical literature review and proposed next steps

Cook, David A, Triola, Marc M·2009·Medical Education

DOI 10.1111/j.1365-2923.2008.03286.x

Open this paper in CoChat — free account

Abstract

Context The opposing forces of increased training expectations and reduced training resources have greatly impacted health professions education. Virtual patients (VPs), which take the form of interactive computer‐based clinical scenarios, may help to reconcile this paradox. Methods We summarise research on VPs, highlight the spectrum of potential variation and identify an agenda for future research. We also critically consider the role of VPs in the educational armamentarium. Results We propose that VPs’ most unique and cost‐effective function is to facilitate and assess the development of clinical reasoning. Clinical reasoning in experts involves a non‐analytical process that matures through deliberate practice with multiple and varied clinical cases. Virtual patients are ideally suited to this task. Virtual patients can also be used in learner assessment, but scoring rubrics should emphasise non‐analytical clinical reasoning rather than completeness of information or algorithmic approaches. Potential variations in VP design are practically limitless, yet few studies have rigorously explored design issues. More research is needed to inform instructional design and curricular integration. Conclusions Virtual patients should be designed and used to promote clinical reasoning skills. More research is needed to inform how to effectively use VPs.

Integrity signals

Registry

Crossref · 10.1111/j.1365-2923.2008.03286.x

Cites

64 of 64 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Maintaining virtual patients' utility requires continuous updates to reflect evolving clinical standards.
“maintaining their utility requires continuous updates to reflect evolving clinical standards17–20.”
From A large language model digital patient system enhances ophthalmology history taking skills (2025) · cites this paper as [17]
Virtual patients effectively foster intrinsic motivation and baseline clinical reasoning competence.
“While VPs effectively foster intrinsic motivation and baseline clinical reasoning competence”
From A large language model digital patient system enhances ophthalmology history taking skills (2025) · cites this paper as [17]
Systematic reviews include studies where the virtual patient has been compared with other strategies and showed positive results against traditional lectures and even standardized patients, but evidence is not conclusive and heterogeneity of the data suggests that more research is needed.
“Moreover, it is possible to find systematic reviews that include studies where VP has been compared with some of those strategies and where it showed positive results against traditional lectures and even standardized patients, but evidence is not [7] conclusive and heterogeneity of the data suggest that more research is needed [7, 26, 29].”
From The virtual patient as a learning tool: a mixed quantitative qualitative study (2018) · cites this paper as [29]
The educational use of digital patients can complement learners' clinical experiences through experiential learning theory, providing a mechanism for information gathering and clinical decision-making in a safe environment.
“The educational use of digital patients can complement learners’ clinical experiences through experiential learning theory, providing a mechanism for information gathering and clinical decision-making in a safe environment [37].”
From Developing Medical Education Curriculum Reform Strategies to Address the Impact of Generative AI: Qualitative Study (2023) · cites this paper as [37]

Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review
Barry Issenberg, S., Mcgaghie, W. C., Petrusa, E. R., Lee Gordon, D., & Scalese, R. J. (2005) · Medical Teacher · doi:10.1080/01421590500046924 · Cited by 3,966 · see citing works
Deliberate Practice and the Acquisition and Maintenance of Expert Performance in Medicine and Related Domains
Ericsson, K. A. (2004) · Academic Medicine · doi:10.1097/00001888-200410001-00022 · Cited by 2,988 · cited 2× · see citing works
“Not only can VP cases illustrate multiple distinct presentations, 46 but deliberate practice 4 can be facilitated by sequencing cases to ensure an ideal case mix, structuring learning to develop constituent skills and reinforce knowledge structures 45 (i. e. considering alternative options, 47…”
Background
The Cambridge handbook of multimedia learning
Mayer, R. E. (2006) · Choice Reviews Online · doi:10.5860/choice.43-5643 · Cited by 2,321 · see citing works
The Cambridge Handbook of Multimedia Learning
(2005) · doi:10.1017/cbo9780511816819 · Cited by 1,595 · see citing works
Internet-Based Learning in the Health Professions
Cook, D., Levinson, A. J., Garside, S., Dupras, D. M., Erwin, P. J., & Montori, V. M. (2008) · JAMA · doi:10.1001/jama.300.10.1181 · Cited by 1,552 · see citing works
Self-citation
Research in clinical reasoning: past history and current trends
Norman, G. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02127.x · Cited by 1,018 · see citing works
Blueprints for complex learning: The 4C/ID-model
van Merriënboer, J. J. G., Clark, R. E., & de Croock, M. B. M. (2002) · Educational Technology Research and Development · doi:10.1007/bf02504993 · Cited by 708 · see citing works
How expertise develops in medicine: knowledge encapsulation and illness script formation
Schmidt, H. G., & Rikers, R. M. J. P. (2007) · Medical Education · doi:10.1111/j.1365-2923.2007.02915.x · Cited by 619 · see citing works
Scripts and clinical reasoning
Charlin, B., Boshuizen, H. P. A., Custers, E. J. F. M., & Feltovich, P. J. (2007) · Medical Education · doi:10.1111/j.1365-2923.2007.02924.x · Cited by 444 · see citing works
The Research We Still Are Not Doing: An Agenda for the Study of Computer-Based Learning
Cook, D. A. (2005) · Academic Medicine · doi:10.1097/00001888-200506000-00005 · Cited by 289 · see citing works
Self-citation
Virtual Patient Simulation at U.S. and Canadian Medical Schools
Huang, G. C., Reynolds, R., & Candler, C. S. (2007) · Academic Medicine · doi:10.1097/acm.0b013e31803e8a0a · Cited by 235 · see citing works
Exploring the Etiology of Content Specificity
Eva, K. W., Neville, A. J., & Norman, G. R. (1998) · Academic Medicine · doi:10.1097/00001888-199810000-00028 · Cited by 220 · see citing works
A randomized trial of teaching clinical skills using virtual and live standardized patients
Triola, M. M., Feldman, H. J., Kalet, A. L., Zabar, S. R., Kachur, E. K., Gillespie, C. C., Anderson, M., Griesser, C., & Lipkin, M. (2006) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2006.00421.x · Cited by 211 · see citing works
Self-citation
Teaching from the clinical reasoning literature: combined reasoning strategies help novice diagnosticians overcome misleading information
Eva, K. W., Hatala, R. A., LeBlanc, V. R., & Brooks, L. R. (2007) · Medical Education · doi:10.1111/j.1365-2923.2007.02923.x · Cited by 211 · see citing works
Building a virtual patient commons
Ellaway, R., Poulton, T., Fors, U., McGee, J. B., & Albright, S. (2008) · Medical Teacher · doi:10.1080/01421590701874074 · Cited by 203 · see citing works
Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment – Web-SP
Zary, N., Johnson, G., Boberg, J., & Fors, U. (2006) · BMC Medical Education · doi:10.1186/1472-6920-6-10 · Cited by 188 · see citing works
Practice Makes Perfect: The Critical Role of Mixed Practice in the Acquisition of ECG Interpretation Skills
Hatala, R. M., Brooks, L. R., & Norman, G. R. (2003) · Advances in Health Sciences Education · doi:10.1023/a:1022687404380 · Cited by 167 · see citing works
The Scope of Simulation-based Healthcare Education
Issenberg, S. B. (2006) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/01.sih.0000246607.36504.5a · Cited by 163 · see citing works
Do medical students respond empathetically to a virtual patient?
Deladisma, A. M., Cohen, M., Stevens, A., Wagner, P., Lok, B., Bernard, T., Oxendine, C., Schumacher, L., Johnsen, K., Dickerson, R., et al. (2007) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2007.01.021 · Cited by 160 · cited 1× · see citing works
“…use of VPs with that of live SPs have found little difference in of correct diagnoses, or perceived post-intervention comfort with patient 29–32 one 31,32 can facilitate the learning and performing of the technical aspects of the medical interview, but affective skills (warmth, empathy and other…”
Standardized Assessment of Reasoning in Contexts of Uncertainty
Charlin, B., & van der Vleuten, C. P. M. (2004) · Evaluation & the Health Professions · doi:10.1177/0163278704267043 · Cited by 155 · see citing works
A Comparison of Critical Thinking in Groups of Third-year Medical Students in Text, Video, and Virtual PBL Case Modalities
Kamin, C. S., O’Sullivan, P., Deterding, R. R., & Younger, M. (2003) · Academic Medicine · doi:10.1097/00001888-200302000-00018 · Cited by 139 · see citing works
Random comparison of ‘virtual patient’ models in the context of teaching clinical communication skills
Bearman, M., Cesnik, B., & Liddell, M. J. (2001) · Medical Education · doi:10.1046/j.1365-2923.2001.00999.x · Cited by 118 · see citing works
The benefits of flexibility: the pedagogical value of instructions to adopt multifaceted diagnostic reasoning strategies
Ark, T. K., Brooks, L. R., & Eva, K. W. (2007) · Medical Education · doi:10.1111/j.1365-2929.2007.02688.x · Cited by 118 · see citing works
CASE
Harless, W. G., Drennon, G. G., Marxer, J. J., Root, J. A., & Miller, G. E. (1971) · Academic Medicine · doi:10.1097/00001888-197105000-00009 · Cited by 112 · see citing works
Multi-institutional Development and Utilization of a Computer-Assisted Learning Program for the Pediatrics Clerkship: The CLIPP Project
Fall, L. H., Berman, N. B., Smith, S., White, C. B., Woodhead, J. C., & Olson, A. L. (2005) · Academic Medicine · doi:10.1097/00001888-200509000-00012 · Cited by 101 · see citing works
Simulation of patient encounters using a virtual patient in periodontology instruction of dental students: design, usability, and learning effect in history‐taking skills
Janda, M., Mattheos, N., Nattestad, A., Wagner, A., Nebel, D., Färbom, C., Lê, D. ‐., & Attström, R. (2004) · European Journal Of Dental Education · doi:10.1111/j.1600-0579.2004.00339.x · Cited by 99 · see citing works
Comparing Interpersonal Interactions with a Virtual Human to Those with a Real Human
Raij, A. B., Johnsen, K., Dickerson, R. F., Lok, B. C. L., Cohen, M. S., Duerson, M. C., Pauly, R. R., Stevens, A. O., Wagner, P. J., & Lind, D. S. (2007) · IEEE Transactions on Visualization and Computer Graphics · doi:10.1109/tvcg.2007.1030 · Cited by 99 · see citing works
Evaluation of an interactive case simulation system in dermatology and venereology for medical students
Wahlgren, C., Edelbring, S., Fors, U., Hindbeck, H., & Ståhle, M. (2006) · BMC Medical Education · doi:10.1186/1472-6920-6-40 · Cited by 93 · see citing works
Is Virtual the Same as Real? Medical Studentsʼ Experiences of a Virtual Patient
Bearman, M. (2003) · Academic Medicine · doi:10.1097/00001888-200305000-00021 · Cited by 83 · see citing works
MedEthEx Online: A Computer-Based Learning Program in Medical Ethics and Communication Skills
Fleetwood, J., Vaught, W., Feldman, D., Gracely, E. J., Kassutto, Z., & Novack, D. H. (2000) · Teaching and Learning in Medicine · doi:10.1207/s15328015tlm1202_7 · Cited by 83 · see citing works
Comparing different types of performance feedback and computer-based instruction in teaching medical students how to diagnose acute abdominal pain
Schwartz, S., & Griffin, T. J. (1993) · Academic Medicine · doi:10.1097/00001888-199311000-00017 · Cited by 61 · see citing works
