CASE: BASED VIRTUAL PATIENT SIMULATION IMPACT on MEDICAL and GRADUATE MEDICAL EDUCATIONAL COMPETENCIES and MILESTONES: A META-ANALYSIS

Abstract

Eric W Lam, Ivan C Lam, Miriam E Schwartz, Deborah Woo and Douglas E Paull*

Objective: Virtual strategies have assumed an even greater role in medical education
and graduate medical education during the recent pandemic. The objective of this
study was to assess the impact of case-based, virtual patient simulation on medical
education and graduate medical education.
Methods: A literature search of years 2000 through 2019 discovered 2,285 potential
articles on virtual patient simulation. Fifty-four articles meeting the following criteria
were included in the meta-analysis: involved medical education or graduate medical
education participants; utilized case-based virtual patient simulations; and contained
enough data to calculate an effect size (number of participants in each study arm,
mean, and standard deviation of at least one measured learning outcome).
Results: Virtual patient simulation had a large overall impact on medical education
and graduate medical education learning outcomes, 0.88 (0.64-1.12), z=7.36, p<0.001. Effect sizes by competencies were patient care, 0.95 (0.62-1.28); medical knowledge,
0.69 (-0.06-1.44); interpersonal and communication skills, 0.52 (0.01-1.05);
professionalism, 1.32 (0.29-2.35); and systems-based practice, 0.71 (0.21-1.20). There
was, however, a high level of heterogeneity between studies (I2=92.6%) lessening the
certainty of the effect size summary.
Conclusions: The current study reinforces the results of previous meta-analyses
demonstrating the moderate to large effect of virtual patient simulation interventions
upon learning outcomes. Additionally, it highlights the effectiveness of virtual patient
simulation for medical education and graduate medical education competencies
beyond patient care, medical knowledge, and communication to include systems-
based practice and professionalism. Virtual patient simulation is well-suited to address
current challenges facing medical education and graduate medical education.