The DOI matches its Crossref record; 64 of the 65 references it cites were found in a registry or an index.
Virtual patients: a critical literature review and proposed next steps
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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“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
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Self-citation
Metadata
- Authors
- Cook, D. A., & Triola, M. M.
- Affiliations
- Mayo Clinic (US)
- New York University (US)
- Corresponding author
- Cook, David A
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2009-03-18
- Volume
- 43
- Issue
- 4
- Pages
- 303-311
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- 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
- 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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