Anatomy of the clinical simulation
Friedman, C. P. (1995) · Academic Medicine · doi:10.1097/00001888-199503000-00011 · Cited by 61 · see citing works
The use of a virtual patient case in an OSCE-based exam – A pilot study
Courteille, O., Bergin, R., Courteille, O., Bergin, R., Stockeld, D., Ponzer, S., & Fors, U. (2008) · Medical Teacher · doi:10.1080/01421590801910216 · Cited by 60 · see citing works
The value of intelligent multimedia simulation for teaching clinical decision-making skills
Garrett, B., & Callear, D. (2001) · Nurse Education Today · doi:10.1054/nedt.2001.0568 · Cited by 59 · see citing works
Improving Student Dentist Competencies and Perception of Difficulty in Delivering Care to Children with Developmental Disabilities Using a Virtual Patient Module
Kleinert, H. L., Sanders, C. L., Mink, J. R., Nash, D. A., Johnson, J., Boyd, S., & Challman, S. D. (2007) · Journal of Dental Education · doi:10.1002/j.0022-0337.2007.71.2.tb04276.x · Cited by 59 · see citing works
Training inter-physician communication using the Dynamic Patient Simulator®
Sijstermans, R., Jaspers, M., Bloemendaal, P. M., & Schoonderwaldt, E. M. (2007) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2007.01.007 · Cited by 50 · see citing works
The Power of the Plural: Effect of Conceptual Analogies on Successful Transfer
Norman, G. R., Dore, K. L., Krebs, J., & Neville, A. J. (2007) · Academic Medicine · doi:10.1097/acm.0b013e3181405ad7 · Cited by 49 · see citing works
VIRTUAL PATIENTS IN UNDERGRADUATE SURGERY EDUCATION: A RANDOMIZED CONTROLLED STUDY
Vash, J. H., Yunesian, M., Shariati, M., Keshvari, A., & Harirchi, I. (2007) · ANZ Journal of Surgery · doi:10.1111/j.1445-2197.2006.03978.x · Cited by 48 · see citing works
A Randomized Comparison of Alternative Formats for Clinical Simulations
Friedman, C. P., France, C. L., & Drossman, D. D. (1991) · Medical Decision Making · doi:10.1177/0272989x9101100404 · Cited by 42 · see citing works
Identification of the Service Quality Dimensions of Pharmaceutical Education
Holdford, D. A., & Patkar, A. D. (2003) · American Journal of Pharmaceutical Education · doi:10.5688/aj6704108 · Cited by 41 · see citing works
E-Learning Virtual Patients for Geriatric Education
Orton, E., & Mulhausen, P. L. (2008) · Gerontology & Geriatrics Education · doi:10.1300/j021v28n03_06 · Cited by 38 · see citing works
Interactive Simulated Patient: Experiences with Collaborative E-Learning in Medicine
Bergin, R., Youngblood, P., Ayers, M. K., Boberg, J., Laksov, K. B., Courteille, O., Dev, P., Hindbeck, H., Leonard, E. E., Stringer, J. R., et al. (2003) · Journal of Educational Computing Research · doi:10.2190/ut9b-f3e7-3p75-hpk5 · Cited by 37 · see citing works
Computer Simulations as a Measure of Nursing Students' Decision-Making Skills
Lowdermilk, D. L., & Fishel, A. H. (1991) · Journal of Nursing Education · doi:10.3928/0148-4834-19910101-09 · Cited by 36 · see citing works
A Multimedia Patient Simulation for Teaching and Assessing Endodontic Diagnosis
Littlefield, J. H., Demps, E. L., Keiser, K., Chatterjee, L. A., Yuan, C. H., & Hargreaves, K. (2003) · Journal of Dental Education · doi:10.1002/j.0022-0337.2003.67.6.tb03667.x · Cited by 32 · see citing works
Evaluation of a Diagnostic Reasoning Program (DxR): Exploring Student Perceptions and Addressing Faculty Concerns
Bryce, D. A., King, N. J. C., Graebner, C. F., & Myers, J. H. (1998) · Journal of Interactive Media in Education · doi:10.5334/1998-1 · Cited by 30 · see citing works
Caring for Children with Intellectual and Developmental Disabilities: Virtual Patient Instruction Improves Students' Knowledge and Comfort Level
Sanders, C. L., Kleinert, H. L., Free, T. A., Slusher, I. L., Clevenger, K., Johnson, S., & Boyd, S. E. (2007) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2007.07.002 · Cited by 29 · see citing works
Virtual patients for assessing medical students–important aspects when considering the introduction of a new assessment format
Waldmann, U.-M., Gulich, M., & Zeitler, H. (2008) · Medical Teacher · doi:10.1080/01421590701758616 · Cited by 29 · see citing works
Resident Physiciansʼ Competencies and Attitudes in Delivering a Postnatal Diagnosis of Down Syndrome
Ferguson, J. E., II, Kleinert, H. L., Lunney, C. A., & Campbell, L. R. (2006) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000235709.55395.6a · Cited by 28 · see citing works
Sharing innovation: the case for technology standards in health professions education
Smothers, V., Greene, P. S., Ellaway, R., & Detmer, D. E. (2008) · Medical Teacher · doi:10.1080/01421590701874082 · Cited by 26 · see citing works
Geriatric patient simulations for dental hygiene
Johnson, L. A., Cunningham, M., Finkelstein, M. W., & Hand, J. (1997) · Journal of Dental Education · doi:10.1002/j.0022-0337.1997.61.8.tb03148.x · Cited by 25 · see citing works
A field test of the TIME patient simulation model
Harless, W. G., DUNCAN, R. C., Zier, M. A., Ayers, W. R., Berman, J. R., & Pohl, H. S. (1990) · Academic Medicine · doi:10.1097/00001888-199005000-00014 · Cited by 23 · see citing works
Reliability and Validity of Key Feature Cases for the Self-Assessment of Colon and Rectal Surgeons
Trudel, J. L., Bordage, G., & Downing, S. M. (2008) · Annals of Surgery · doi:10.1097/sla.0b013e31818233d3 · Cited by 22 · see citing works
Measuring the effects of problem-based learning on the development of veterinary studentsʼ clinical expertise
Farnsworth, C. C. (1997) · Academic Medicine · doi:10.1097/00001888-199706000-00024 · Cited by 21 · see citing works
Evaluation of a Multimedia Case-History Simulation Program for Pharmacy Students
Chaikoolvatana, A., & Goodyer, L. I. (2003) · American Journal of Pharmaceutical Education · doi:10.5688/aj670116 · Cited by 21 · see citing works
Challenges and Perspectives of Computerassisted Instruction in Medical Education
Singer, R., Bauch, M. J., Heid, J., Hess, F., Leven, F. J., & Haag, M. (2007) · Methods of Information in Medicine · doi:10.1055/s-0038-1628135 · Cited by 20 · see citing works
Validity of Scores Generated by a Web-Based Multimedia Simulated Patient Case Software: A Pilot Study
Jerant, A. F., & Azari, R. S. (2004) · Academic Medicine · doi:10.1097/00001888-200408000-00017 · Cited by 20 · see citing works
Development of an Undergraduate Medical Curriculum
FLEISZER, D. M., & Posel, N. H. (2003) · Academic Medicine · doi:10.1097/00001888-200303000-00005 · Cited by 19 · see citing works
The yin and yang of education research
Eva, K. W. (2007) · Medical Education · doi:10.1111/j.1365-2923.2007.02806.x · Cited by 19 · see citing works
Specialty preferences of 1993 medical school graduates
KASSEBAUM, D. G., & Szenas, P. L. (1993) · Academic Medicine · doi:10.1097/00001888-199311000-00019 · Cited by 16 · see citing works
Virtual reality training improves students' knowledge structures of medical concepts.
Stevens, S. M., Goldsmith, T. E., Summers, K. L., Sherstyuk, A. V., Kihmm, K., Holten, J. R., Davis, C., Speitel, D., Maris, C., Stewart, R., et al. (2005) · PubMed · Cited by 13 · see citing works
The glass is a little full – of something: revisiting the issue of content specificity of problem solving
Norman, G. R. (2008) · Medical Education · doi:10.1111/j.1365-2923.2008.03096.x · Cited by 12 · see citing works
Scoring performance on computer-based patient simulations: beyond value of information.
Downs, S. M., Marasigan, F., Abraham, V., Wildemuth, B. M., & Friedman, C. P. (1999) · PubMed Central · Cited by 11 · see citing works
Computerized clinical simulations: a strategy for staff development in critical care
Henry, S. B., & Waltmire, D. (1992) · American Journal of Critical Care · doi:10.4037/ajcc1992.1.2.99 · Cited by 9 · see citing works
Evaluation of an Online Analogical Patient Simulation Program
Thompson, G. A., Morrison, R., Holyoak, K. J., & Clark, T. K. (2006) · Proceedings - IEEE Symposium on Computer-Based Medical Systems · doi:10.1109/cbms.2006.85 · Cited by 6 · see citing works

