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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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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