Virtual Patient: Real Learning for Medical Students in Primary Care

Salminen, Zary, et. al submitted an original paper in JMIR “Virtual Patients (VP) in Primary Care: Developing a Reusable Model That Fosters Reflective Practice and Clinical Reasoning“. 

The authors were looking to create a virtual patient model for the primary care setting that would drive reflective practice and clinical reasoning. The virtual patient they sought to create included embedded process skills applicable to the primary care setting. 

Using virtual patients in medical education is not new. It has been used in all stages of a medical students learning to teach communication skills, patient focus, clinical reasoning, and reflective learning. What the authors note as lacking are reports on how to design and use VP within the primary care setting. 

The model the authors build they embedded ways to promote meaningful learning such as reflection, clinical reason, and in depth subject knowledge. This was accomplished with open-ended questions and free-text answers as well video clips. Students worked these cases independently without help from teachers it is self-directed and at their own pace. 

What struck me about this study is how they authors approached this. They built the VP around adult learning and not how can we cram as much knowledge as possible into a student and how do we do this around primary care. Using adult learning theory primarily Kolb and Schon’s reflection and change they found unsurprisingly students responded  positively and were able to apply new knowledge to their understanding of medicine. 

It would be interesting to see how a VP can be build around current epatients and their behavior as active learners and participants in their healthcare. Can a VP be used to demonstrate how to engage patients better and improve communications skills of those physicians well past medical school.