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1 2009

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Repurposing virtual patients for clinical reasoning: development of a guideline and assessment of time and effort

Hanebeck B., Tönshoff B., Huwendiek S.

Bio-Algorithms and Med-Systems

2009

Vol. 5, no. 9

69--72

Introduction: Fostering clinical reasoning is considered to be one of the major learning goals in medical education. However, there is only limited access to real patients to learn clinical reasoning. This deficiency can be overcome by providing virtual patients as an adjunct to real patient encounters. Research has been carried out on design features for virtual patients, especially to improve clinical diagnostic reasoning skills. However, developing new virtual patient cases from scratch is costly, making it reasonable to repurpose existing cases. Efforts to apply these to already existing virtual patients are, as yet, unreported, but are considered to be considerably lower than creation of new cases. Methods: We established a guideline for repurposing virtual patients for fostering clinical reasoning, which was developed from the literature and from our own experiences in repurposing 15 virtual patients. Furthermore, we documented the associated effort in terms of work hours. Results: The established guideline for repurposing virtual patients for clinical reasoning includes the following six major steps: (1) Case selection and initial check; (2) Literature review; (3) Development of a repurposing concept; (4) Enrichment for fostering clinical reasoning; (5) Reduction of cognitive load; (6) Final checks including review by expert and completion. The six steps are described in detail. The associated time and effort were calculated on average by 33 hours per case. Conclusion: We describe a guideline for repurposing virtual patients for clinical reasoning and its associated time and effort. We hope that others planning to repurpose virtual patients for clinical reasoning find this guideline helpful.