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

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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

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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.

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Retracted
The effectiveness of sequencing virtual patients with lectures in a deductive or inductive learning approach
Marei, H. F., Donkers, J. H. H. L. M., Al-Eraky, M. M., & van Merriënboer, J. J. G. (2017) · Medical Teacher · doi:10.1080/0142159x.2017.1372563 · Cited by 27
Using Interactive Fiction to Teach Clinical Decision-Making in a PharmD Curriculum
Morningstar-Kywi, N., & Kim, R. E. (2021) · Medical Science Educator · doi:10.1007/s40670-021-01245-7 · Cited by 24
Virtual patients in undergraduate psychiatry education: a systematic review and synthesis
Jensen, R. A. A., Musaeus, P., & Pedersen, K. S. (2023) · Advances in Health Sciences Education · doi:10.1007/s10459-023-10247-6 · Cited by 24
A Framework for Different Levels of Integration of Computational Models Into Web-Based Virtual Patients
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Virtual Patients: ED-2 Band-Aid or Valuable Asset in the Learning Portfolio?
Tworek, J., Coderre, S., Wright, B. J., & McLaughlin, K. (2009) · Academic Medicine · doi:10.1097/acm.0b013e3181c4f8bf · Cited by 24
Simulation-Based Cryosurgery Intelligent Tutoring System Prototype
Sehrawat, A., Keelan, R., Shimada, K., Wilfong, D. M., McCormick, J. T., & Rabin, Y. (2015) · Technology in Cancer Research & Treatment · doi:10.1177/1533034615583187 · Cited by 23
Usability testing of a multimedia e‐learning resource for electrolyte and acid‐base disorders
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Virtual Environments for Substance Abuse Assessment and Treatment
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Management reasoning scripts: Qualitative exploration using simulated physician-patient encounters
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Self-citation
Children With Medical Complexity: A Web-Based Multimedia Curriculum Assessing Pediatric Residents Across North America
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Impact of Virtual Patients as Optional Learning Material in Veterinary Biochemistry Education
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Using Case-Based Learning to Facilitate Clinical Reasoning Across Practice Courses in an Occupational Therapy Curriculum
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Potential Barriers to the Implementation of Computer-Based Simulation in Pharmacy Education: A Systematic Review
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Virtual Patient Case Sharing Across Two Schools of Pharmacy
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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: Social Sciences › Education › Simulation-Based Education in Healthcare
Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Social Sciences › Education › 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

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Virtual patients: a critical literature review and proposed next steps

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