![]() We are using it in its most common form of interactive patient scenarios, where a multimedia presentation of a patient case is used primarily to teach clinical reasoning skills. The term “virtual patients” has been used in several different ways. ![]() ![]() Teaching innovations using virtual patients can circumvent logistical difficulties in gaining access to real patients, face-to-face. Teaching through supervised face-to-face consultations also has limitations as students rarely have the time to reflect on their decisions. Students may have limited opportunities for exposure to face-to-face patients, particularly in primary care a clinical setting where CR skills to maximise prompt diagnosis are essential. face-to-face interaction with real patients has been required in order for delivery of effective CR teaching methods. However, in many instances it has not been explicitly taught in medical schools but rather assumed that students develop their CR skills by knowledge accumulation and observing consultations. In the UK, CR capability is expected of graduating medical students. Our adapted framework from healthcare implementation science may be useful in future studies of implementation in medical education.Ĭlinical reasoning (CR) generally refers to the thought processes required to identify likely diagnoses, formulate appropriate questions and reach clinical decisions. Framing virtual patient learning tools as additional rather than as a replacement for face-to-face teaching could reduce resistance. These include access to face-to-face teaching opportunities, positioning of clinical reasoning in the curriculum, relationship between educators and institutions and decision-making processes. Conclusionsīy adapting an implementation framework for health services, we were able to identify features of educators, teaching processes and medical schools that may determine the adoption of teaching innovations using virtual patients. Adoption was also influenced by the implementation climate of the setting, including positioning of CR in curricula relationships between faculty, particularly where faculty were dispersed. Beliefs that virtual patients may not mirror real-life consultations and perceptions of a lack of evidence for them could be barriers to adoption. For example, participants with experience of teaching using online tools viewed limited face-to-face placements as opportunities to introduce innovations using virtual patients. Participants’ recognition of situations as opportunities or barriers related to their prior experiences of implementing online learning tools. Three themes were identified from the data that influenced adoption: the wider context (outer setting) perceptions about the innovation and the medical school (inner context). Thirteen medical educators participated in the study. Thematic analysis was used to analyse the data. The Consolidated Framework for Implementation Research (CFIR), commonly used in healthcare services implementation research was adapted to inform the analysis. ![]() MethodsĪ qualitative research study using semi-structured telephone interviews with medical educators in the UK with control over teaching materials of CR was conducted. The aim of this study was to explore UK medical educators’ perspectives of what influences the adoption of virtual patient learning tools to teach CR. However, the adoption of new tools is often challenging. Learning tools using virtual patients can be used to teach clinical reasoning (CR) skills and overcome limitations of using face-to-face methods.
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