The impact of small-group virtual patient simulator training on perceptions of individual learning process and curricular integration: a multicentre cohort study of nursing and medical students

Abstract

Background The COVID-19 pandemic has precipitated rapid changes in medical education to protect students and patients from the risk of infection. Virtual Patient Simulators (VPS) provide a simulated clinical environment in which students can interview and examine a patient, order tests and exams, prioritize interventions, and observe response to therapy, all with minimal risk to themselves and their patients. Like high-fidelity simulators (HFS), VPS are a tool to improve curricular integration. Unlike HFS, VPS require limited infrastructure investment and can be used in low-resource settings. Few studies have examined the impact of VPS training on clinical education. This international, multicenter cohort study was designed to assess the impact of small-group VPS training on individual learning process and curricular integration from the perspective of nursing and medical students. Methods We conducted a multi-centre, international cohort study of nursing and medical students. Baseline perceptions of individual learning process and curricular integration were assessed using a 27-item pre-session questionnaire. Students subsequently participated in small-group VPS training sessions lead by a clinical tutor and then completed a 32-item post-session questionnaire, including 25 paired items. Pre- and post-session responses were compared to determine the impact of the small-group VPS experience. Results Participants included 617 nursing and medical students from 11 institutions in 8 countries. At baseline, nursing students reported greater curricular integration and more clinical and simulation experience than did medical students. After exposure to small-group VPS training, participants reported significant improvements in 5/6 items relating to individual learning process and 7/7 items relating to curricular integration. The impact of the VPS experience was similar amongst nursing and medical students. Conclusions In this multi-centre study, perceptions of individual learning process and curricular integration improved after exposure to small-group VPS training. Nursing and medical students showed similar impact. Small-group VPS training is an accessible, low-risk educational strategy that can improve student perceptions of individual learning process and curricular integration.

Exploring medical students’ perceptions of individual and group-based clinical reasoning with virtual patients: a qualitative study

“…SLT posits that social interaction plays a critical role in the learning process. Through group discussions, students actively engage with it, discussing and sharing insights, a key component of learning in social contexts [ 26 ].…”

“…Collaborative learning environments like small group-work can enable learners to engage in activities that are valuable for facilitating the learning process, like self-directed learning, justifications, and reflections or developing arguments [ 24 ]. Students can practice their clinical reasoning skills individually or in groups with VPs [ 25 , 26 ]. Individually or as a group, VPs can be used for various purposes as an educational practice tool.…”

“…For example, at the individual level, they might be used to determine the progression or order of a learning session [ 27 , 28 ]. At the group level, they can be utilized to bring together individuals with diverse perspectives and abilities, and help them progress toward a shared goal [ 26 ]. Before selecting whether individual or group-based applications are appropriate for developing instructional activities with VPs, instructors must consider the student competency desired.…”