scholarly journals Assessment of Diagnostic Competences with Standardized Patients vs. Virtual Patients: An Experimental Study in the Context of History Taking (Preprint)

10.2196/21196 ◽  
2020 ◽  
Author(s):  
Maximilian C Fink ◽  
Victoria Reitmeier ◽  
Matthias Stadler ◽  
Matthias Siebeck ◽  
Frank Fischer ◽  
...  
Keyword(s):  
Experimental Study ◽  
Standardized Patients ◽  
Virtual Patients ◽  
History Taking ◽  
Diagnostic Competences

scholarly journals Assessment of Diagnostic Competences With Standardized Patients Versus Virtual Patients: Experimental Study in the Context of History Taking (Preprint)

2020 ◽  
Author(s):  
Maximilian C Fink ◽  
Victoria Reitmeier ◽  
Matthias Stadler ◽  
Matthias Siebeck ◽  
Frank Fischer ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Cognitive Load ◽  
Standardized Patients ◽  
Assessment Methods ◽  
Virtual Patients ◽  
History Taking ◽  
Quality Of Evidence ◽  
Diagnostic Competences ◽  
Evidence Generation

BACKGROUND Standardized patients (SPs) have been one of the popular assessment methods in clinical teaching for decades, although they are resource intensive. Nowadays, simulated virtual patients (VPs) are increasingly used because they are permanently available and fully scalable to a large audience. However, empirical studies comparing the differential effects of these assessment methods are lacking. Similarly, the relationships between key variables associated with diagnostic competences (ie, diagnostic accuracy and evidence generation) in these assessment methods still require further research. OBJECTIVE The aim of this study is to compare perceived authenticity, cognitive load, and diagnostic competences in performance-based assessment using SPs and VPs. This study also aims to examine the relationships of perceived authenticity, cognitive load, and quality of evidence generation with diagnostic accuracy. METHODS We conducted an experimental study with 86 medical students (mean 26.03 years, SD 4.71) focusing on history taking in dyspnea cases. Participants solved three cases with SPs and three cases with VPs in this repeated measures study. After each case, students provided a diagnosis and rated perceived authenticity and cognitive load. The provided diagnosis was scored in terms of diagnostic accuracy; the questions asked by the medical students were rated with respect to their quality of evidence generation. In addition to regular null hypothesis testing, this study used equivalence testing to investigate the absence of meaningful effects. RESULTS Perceived authenticity (1-tailed <i>t</i><sub>81</sub>=11.12; <i>P</i>&lt;.001) was higher for SPs than for VPs. The correlation between diagnostic accuracy and perceived authenticity was very small (<i>r</i>=0.05) and neither equivalent (<i>P</i>=.09) nor statistically significant (<i>P</i>=.32). Cognitive load was equivalent in both assessment methods (<i>t</i><sub>82</sub>=2.81; <i>P</i>=.003). Intrinsic cognitive load (1-tailed <i>r</i>=−0.30; <i>P</i>=.003) and extraneous load (1-tailed <i>r</i>=−0.29; <i>P</i>=.003) correlated negatively with the combined score for diagnostic accuracy. The quality of evidence generation was positively related to diagnostic accuracy for VPs (1-tailed <i>r</i>=0.38; <i>P</i>&lt;.001); this finding did not hold for SPs (1-tailed <i>r</i>=0.05; <i>P</i>=.32). Comparing both assessment methods with each other, diagnostic accuracy was higher for SPs than for VPs (2-tailed <i>t</i><sub>85</sub>=2.49; <i>P</i>=.01). CONCLUSIONS The results on perceived authenticity demonstrate that learners experience SPs as more authentic than VPs. As higher amounts of intrinsic and extraneous cognitive loads are detrimental to performance, both types of cognitive load must be monitored and manipulated systematically in the assessment. Diagnostic accuracy was higher for SPs than for VPs, which could potentially negatively affect students’ grades with VPs. We identify and discuss possible reasons for this performance difference between both assessment methods.

