How common are virtual patient simulations in Germany?
Hege: We have seen a significant increase in demand for virtual patient simulations amid the coronavirus pandemic. In some instances, the medical students no longer had any direct patient contact. This prompted many faculties to use virtual patients at an increasing rate. Having said that, this only pertained to selected subject areas – unfortunately, there is often a lack of a global concept to guide students through the entire curriculum using virtual patients and foster longitudinal experience.
Can virtual patients replace “real” patients?
Hege: No. This model serves to prepare students for contact with real patients. It works best if you combine three components: learning on virtual patients, bedside education, and patient simulation training. This gradual introduction to reality allows you to train the cognitive and critical thinking skills of the students. This prepares them to be able to fully focus on the real patient down the road because it is impossible to reflect this human aspect with virtual patients.
Do you find that students struggle less with the pressure to perform if they can practice on virtual patients?
Hege: Even in a calm learning environment with virtual patients, we notice that minor changes can increase work-related stress, or the complexity students face. For example, if you make the virtual patient slightly more hostile or aggressive, it instantly makes his/her treatment more challenging and difficult for the learner. As you can see, there are many ways to adjust the complexity.
We are working on a real-time control option at the moment. Up to now, we have defined the patient collection ahead of time, but we are exploring learning analytics in this context. Initial studies are already underway to determine whether we can use the data about the students’ management of virtual patients to optimize learning and increase the exercise complexity.
Do you think learning with virtual patients effectively prepares students for a career in medicine?
Hege: I think practicing with virtual patients is a great complement. After all, the idea is not that students should exclusively learn via virtual patients and not be exposed to real patients in their first years. In my view, it’s definitely possible to train the cognitive aspects using virtual patients and combine it with in-person real patient contact activities starting with the first semester. In case of the latter, students can focus on communication and practice respectful interactions with patients at eye level.
Do you think medical degrees will reflect these aspects in the future?
Hege: I am certain that the applications of virtual patients will continue to increase, prompting medical studies to take a more student-centered learning approach. I think students are capable of deciding on their own how many virtual patients they want to engage with to feel prepared to move on and interact with real patients.