Shared Decision-Making With a Virtual Patient in Medical Education: Mixed Methods Evaluation Study (Preprint)

Abstract

BACKGROUND Shared decision-making (SDM) is a process where clinicians and patients work together to select tests, treatments, management or support packages, based on clinical evidence and the patient’s informed preferences. Like any skill, SDM requires practice to improve. Virtual Patients (VPs) are simulations that allow one to practice their communication skills. VPs could be used to help professionals and students practice the communication skills required to engage in SDM, but this specific focus has not received much attention within the literature. OBJECTIVE To evaluate a VP workshop for medical students aimed at developing the communication skills required for SDM. METHODS A pre and post-intervention questionnaire followed by semi-structured interviews. RESULTS The interviews and questionnaires suggested that the VP was enjoyable and easy to use. When the participants were asked to rank their priorities in a consultation both pre and post-VP, there was a statistically significant change in the rank position of “respecting patient choices” (P = 0.038) with the median rank changing from 2nd to 1st. The VP allowed the participants to explore a consultation in a way that they could not with simulated or real patients; this may be part of the reason that the VP was suggested as a useful intervention for bridging from the early, theory focused years of the curriculum to the more patient focused ones later on. CONCLUSIONS The VP was well accepted by the participants. The multiple choice system of interaction was reported as both useful but also restrictive. Future work should look at further developing the mode of interaction and explore whether the VP results in any changes in observed behaviour or practice.