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Medical Teacher Volume 35, 2013 - Issue 11
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Research Article

Learner preferences regarding integrating, sequencing and aligning virtual patients with other activities in the undergraduate medical curriculum: A focus group study

Sören HuwendiekUniversity of Bern, Switzerland;University Children's Hospital Heidelberg, Germany; SÖREN HUWENDIEK, MD, MME (Univ. Bern), is a Paediatrician, was one of the Curriculum Co-ordinators, Chairman of the Centre for Virtual Patients and E-learning Commissioner at Heidelberg Medical Faculty. He is now Head of the Department of Assessment and Evaluation at the Institute of Medical Education in Bern.Correspondence[email protected]
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Cecilia DunckerKiel University Hospital, Germany; CECILIA DUNCKER, MD, is a Paediatric Resident at the University Hospital in Kiel wrote her MD-Thesis about the optimal integration of Virtual Patients into medical curricula.
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Friedrich ReichertKlinikum Stuttgart Olgahospital, Germany; FRIEDRICH REICHERT, MD, is a Paediatric Resident at Olgahospital, Klinikum Stuttgart, wrote his MD-Thesis about the design of Virtual Patients and their integration into medical curricula.
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Bas A. De LengMaastricht University, The Netherlands; BAS DE LENG, PhD, is an Educational Technologist at the Department of Educational Development and Research, Maastricht University, Maastricht, The Netherlands.
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Diana DolmansMaastricht University, The Netherlands; DIANA H.J.M. DOLMANS, PhD, is a Professor of Innovative Learning Arrangements within the School of Health Professions Education/Department of Educational Development and Research at Maastricht University, the Netherlands.
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Cees P. M. van der VleutenMaastricht University, The Netherlands; CEES PM VAN DER VLEUTEN, PhD, is a Professor of Education, Chair of the Department of Educational Development and Research, Scientific Director of the School of Health Professions Education (SHE) at Maastricht University, Maastricht, The Netherlands. He holds honorary appointments in the University of Copenhagen (Denmark), King Saud University (Riyadh) and Radboud University (Nijmegen).
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Martin HaagHeilbronn University of Applied Sciences, Germany; MARTIN HAAG, PhD, is a Professor of Software Engineering and Dean at the Faculty of Informatics at Heilbronn University, Germany. Furthermore, he is head of the Centre for Virtual Patients at the University of Heidelberg, Germany and speaker of the working group technology-enhanced learning of the German Society for Medical Informatics.
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Georg Friedrich HoffmannUniversity Children's Hospital Heidelberg, Germany; GEORG F. HOFFMANN, MD, is a Professor of Pediatrics and Chairman of the University Childrens Hospital Heidelberg, Vice Dean of the Medical Faculty of the Ruprecht-Karls-University Heidelberg. He holds honorary appointments at the Medical Faculties of Padua, Italy, and Tongji, University Wuhan, China.
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Burkhard TönshoffUniversity Children's Hospital Heidelberg, Germany; BURKHARD TÖNSHOFF, MD, PhD, is a Professor of Pediatrics and Pediatric Nephrology, holds the position of a Vice Chairman of the Department of Pediatrics I, University Children’s Hospital Heidelberg, Germany. He is involved since many years in the field of Virtual Patients.
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Pages 920-929 | Published online: 04 Sep 2013
 
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Abstract

Context: E-learning resources, such as virtual patients (VPs), can be more effective when they are integrated in the curriculum. To gain insights that can inform guidelines for the curricular integration of VPs, we explored students’ perceptions of scenarios with integrated and non-integrated VPs aimed at promoting clinical reasoning skills.

Methods: During their paediatric clerkship, 116 fifth-year medical students were given at least ten VPs embedded in eight integrated scenarios and as non-integrated add-ons. The scenarios differed in the sequencing and alignment of VPs and related educational activities, tutor involvement, number of VPs, relevance to assessment and involvement of real patients. We sought students’ perceptions on the VP scenarios in focus group interviews with eight groups of 4–7 randomly selected students (n = 39). The interviews were recorded, transcribed and analysed qualitatively.

Results: The analysis resulted in six themes reflecting students’ perceptions of important features for effective curricular integration of VPs: (i) continuous and stable online access, (ii) increasing complexity, adapted to students’ knowledge, (iii) VP-related workload offset by elimination of other activities, (iv) optimal sequencing (e.g.: lecture – 1 to 2 VP(s) – tutor-led small group discussion – real patient) and (V) optimal alignment of VPs and educational activities, (vi) inclusion of VP topics in assessment.

Conclusions: The themes appear to offer starting points for the development of a framework to guide the curricular integration of VPs. Their impact needs to be confirmed by studies using quantitative controlled designs.

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