History-taking and Preventive Medicine Skills among Primary Care Physicians: An Assessment Using Standardized Patients

1998 ◽  
Vol 104 (2) ◽  
pp. 152-158 ◽  
Author(s):  
Paul G Ramsey ◽  
J.Randall Curtis ◽  
Douglas S Paauw ◽  
Jan D Carline ◽  
Marjorie D Wenrich
Keyword(s):  
Primary Care ◽  
Preventive Medicine ◽  
Primary Care Physicians ◽  
Standardized Patients ◽  
History Taking

Assessing Past, Present, and Future Interactions with Virtual Patients

2012 ◽  
Vol 4 (3) ◽  
pp. 20-37 ◽  
Author(s):  
Richard E. Ferdig ◽  
Katherine Schottke ◽  
Diego Rivera-Gutierrez ◽  
Benjamin Lok
Keyword(s):  
Nonverbal Communication ◽  
Performance Feedback ◽  
Health Professionals ◽  
Medical Curriculum ◽  
Standardized Patients ◽  
Virtual Patient ◽  
Virtual Human ◽  
Virtual Patients ◽  
Educational Tool ◽  
Future Directions

Virtual patients have proven to be an effective educational tool for learning and applying clinical examination skills. Interactive virtual patient scenarios provide opportunities for medical students to practice and improve verbal and nonverbal communication through the use of performance feedback. This feedback helps students to understand the ways in which they are perceived by their patients which otherwise could not be analyzed by health professionals. Evidence supports that interactive VPs fill a niche in medical education and testing for scenarios that cannot be practiced outside the virtual environment or with standardized patients. Not only are virtual patients effective in medical curriculum, as evidenced by various studies, they are applicable in understanding the ways in which learning occurs and can be implemented into a number of educational settings. In this article, the authors summarize seven years of findings on the use of virtual patients. They also describe current efforts at implementing virtual patients in community scenarios. The paper concludes with avenues for future directions with virtual human patients.

Quality of Virtual Patients on WeChat for Nursing History-Taking Training

2019 ◽  
Vol 36 ◽  
pp. 37-46
Author(s):  
Jie Luo ◽  
Jing Zheng ◽  
Huan He ◽  
Ting Liu ◽  
Juanjuan Zhao ◽  
...  
Keyword(s):  
Virtual Patients ◽  
History Taking ◽  
Nursing History

scholarly journals A Framework of Simulating Virtual Spine Patients to Assess Thoracic Volume Variations due to Wedging Deformities

2018 ◽  
Author(s):  
Po-Chih Lee ◽  
Arthur G. Erdman ◽  
Charles Ledonio ◽  
David Polly
Keyword(s):  
Computer Aided Design ◽  
Information Technologies ◽  
Clinical Skills ◽  
Standardized Patients ◽  
Disease Diagnosis ◽  
Virtual Patient ◽  
High Fidelity ◽  
Virtual Patients ◽  
Clinical Skills Assessment ◽  
Cad Models

In 1964, Dr. Barrows first introduced the standardized patients, who are individuals trained to imitate the pathological symptoms of the real patients, and involved them in teaching and clinical skills assessment for healthcare education. In recent decades, the application of the virtual patient has been rapidly grown and has been widely used in clinical or educational practice among residents, surgeons, or other medical professionals because the virtual patient is cost-effective and time-efficient [1]. The Food and Drug Administration (FDA) collaborated with the Foundation of Research on Information Technologies in Society (IT’IS Foundation, Zürich, Switzerland) to produce a virtual family, which is a set of anatomical computer-aided design (CAD) models of adults and children [2, 3], and those CAD models are used in electromagnetic, thermal, and computer fluid dynamics simulations. However, the meaning of virtual patients or models has varied across the recent years and more and more researchers tried to categorize the terminology of virtual patients. In general, virtual patients can be classified into seven major types including: case presentation, interactive patient scenarios, virtual patient game, high fidelity software simulation, human standardized patients, high fidelity manikins, and virtual standardized patients [4]. The virtual patients discussed in this study can be classified as interactive patient scenarios, whose application includes clinical reasoning, surgical planning, and disease diagnosis.

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