The effect of constructing versus solving virtual patient cases on transfer of learning: a randomized trial.

Martin G Tolsgaard,Charlotte Ringsted,Lars Kayser,Maria B Rasmussen,Uno Fors,Lars C Laursen,Rikke M H G Jepsen,Jesper H Svendsen

doi:10.1007/s40037-015-0242-4

Abstract

The purpose of this study was to explore the effect of actively constructing virtual patient (VP) cases compared with solving VP cases on knowledge gains, skills transfer and time spent on cases. Forty-five fourth-year medical students were randomized to constructing (VP-construction, n = 23) or solving (VP-solving, n = 22) four cardiopulmonary VP cases. Whereas the VP-solving group solved the cases, the VP-construction group only 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 representing cardiopulmonary cases. Performances on the transfer test were video-recorded and assessed by two blinded raters using the Reporter, Interpreter, Manager, Educator (RIME) framework. Thirty-nine participants completed the transfer test. The VP-construction group spent significantly more time on the VP cases compared with the VP-solving group, p = 0.002. There were no significant differences in RIME scores between the VP-construction group and VP-solving group, p = 0.54.In conclusion, engaging novice students in active VP case construction may be more time consuming than solving VP cases, without resulting in superior skills transfer.

Highlights

IntroductionVirtual patients (VPs) have been increasingly used to expose learners to multiple and varied patient cases
Over the past decades, virtual patients (VPs) have been increasingly used to expose learners to multiple and varied patient cases
There was no effect of constructing VP cases as opposed to solving them on participants’ knowledge gains or transfer of skills

Summary

Introduction

Virtual patients (VPs) have been increasingly used to expose learners to multiple and varied patient cases. Virtual patients can be defined as ‘an interactive computer simulation of real-life clinical scenarios for the purpose of health care and medical training, education or assessment’ [1]. Their educational effect is presumably exerted through stimulating knowledge acquisition and application in order to arrive at a diagnosis or a management plan [2]. In order to engage learners in constructive activities, [8] VPs should prompt learners to produce mental models of the information to be learned by linking new knowledge with existing knowledge in order to elaborate, justify and provide reasons for their choices. Designing VP cases as constructive activities, where learners build mental models based on less structured platforms, may produce superior learning outcomes than highly structured step-by-step VP cases

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