Using virtual patients to teach medical ethics, medical law and medical professionalism

It has long been understood that there are many good reasons for using virtual patient (VP) cases in medical education (Botezatu et al. 2010). This is partly because VPs engage students but it is also because VPs have been shown to improve student's knowledge, clinical reasoning and decision-making skills (Cook & Triola et al. 2009). However, although VPs have been used in a range of different contexts in medical education, they have never previously been used to facilitate the teaching of medical ethics, medical law or medical professionalism.

To rectify this omission eight ethics virtual patient (EVP) cases were created at St George's, University of London between October 2008 and April 2011. Four of these cases were then used in different large and small group teaching sessions. Feedback from the students was collected at the end of each session using a questionnaire.

Six hundred and one students (77%) completed the feedback form and the general response of the student to the EVP cases was extremely positive. For example, the vast majority (85%) strongly agreed or agreed that EVPs were an effective way of gaining knowledge about medical ethics and 85% also thought that using EVP cases made them more confident to make ethical decisions. 95.2% also agreed or strongly agreed that using the EVP cases encouraged deliberation, debate and interaction.

Our research demonstrates that EVP cases can be deployed effectively in both large and small group teaching sessions and although we do not think that EVP cases are a pedagogical panacea, we do think that they are an important new development. Further research is certainly needed to determine whether or not using EVPs actually influence knowledge retention, ethical reasoning and ethical decision-making ability, but the evidence that we have collected thus far suggests that EVPs have a promising future.