Abstract
BackgroundAn important aspect of virtual patients (VPs), which are interactive computer-based patient scenarios, is authenticity. This includes design aspects, but also how a VP collection represents a patient population and how a patient is presented in a VP scenario. Therefore, our aim was to analyze VP scenarios integrated into the combined internal medicine and surgery curriculum at the University of Munich (LMU) and compare the results with data from the population in Germany.MethodWe developed a coding framework with four main categories: patient data, patient representation, diagnoses, and setting. Based on the framework we analyzed 66 VP and compared the results with data from the German healthcare system.ResultsEspecially in the categories of patient data and patient representation, the VPs presented an unrealistic image of the real world; topics such as unemployment, disability, or migration background were almost non-existent. The diagnoses of the VPs and the onset of diseases were comparable with the healthcare data.ConclusionsAn explanation for the lack of representativeness of the patient data and representation might be a trend to create VPs based on fictional patient stories with VP authors trying to minimize complexity and cognitive load for the students.We suggest raising awareness among VP authors concerning personalized representations of patients without overwhelming their students. Our framework can support educators to assess the authenticity and diversity of a VP collection.
Highlights
An important aspect of virtual patients (VPs), which are interactive computer-based patient scenarios, is authenticity
The age distribution of the VPs compared to the German population is shown in Fig. 1, in 5 VPs this information was missing
We developed a coding framework to analyze the VP collection that is provided to medical students in the interdisciplinary year at LMU Munich and evaluate (1) its authenticity compared to the German population and (2) how the patient is represented as a person
Summary
An important aspect of virtual patients (VPs), which are interactive computer-based patient scenarios, is authenticity. This includes design aspects, and how a VP collection represents a patient population and how a patient is presented in a VP scenario. In addition to authenticity-related aspects of each VP, we should consider the VP collection as a whole and its relation to the world outside medical school; this encompasses how well a VP collection represents a relevant patient population - for example in terms of diversity, age and gender distribution, diagnoses, setting of the clinical encounter, or how the virtual patients are represented as persons
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