The Effect of Constructing Virtual Patient Cases

The Effect of Constructing Versus Solving Virtual Patient Cases on Transfer of Learning: A Randomized Trial

The aim of the study was to explore the effect of actively constructing Virtual patient (VP) cases compared with solving VP cases using 'Web-SP', Stockholm University, Stockholm, Sweden on knowledge gains and skills transfer in a group of pre-clerkship medical students.

Solving VP cases is associated with large improvements in learning but its effectiveness is dependent on active student involvement. Constructing VP cases rather than solving them may engage students more actively in encoding new information and integrating it with previous knowledge.

Fourth-year medical students were included and randomized to constructing (intervention) or solving (control) four cardiopulmonary VP cases. The participants were presented with a short case overview. The control group solved the cases, whereas the intervention group also received the final diagnosis and had to complete the history, physical findings, and lab results. After a week, participants completed a transfer test involving two standardized patients presenting a respiratory case and a cardiology case, respectively. Performances were video-recorded and subsequently assessed by two blinded raters using the Reporter-Interpreter- Manager-Educator (RIME) framework. Knowledge gains were assessed using a pre- and post-test of a 95-item Multiple-Response-Questionnaire (MRQ).

Inclusion Criteria:

• fourth-year medical students, University of Copenhagen
• pre-study participation in the mandatory patient encounter skills course

Exclusion Criteria:

• medical students who had taken the three pre-clerkship years at other universities, because of curriculum discrepancies