The Considerations of Simulation Fidelity with the Uses of Virtual Patients

10.6145/jme.202303_27(1).0004

Tsuen-Chiuan Tsai

virtual patient ； simulation ； fidelity ； artificial intelligence ； natural language processing ； medical education

Journal of Medical Education

27卷1期（2023 / 03 / 01）

5 - 8

英文

To be effective and affordable, medical simulation has to be "authentic" in parts related to learners' clinical tasks rather than to pursue high-fidelity that focuses on replicating a real world. As the advances of AI and multimedia technology, virtual patients have been used in medical education with wide range of technology, from basic digital case presentations to advanced virtual/mixed reality. When considering their advantages and disadvantages in clinical education, the smart choice of a virtual simulation model should focus on creation of "authenticity" rather than "fidelity". As clinical skills are multifaceted, there is no one-size-fits-all virtual simulation model or technology that is the best for all. The clinical competency includes clinical reasoning, patient interview, physical examination, procedural skills, communication and medical knowledge. Virtual patients with natural language processing and machine learning algorithms are the technology for training clinical reasoning, communication and patient interview. With the tactile limitation of haptic feedback, technology can only teach and assess the knowledge associated with physical examination & procedural skills. As for clinical knowledge, besides the basic digital technology and multimedia, gamification makes education more engaging and enjoyable. AI further suggests personalized and precision learning. In conclusion, virtual simulation is now a powerful educational tool that can be delivered to a large number of learners in a safe, repeatable, cost-effective, and engaging way. Pursuing high-fidelity and high-level technology will not guarantee the learning effectiveness. The key of success is competency oriented, aligning the educational design & tools and the learning objectives.

1. Paige JT, Garbee DD, Brown KM, et al.: Using simulation in interprofessional education. Surg Clin North Am 2015; 95(4): 751-66. DOI: 10.1016/j.suc.2015.04.004
   連結：
2. Norman G, Dore K, Grierson L: The minimal relationship between simulation fidelity and transfer of learning. Med Educ 2012; 46(7): 636-47. DOI: 10.1111/j.1365-2923.2012.04243.x.
   連結：
3. Bland AJ, Topping A, Tobbell J, et al.: Time to unravel the conceptual confusion of authenticity and fidelity and their contribution to learning within simulation-based nurse education. Nurse Educ Today 2014; 34(7): 1112-8. DOI: 10.1016/j.nedt.2014.03.009
   連結：
4. Combs CD, Combs PF: Emerging roles of virtual patients in the age of AI. AMA J Ethics 2019; 21(2): E153-9. DOI 10.1001/amajethics.2019.153.
   連結：
5. Kononowicz AA, Zary N, Edelbring S, et al.: Virtual patients - what are we talking about? A framework to classify the meanings of the term in healthcare education. BMC Med Educ 2015; 15(11). DOI 10.1186/s12909-015-0296-3
   連結：

1. Ming-Che Tsai,Kuo-Piao Chung,Chao-Yen Huang(2023)。Evaluating Attitudinal Transformation in Medical and Nursing Students: The Role of the Teamwork Oriented Interprofessional Simulation (TOPS) Educational Program。醫學教育，27(3)，197-206。