Flagged first, then by citations

1 of the 65 references couldn’t be matched to a known paper.

Sorted by citations

Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis
Cook, D. A., Hamstra, S. J., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hatala, R. A. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.714886 · Cited by 729 · see citing works
Self-citation
Blended Learning Compared to Traditional Learning in Medical Education: Systematic Review and Meta-Analysis
Vallée, A., Blacher, J., Cariou, A., & Sorbets, E. (2019) · Journal of Medical Internet Research · doi:10.2196/16504 · Cited by 717 · see citing works
Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration
Kononowicz, A. A., Woodham, L. A., Edelbring, S., Stathakarou, N., Davies, D., Saxena, N., Tudor Car, L., Carlstedt-Duke, J., Car, J., & Zary, N. (2019) · Journal of Medical Internet Research · doi:10.2196/14676 · Cited by 600 · see citing works
Computerized Virtual Patients in Health Professions Education: A Systematic Review and Meta-Analysis
Cook, D. A., Erwin, P. J., & Triola, M. M. (2010) · Academic Medicine · doi:10.1097/acm.0b013e3181edfe13 · Cited by 570 · see citing works
Self-citation
Comparative Effectiveness of Technology-Enhanced Simulation Versus Other Instructional Methods
Cook, D. A., Brydges, R., Hamstra, S. J., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hatala, R. A. (2012) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0b013e3182614f95 · Cited by 345 · see citing works
Self-citation
The effect of simulation games on the learning of computational problem solving
Liu, C., Cheng, Y., & Huang, C.-W. (2011) · Computers & Education · doi:10.1016/j.compedu.2011.04.002 · Cited by 298 · see citing works
What do we mean by web‐based learning? A systematic review of the variability of interventions
Cook, D. A., Garside, S., Levinson, A. J., Dupras, D. M., & Montori, V. M. (2010) · Medical Education · doi:10.1111/j.1365-2923.2010.03723.x · Cited by 256 · see citing works
Self-citation
Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection
Chiniara, G., Cole, G., Brisbin, K., Huffman, D., Cragg, B., Lamacchia, M., Norman, D., & Canadian Network For Simulation In Healthcare, G. W. G. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.733451 · Cited by 259 · see citing works
Using Virtual Reality Simulation Environments to Assess Competence for Emergency Medicine Learners
McGrath, J. L., Taekman, J. M., Dev, P., Danforth, D. R., Mohan, D., Kman, N. E., Crichlow, A., & Bond, W. F. (2017) · Academic Emergency Medicine · doi:10.1111/acem.13308 · Cited by 249 · see citing works
A Virtual Counseling Application Using Artificial Intelligence for Communication Skills Training in Nursing Education: Development Study
Shorey, S., Ang, E., Yap, J., Ng, E. D., Lau, S. T., & Chui, C. K. (2019) · Journal of Medical Internet Research · doi:10.2196/14658 · Cited by 238 · see citing works
Benefits of gamification in medical education
Krishnamurthy, K., Selvaraj, N., Gupta, P., Cyriac, B., Dhurairaj, P., Abdullah, A., Krishnapillai, A. D. S., Lugova, H., Haque, M., Xie, S., et al. (2022) · Clinical Anatomy · doi:10.1002/ca.23916 · Cited by 269 · see citing works
Gamification and multimedia for medical education: a landscape review
McCoy, L., Lewis, J. H., & Dalton, D. (2016) · Journal of Osteopathic Medicine · doi:10.7556/jaoa.2016.003 · Cited by 223 · see citing works
Effective virtual patient simulators for medical communication training: A systematic review
Lee, J., Kim, H., Kim, K. H., Jung, D., Jowsey, T., & Webster, C. S. (2020) · Medical Education · doi:10.1111/medu.14152 · Cited by 210 · see citing works
The Role for Virtual Patients in the Future of Medical Education
Berman, N. B., Durning, S. J., Fischer, M. R., Huwendiek, S., & Triola, M. M. (2016) · Academic Medicine · doi:10.1097/acm.0000000000001146 · Cited by 211 · see citing works
Self-citation
Efficacy of virtual patients in medical education: A meta-analysis of randomized studies
Consorti, F., Mancuso, R., Nocioni, M., & Piccolo, A. (2012) · Computers & Education · doi:10.1016/j.compedu.2012.04.017 · Cited by 205 · see citing works
Cost-Utility Analysis of Virtual and Mannequin-Based Simulation
Adamson, K. A. (2018) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0000000000000280 · Cited by 176 · see citing works
Virtual Simulation to Enhance Clinical Reasoning in Nursing: A Systematic Review and Meta-analysis
Sim, J. J. M., Rusli, K. D. B., Seah, B., Levett-Jones, T., Lau, Y., & Liaw, S. Y. (2022) · Clinical Simulation in Nursing · doi:10.1016/j.ecns.2022.05.006 · Cited by 171 · see citing works
Virtual patients - what are we talking about? A framework to classify the meanings of the term in healthcare education
Kononowicz, A. A., Zary, N., Edelbring, S., Corral, J., & Hege, I. (2015) · BMC Medical Education · doi:10.1186/s12909-015-0296-3 · Cited by 203 · see citing works
Roles of Innovation in Education Delivery
Blouin, R. A., Riffee, W. H., Robinson, E. T., Beck, D. E., Green, C., Joyner, P. U., Persky, A. M., & Pollack, G. M. (2009) · American Journal of Pharmaceutical Education · doi:10.5688/aj7308154 · Cited by 155 · see citing works
Comparison of Virtual Patient Simulation With Mannequin-Based Simulation for Improving Clinical Performances in Assessing and Managing Clinical Deterioration: Randomized Controlled Trial
Liaw, S. Y., Chan, S. W., Chen, F.-G., Hooi, S. C., & Siau, C. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3322 · Cited by 147 · see citing works
The effectiveness of using virtual patient educational tools to improve medical students’ clinical reasoning skills: a systematic review
Plackett, R., Kassianos, A. P., Mylan, S., Kambouri, M. A., Raine, R., & Sheringham, J. (2022) · BMC Medical Education · doi:10.1186/s12909-022-03410-x · Cited by 157 · see citing works
The virtual patient as a learning tool: a mixed quantitative qualitative study
Isaza-Restrepo, A., Gómez, M. T., Cifuentes, G., & Argüello, A. (2018) · BMC Medical Education · doi:10.1186/s12909-018-1395-8 · Cited by 129 · see citing works
What can virtual patient simulation offer mental health nursing education?
Guise, V., Chambers, M. G. A., & Valimaki, M. A. (2011) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2011.01797.x · Cited by 126 · see citing works
Towards a typology of virtual patients
Huwendiek, S., de Leng, B. A., Zary, N., Fischer, M. R., Ruiz, J. G., & Ellaway, R. (2009) · Medical Teacher · doi:10.1080/01421590903124708 · Cited by 124 · see citing works
The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics - A Study of Medical Ethics Using Immersive Virtual Reality
