Abstract:

Background:
Safe and effective approaches to facilitate the development of clinically relevant knowledge and skills are necessary in health professional education. One means of developing clinical reasoning skills is through the use of virtual patients cases (VPs). There is little work documenting the study of when and how to effectively use VPs. Hypothesis: students using virtual patient cases to prepare for written examinations will do better than those without access.

Methods:
A randomized controlled trial of Physiotherapy students. All participants took a Multiple-Choice Question (MCQ) exam, testing their knowledge in four domains of practice. They were then computer randomised into immediate access (group A) or delayed access (group B) for 12 days of VP access. After Group A accessed the VPs, a second MCQ exam was made available to all students. Two weeks after the VPs were made available to group B, all students completed a questionnaire about their perceptions of learning from the VPs.

Results:
Of the 78 available students 67 (86%) volunteered to participate, and 65 (83%) took the first exam with 32 randomised to immediate VP access. Of these, 5 students did not complete the second exam, 4 from group A. The mean score (SD) for the first exam for group A and B is, 67(±7) and 66(±7) respectively. The mean score (SD) for the second exam for group A and B respectively is, 66(±4) and 67(±6): no statistically significantly different change p = 0.37. Mean difference between groups = -1.2 (95% CI -3.98 to 1.49). Omitting those who got >65% in the first exam, the median change in score (SD) between the first and second exams of groups A and B are, 7(±6) and 3(±7) respectively.

Conclusions:
Students may benefit from the use of virtual patients for revision.

Keywords:

Virtual Patient Cases, Health Education, Simulation, Examination.