The Establishment of a Virtual Patient-based Nationwide Contest on Clinical Reasoning

10.6145/jme.202209_26(3).0005

Hui-Fang Yeh；Tsuen-Chiuan Tsai

virtual patient ； remote education ； online learning ； clinical reasoning ； diagnostic competency

Journal of Medical Education

26卷3期（2022 / 09 / 01）

173 - 179

英文

Virtual patients (VPs) have been reported as a pedagogical tool for enhancing medical students' clinical reasoning skills, while its feasibility of being used for a large-scaled clinical assessment on clinical reasoning has not be addressed. Purpose: This study is to report the establishment of a large-scale VP-based interactive clinical examination. Methods: Through a computer and web-connection, each contestant gained access to the interactions with the VPs in a virtual hospital. The preconditions for a success nationwide contest was provided. Results: Between 2018 and 2021, a VP‐based nationwide clinical reasoning contest was established and held simultaneously in three different locations in Taiwan. The annual participant number ranged between 100 and 144. The contestants were scored based on the number of appropriate items in history‐taking, physical examination, laboratory/imaging studies, and finally the diagnoses. The summary of the performance scores and feedback are provided immediately after the examination. Two models of contest agenda were conducted for regular and COVID outbreak periods. Conclusions: The study supports the use of a web-based V-DxM for both summative and formative assessment on medical professional clinical reasoning skills. The success of establishment and implementation in a large group of test takers also open up the possibilities of a high‐stakes clinical examination.

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