Pan, X., Slater, M., Beacco, A., Navarro, X., Rivas, A. I. B., Swapp, D., Hale, J., Forbes, P., Denvir, C., Hamilton, A. F. D. C., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0146837 · Cited by 120 · see citing works
Digitale Lehr- und Lernangebote in der medizinischen Ausbildung
Kühn, S., Frankenhauser, S., & Tolks, D. (2017) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-017-2673-z · Cited by 116 · see citing works
The use of virtual patients in medical school curricula
Cendan, J., & Lok, B. (2012) · Advances in Physiology Education · doi:10.1152/advan.00054.2011 · Cited by 109 · see citing works
Transforming traditional teaching laboratories for effective remote delivery—A review
Bhute, V. J., Inguva, P., Shah, U. V., & Brechtelsbauer, C. (2021) · Education for Chemical Engineers · doi:10.1016/j.ece.2021.01.008 · Cited by 108 · see citing works
Clinical reasoning in nursing, a think-aloud study using virtual patients – A base for an innovative assessment
Forsberg, E., Ziegert, K., Hult, H., & Fors, U. (2013) · Nurse Education Today · doi:10.1016/j.nedt.2013.07.010 · Cited by 107 · see citing works
Serious Gaming in Medical Education
Olszewski, A. E., & Wolbrink, T. A. (2016) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0000000000000212 · Cited by 104 · see citing works
Digital Education for Health Professionals: An Evidence Map, Conceptual Framework, and Research Agenda
Car, L. T., Poon, S., Kyaw, B. M., Cook, D. A., Ward, V. C., Atun, R. A., Majeed, A., Johnston, J. S., van der Kleij, R., Molokhia, M., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/31977 · Cited by 112 · see citing works
Self-citation
Twelve tips to support the development of clinical reasoning skills using virtual patient cases
Posel, N. H., McGee, J. B., & FLEISZER, D. M. (2014) · Medical Teacher · doi:10.3109/0142159x.2014.993951 · Cited by 101 · see citing works
Management Reasoning: Implications for Health Professions Educators and a Research Agenda
Cook, D. A., Durning, S. J., Sherbino, J., & Gruppen, L. D. (2019) · Academic Medicine · doi:10.1097/acm.0000000000002768 · Cited by 99 · see citing works
Self-citation
Virtual Patients Using Large Language Models: Scalable, Contextualized Simulation of Clinician-Patient Dialogue With Feedback
Cook, D. A., Overgaard, J., Pankratz, V. S., Del Fiol, G., & Aakre, C. A. (2025) · Journal of Medical Internet Research · doi:10.2196/68486 · Cited by 96 · see citing works
Self-citation
The shortage of skilled workers in Europe: its impact on geriatric medicine
Michel, J., & Ecarnot, F. (2020) · European Geriatric Medicine · doi:10.1007/s41999-020-00323-0 · Cited by 92 · see citing works
Virtual Patients and Nontechnical Skills in Undergraduate Health Professional Education: An Integrative Review
Peddle, M., Bearman, M., & Nestel, D. (2016) · Clinical Simulation in Nursing · doi:10.1016/j.ecns.2016.04.004 · Cited by 91 · see citing works
Promotion of Self-directed Learning Using Virtual Patient Cases
Benedict, N. J., Schonder, K. S., & McGee, J. B. (2013) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe777151 · Cited by 89 · see citing works
Virtual patients for assessment of clinical reasoning in nursing — A pilot study
Forsberg, E., Georg, C., Ziegert, K., & Fors, U. (2010) · Nurse Education Today · doi:10.1016/j.nedt.2010.11.015 · Cited by 89 · see citing works
Virtual patient simulation: Knowledge gain or knowledge loss?
Botezatu, M., Hult, H., Tessma, M. K., & Fors, U. (2010) · Medical Teacher · doi:10.3109/01421590903514630 · Cited by 89 · see citing works
Twelve tips to enhance student engagement in synchronous online teaching and learning
Khan, R. A., Atta, K., Sajjad, M., & Jawaid, M. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.1912310 · Cited by 91 · see citing works
Virtual Patients in a Behavioral Medicine Massive Open Online Course (MOOC): A Qualitative and Quantitative Analysis of Participants’ Perceptions
Berman, A. H., Biguet, G., Stathakarou, N., Westin-Hägglöf, B., Jeding, K., McGrath, C., Zary, N., & Kononowicz, A. A. (2017) · Academic Psychiatry · doi:10.1007/s40596-017-0706-4 · Cited by 86 · see citing works
Learning the facts in medical school is not enough: which factors predict successful application of procedural knowledge in a laboratory setting?
Schmidmaier, R., Eiber, S., Ebersbach, R., Schiller, M., Hege, I., Holzer, M., & Fischer, M. R. (2013) · BMC Medical Education · doi:10.1186/1472-6920-13-28 · Cited by 87 · see citing works
Provision of e-learning programmes to replace undergraduate medical students’ clinical general practice attachments during COVID-19 stand-down
Roskvist, R. P., Eggleton, K. S., & Goodyear‐Smith, F. (2020) · Education for Primary Care · doi:10.1080/14739879.2020.1772123 · Cited by 84 · see citing works
Can a Virtual Patient Trainer Teach Student Nurses How to Save Lives—Teaching Nursing Students About Pediatric Respiratory Diseases
LeFlore, J. L., Anderson, M., Zielke, M. A., Nelson, K. A., Thomas, P. E., Hardee, G. M., & John, L. D. (2012) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0b013e31823652de · Cited by 84 · see citing works
Sorting Out the Virtual Patient
Talbot, T. B., Sagae, K., John, B., & Rizzo, A. (2012) · International Journal of Gaming and Computer-Mediated Simulations · doi:10.4018/jgcms.2012070101 · Cited by 84 · see citing works
Effectiveness of simulation in psychiatry for nursing students, nurses and nurse practitioners: A systematic review and meta‐analysis
Piot, M., Dechartres, A., Attoe, C., Romeo, M., Jollant, F., Billon, G., Cross, S., Lemogne, C., Burn, C. L., Michelet, D., et al. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.14986 · Cited by 83 · see citing works
Reproducibility of Literature Search Reporting in Medical Education Reviews
Maggio, L. A., Tannery, N. H., & Kanter, S. L. (2011) · Academic Medicine · doi:10.1097/acm.0b013e31822221e7 · Cited by 77 · see citing works
Virtual patient simulation: what do students make of it? A focus group study
Botezatu, M., Hult, H., & Fors, U. (2010) · BMC Medical Education · doi:10.1186/1472-6920-10-91 · Cited by 81 · see citing works
Improving Pediatric Basic Life Support Performance Through Blended Learning With Web-Based Virtual Patients: Randomized Controlled Trial
Lehmann, R., Thiessen, C., Frick, B., Bosse, H. M., Nikendei, C., Hoffmann, G. F., Tönshoff, B., & Huwendiek, S. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4141 · Cited by 79 · see citing works
Review article: Simulation in anesthesia: state of the science and looking forward
