Medical Student and Tutor Perceptions of Video Versus Text in an Interactive Online Virtual Patient for Problem-Based Learning: A Pilot Study

Abstract

BackgroundThe impact of the use of video resources in primarily paper-based problem-based learning (PBL) settings has been widely explored. Although it can provide many benefits, the use of video can also hamper the critical thinking of learners in contexts where learners are developing clinical reasoning. However, the use of video has not been explored in the context of interactive virtual patients for PBL.ObjectiveA pilot study was conducted to explore how undergraduate medical students interpreted and evaluated information from video- and text-based materials presented in the context of a branched interactive online virtual patient designed for PBL. The goal was to inform the development and use of virtual patients for PBL and to inform future research in this area.MethodsAn existing virtual patient for PBL was adapted for use in video and provided as an intervention to students in the transition year of the undergraduate medicine course at St George’s, University of London. Survey instruments were used to capture student and PBL tutor experiences and perceptions of the intervention, and a formative review meeting was run with PBL tutors. Descriptive statistics were generated for the structured responses and a thematic analysis was used to identify emergent themes in the unstructured responses.ResultsAnalysis of student responses (n=119) and tutor comments (n=18) yielded 8 distinct themes relating to the perceived educational efficacy of information presented in video and text formats in a PBL context. Although some students found some characteristics of the videos beneficial, when asked to express a preference for video or text the majority of those that responded to the question (65%, 65/100) expressed a preference for text. Student responses indicated that the use of video slowed the pace of PBL and impeded students’ ability to review and critically appraise the presented information.ConclusionsOur findings suggest that text was perceived to be a better source of information than video in virtual patients for PBL. More specifically, the use of video was perceived as beneficial for providing details, visual information, and context where text was unable to do so. However, learner acceptance of text was higher in the context of PBL, particularly when targeting clinical reasoning skills. This pilot study has provided the foundation for further research into the effectiveness of different virtual patient designs for PBL.

Problem‐based learning in internal medicine: virtual patients or paper‐based problems?

“…However, this was not the case with VP. Woodham et al . pointed out that when learning basic concepts in PBL sessions, students and tutors were more appreciative of text than they were of multimedia content.…”

“…Woodham et al . pointed out that when learning basic concepts in PBL sessions, students and tutors were more appreciative of text than they were of multimedia content. As indicated by the findings, this is probably because of the fact that the use of multimedia (within VP sessions) impedes the possibility of fully exploring a problem and critically appraising the data since the focus in VP is more on patient management (from initial symptoms to patient treatment) and less on exploring the gaps in one's knowledge.…”

How does video case-based learning influence clinical decision-making by midwifery students? An exploratory study

“…Video cases elicit students' attention and emotions [21], promote empathy [22], improve memory retention [17], increase understanding of the cases [18], and improve students' patient-centredness [23]. However, some studies have questioned whether video cases make it difficult to identify relevant information and also hamper information retention [24] and deep critical thinking [20]. Two-thirds of students preferred paper cases since video cases impeded their ability to critically review the presented information [24].…”

Turk Talk: human-machine hybrid virtual scenarios for professional education

“…As with other virtual patient studies that have used OpenLabyrinth, branched case designs with pathway options that reflect realistic decision points and clinical choices are much preferred over simple linear case designs, which are often disparagingly paraphrased as "page turners". (Woodham et al, 2015;Topps et al, 2014) The provision of an interface that resembles natural language processing appears to make the case design process much easier, avoiding the need for complex logic designs or choice restrictions. This has been attempted before with Interactive Fiction software (Derksen & Zundark, 2011) and with very sophisticated designs such as the Maryland Project (Nirenberg et al, 2009) but our approach seems to be simpler, more affordable and more efficient.…”