LeBlanc, V. R. (2011) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-011-9638-8 · Cited by 79 · see citing works
Experiencing virtual patients in clinical learning: a phenomenological study
Edelbring, S., Dastmalchi, M., Hult, H., Lundberg, I. E., & Dahlgren, L. O. (2011) · Advances in Health Sciences Education · doi:10.1007/s10459-010-9265-0 · Cited by 77 · see citing works
Virtual Patients and Problem-Based Learning in Advanced Therapeutics
Benedict, N. J. (2010) · American Journal of Pharmaceutical Education · doi:10.5688/aj7408143 · Cited by 78 · see citing works
Online Virtual-Patient Cases Versus Traditional Problem-Based Learning in Advanced Pharmacy Practice Experiences
Al-Dahir, S., Bryant, K., Kennedy, K. B., & Robinson, D. S. (2014) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe78476 · Cited by 78 · see citing works
Virtual patient design: exploring what works and why. A grounded theory study
Bateman, J., Allen, M. E., Samani, D., Kidd, J. M., & Davies, D. (2013) · Medical Education · doi:10.1111/medu.12151 · Cited by 77 · see citing works
Developing Medical Education Curriculum Reform Strategies to Address the Impact of Generative AI: Qualitative Study
Shimizu, I., Kasai, H., Shikino, K., Araki, N., Takahashi, Z., Onodera, M., Kimura, Y., Tsukamoto, T., Yamauchi, K., Asahina, M., et al. (2023) · JMIR Medical Education · doi:10.2196/53466 · Cited by 81 · see citing works
Virtual patients: A year of change
Poulton, T., & Balasubramaniam, C. (2011) · Medical Teacher · doi:10.3109/0142159x.2011.613501 · Cited by 75 · see citing works
Cognitive Load and Self-Determination Theories Applied to E-Learning: Impact on Students' Participation and Academic Performance
Grangeia, T. D. A. G., de Jorge, B., Franci, D., Santos, T. M., Setúbal, M. S. V., Schweller, M., & Filho, C. (2016) · PLoS ONE · doi:10.1371/journal.pone.0152462 · Cited by 75 · see citing works
Screen-Based Simulation and Virtual Reality for Pediatric Emergency Medicine
Chang, T. P., & Weiner, D. L. (2016) · Clinical Pediatric Emergency Medicine · doi:10.1016/j.cpem.2016.05.002 · Cited by 75 · see citing works
Creating virtual patients using large language models: scalable, global, and low cost
Cook, D. A. (2025) · Medical Teacher · doi:10.1080/0142159x.2024.2376879 · Cited by 73 · see citing works
Self-citation
Benefits of computer screen‐based simulation in learning cardiac arrest procedures
Bonnetain, E., Boucheix, J., Hamet, M., & Freysz, M. (2010) · Medical Education · doi:10.1111/j.1365-2923.2010.03708.x · Cited by 72 · see citing works
An Online Virtual-Patient Program to Teach Pharmacists and Pharmacy Students How to Provide Diabetes-Specific Medication Therapy Management
Battaglia, J. N., Kieser, M. A., Bruskiewitz, R. H., Pitterle, M. E., & Thorpe, J. M. (2012) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe767131 · Cited by 70 · see citing works
Simulation in Undergraduate Psychiatry: Exploring the Depth of Learner Engagement
Abdool, P. S., Nirula, L., Bonato, S., Rajji, T. K., & Silver, I. L. (2017) · Academic Psychiatry · doi:10.1007/s40596-016-0633-9 · Cited by 66 · see citing works
A Natural Language Processing–Based Virtual Patient Simulator and Intelligent Tutoring System for the Clinical Diagnostic Process: Simulator Development and Case Study
Furlan, R., Gatti, M., Menè, R., Shiffer, D., Marchiori, C., Giaj Levra, A., Saturnino, V., Brunetta, E., & Dipaola, F. (2021) · JMIR Medical Informatics · doi:10.2196/24073 · Cited by 67 · see citing works
Evaluating the impact of high‐ and low‐fidelity instruction in the development of auscultation skills
Chen, R., Grierson, L., & Norman, G. R. (2015) · Medical Education · doi:10.1111/medu.12653 · Cited by 66 · see citing works
Advancing virtual patient simulations through design research and interPLAY: part I: design and development
Hirumi, A. “. C., Kleinsmith, A., Johnsen, K., Kubovec, S., Eakins, M., Bogert, K., Rivera-Gutierrez, D. J., Reyes, R. J., Lok, B. C. L., & Cendan, J. C. (2016) · Educational Technology Research and Development · doi:10.1007/s11423-016-9429-6 · Cited by 65 · see citing works
Virtual patient simulations for brief assessment of mental health disorders in integrated care settings
Washburn, M., Parrish, D. E., & Bordnick, P. S. (2017) · Social Work in Mental Health · doi:10.1080/15332985.2017.1336743 · Cited by 64 · see citing works
Just enough, but not too much interactivity leads to better clinical skills performance after a computer assisted learning module
Kalet, A. L., Song, H. S., Sarpel, U., Schwartz, R. N., Brenner, J. M., Ark, T. K., & Plass, J. L. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.706727 · Cited by 62 · see citing works
Simulation in Occupational Therapy Curricula: A literature review
Bennett, S. H., Rodger, S., Fitzgerald, C., & Gibson, E. M. (2017) · Australian Occupational Therapy Journal · doi:10.1111/1440-1630.12372 · Cited by 63 · see citing works
Evaluation of Medical Simulations
Bewley, W. L., & O’Neil, H. F. (2013) · Military Medicine · doi:10.7205/milmed-d-13-00255 · Cited by 60 · see citing works
Cost Considerations in Using Simulations for Medical Training
Fletcher, J. D., & Wind, A. P. (2013) · Military Medicine · doi:10.7205/milmed-d-13-00258 · Cited by 60 · see citing works
Patient Simulation Software to Augment an Advanced Pharmaceutics Course
Benedict, N. J., & Schonder, K. S. (2011) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe75221 · Cited by 59 · see citing works
Virtual patients design and its effect on clinical reasoning and student experience: a protocol for a randomised factorial multi-centre study
Bateman, J., Allen, M. E., Kidd, J. M., Parsons, N., & Davies, D. (2012) · BMC Medical Education · doi:10.1186/1472-6920-12-62 · Cited by 59 · see citing works
Web-Based Virtual Patients in Nursing Education: Development and Validation of Theory-Anchored Design and Activity Models
Georg, C., & Zary, N. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.2556 · Cited by 59 · see citing works
Learning clinical reasoning: how virtual patient case format and prior knowledge interact
Kiesewetter, J., Sailer, M., Jung, V. M., Schönberger, R., Bauer, E., Zottmann, J., Hege, I., Zimmermann, H., Fischer, F., & Fischer, M. R. (2020) · BMC Medical Education · doi:10.1186/s12909-020-1987-y · Cited by 62 · see citing works
Integrating virtual patients into courses: follow‐up seminars and perceived benefit
Edelbring, S., Broström, O., Henriksson, P., Vassiliou, D., Spaak, J., Dahlgren, L. O., Fors, U., & Zary, N. (2012) · Medical Education · doi:10.1111/j.1365-2923.2012.04219.x · Cited by 58 · see citing works
Virtual Patients in Primary Care: Developing a Reusable Model That Fosters Reflective Practice and Clinical Reasoning
Salminen, H., Zary, N., Björklund, K. L., Toth-Pal, E., & Leanderson, C. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.2616 · Cited by 56 · see citing works
Design and Evaluation of a Simulation for Pediatric Dentistry in Virtual Worlds
Papadopoulos, L., Pentzou, A.-E., Louloudiadis, K., & Tsiatsos, T.-K. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2651 · Cited by 56 · see citing works
Use of Virtual Patients in an Advanced Therapeutics Pharmacy Course to Promote Active, Patient-Centered Learning
Smith, M. A., Mohammad, R. A., & Benedict, N. J. (2014) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe786125 · Cited by 56 · see citing works
Assessing progression of clinical reasoning through virtual patients: An exploratory study
Forsberg, E., Ziegert, K., Hult, H., & Fors, U. (2015) · Nurse Education in Practice · doi:10.1016/j.nepr.2015.09.006 · Cited by 55 · see citing works
Combination of a Flipped Classroom Format and a Virtual Patient Case to Enhance Active Learning in a Required Therapeutics Course
Lichvar, A. B., Hedges, A., Benedict, N. J., & Donihi, A. C. (2016) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe8010175 · Cited by 55 · see citing works
The effectiveness of the virtual patient-based social learning approach in undergraduate nursing education: A quasi-experimental study
Hwang, G., Chang, C., & Ogata, H. (2021) · Nurse Education Today · doi:10.1016/j.nedt.2021.105164 · Cited by 54 · see citing works
Review article: New directions in medical education related to anesthesiology and perioperative medicine
Bould, M. D., Naik, V. N., & Hamstra, S. J. (2011) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-011-9633-0 · Cited by 48 · see citing works
The value of online learning and MRI: Finding a niche for expensive technologies
Cook, D. A. (2014) · Medical Teacher · doi:10.3109/0142159x.2014.917284 · Cited by 52 · see citing works
Self-citation
Virtual patient simulation in psychiatric care – A pilot study of digital support for collaborate learning
Sunnqvist, C., Karlsson, K. B., Lindell, L., & Fors, U. (2016) · Nurse Education in Practice · doi:10.1016/j.nepr.2016.02.004 · Cited by 53 · see citing works
Intelligent virtual case learning system based on real medical records and natural language processing
Wang, M., Sun, Z., Jia, M., Wang, Y., Wang, H., Zhu, X., Chen, L., & Ji, H. (2022) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-022-01797-7 · Cited by 52 · see citing works
Evaluation of the Use of a Virtual Patient on Student Competence and Confidence in Performing Simulated Clinic Visits
Taglieri, C. A., Crosby, S. J., Zimmerman, K. M., Schneider, T., & Patel, D. K. (2017) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe81587 · Cited by 52 · see citing works
Virtual Patient Simulations Using Social Robotics Combined With Large Language Models for Clinical Reasoning Training in Medical Education: Mixed Methods Study
Borg, A., Georg, C., Jobs, B., Huss, V., Waldenlind, K., Ruiz, M., Edelbring, S., Skantze, G., & Parodis, I. (2025) · Journal of Medical Internet Research · doi:10.2196/63312 · Cited by 51 · see citing works
The Effect of High-Fidelity Cardiopulmonary Resuscitation (CPR) Simulation on Athletic Training Student Knowledge, Confidence, Emotions, and Experiences
Tivener, K. A., & Gloe, D. S. (2015) · Athletic Training Education Journal · doi:10.4085/1002103 · Cited by 52 · see citing works
Adoption of computer‐assisted learning in medical education: the educators’ perspective
Schifferdecker, K. E., Berman, N. B., Fall, L. H., & Fischer, M. R. (2012) · Medical Education · doi:10.1111/j.1365-2923.2012.04350.x · Cited by 51 · see citing works
Educational agenda for diagnostic error reduction
Trowbridge, R. L., Dhaliwal, G., & Cosby, K. S. (2013) · BMJ Quality & Safety · doi:10.1136/bmjqs-2012-001622 · Cited by 51 · see citing works
An innovative blended learning approach using virtual patients as preparation for skills laboratory training: perceptions of students and tutors
Lehmann, R., Bosse, H. M., Simon, A., Nikendei, C., & Huwendiek, S. (2013) · BMC Medical Education · doi:10.1186/1472-6920-13-23 · Cited by 51 · see citing works
New directions in e-learning research in health professions education: Report of two symposia
Triola, M. M., Huwendiek, S., Levinson, A. J., & Cook, D. A. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.638010 · Cited by 51 · see citing works
Self-citation
Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial
Plackett, R., Kassianos, A. P., Kambouri, M. A., Kay, N., Mylan, S., Hopwood, J., Schartau, P., Gray, S., Timmis, J., Bennett, S., et al. (2020) · BMC Medical Education · doi:10.1186/s12909-020-02168-4 · Cited by 48 · see citing works
Medical Student and Tutor Perceptions of Video Versus Text in an Interactive Online Virtual Patient for Problem-Based Learning: A Pilot Study
Woodham, L. A., Ellaway, R., Round, J. E. C., Vaughan, S., Poulton, T., & Zary, N. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3922 · Cited by 49 · see citing works
Design for learning: deconstructing virtual patient activities
Ellaway, R., & Davies, D. (2011) · Medical Teacher · doi:10.3109/0142159x.2011.550969 · Cited by 49 · see citing works
Critical design choices in healthcare simulation education: a 4C/ID perspective on design that leads to transfer
Frèrejean, J., van Merriënboer, J. J. G., Condron, C. M., Strauch, U., & Eppich, W. (2023) · Advances in Simulation · doi:10.1186/s41077-023-00242-7 · Cited by 49 · see citing works
Virtual patients come of age
Ellaway, R., Poulton, T., Smothers, V., & Greene, P. S. (2009) · Medical Teacher · doi:10.1080/01421590903124765 · Cited by 48 · see citing works
A qualitative analysis of virtual patient descriptions in healthcare education based on a systematic literature review
Hege, I., Kononowicz, A. A., Tolks, D., Edelbring, S., & Kuehlmeyer, K. (2016) · BMC Medical Education · doi:10.1186/s12909-016-0655-8 · Cited by 48 · see citing works
Transformative Learning through Virtual Patient Simulations: Predicting Critical Student Reflections
Kleinheksel, A. J. (2014) · Clinical Simulation in Nursing · doi:10.1016/j.ecns.2014.02.001 · Cited by 48 · see citing works
A Big Data and Learning Analytics Approach to Process-Level Feedback in Cognitive Simulations
Pecaric, M. R., Boutis, K., Beckstead, J. W., & Pusic, M. V. (2016) · Academic Medicine · doi:10.1097/acm.0000000000001234 · Cited by 47 · see citing works

Authors: Cook, D. A., & Triola, M. M.
Affiliations: Mayo Clinic (US)
New York University (US)
Corresponding author: Cook, David A
ORCID: Cook, David A
Triola, Marc M
Venue: Medical Education
Publisher: Wiley
Published: 2009-03-18
Volume: 43
Issue: 4
Pages: 303-311
ISSN: 0308-0110 (ISSN-L)
1365-2923
DOI: 10.1111/j.1365-2923.2008.03286.x
OpenAlex: W2036488299
Cited by: 624
References: 65
Citations by year: 2026: 49 · 2025: 39 · 2024: 37 · 2023: 28 · 2022: 33 · 2021: 34 · 2020: 33 · 2019: 37 · 2018: 41 · 2017: 31 · 2016: 45 · 2015: 35 · 2014: 39 · 2013: 34 · 2012: 45
FWCI: 3.98
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Medical Education (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Keywords: virtual patients, clinical reasoning, clinical reasoning assessment, student assessment, rubric development, instructional design, curriculum integration, health professions education, deliberate practice, training materials
MeSH terms: Clinical Competence, Computer-Assisted Instruction, Education, Medical, Undergraduate, Educational Measurement, Humans, Patient Simulation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Virtual patients: a critical literature review and proposed next steps

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks