title: A randomized trial of teaching clinical skills using virtual and live standardized patients.
abstract: BACKGROUND
  We developed computer-based virtual patient (VP) cases to complement an interactive continuing medical education (CME) course that emphasizes skills practice using standardized patients (SP). Virtual patient simulations have the significant advantages of requiring fewer personnel and resources, being accessible at any time, and being highly standardized. Little is known about the educational effectiveness of these new resources. We conducted a randomized trial to assess the educational effectiveness of VPs and SPs in teaching clinical skills.
  
  
  OBJECTIVE
  To determine the effectiveness of VP cases when compared with live SP cases in improving clinical skills and knowledge.
  
  
  METHODS
  Randomized trial.
  
  
  METHODS
  Fifty-five health care providers (registered nurses 45%, physicians 15%, other provider types 40%) who attended a CME program.
  
  
  METHODS
  Participants were randomized to receive either 4 live cases (n=32) or 2 live and 2 virtual cases (n=23). Other aspects of the course were identical for both groups.
  
  
  RESULTS
  Participants in both groups were equivalent with respect to pre-post workshop improvement in comfort level (P=.66) and preparedness to respond (P=.61), to screen (P=.79), and to care (P=.055) for patients using the skills taught. There was no difference in subjective ratings of effectiveness of the VPs and SPs by participants who experienced both (P=.79). Improvement in diagnostic abilities were equivalent in groups who experienced cases either live or virtually.
  
  
  CONCLUSIONS
  Improvements in performance and diagnostic ability were equivalent between the groups and participants rated VP and SP cases equally. Including well-designed VPs has a potentially powerful and efficient place in clinical skills training for practicing health care workers.
authors.affiliation: NYU School of Medicine, New York, NY 10016, USA. marc.triola@nyumc.org
authors.forename: M
authors.initials: M
authors.lastname: Triola
authors.forename: H
authors.initials: H
authors.lastname: Feldman
authors.forename: A L
authors.initials: AL
authors.lastname: Kalet
authors.forename: S
authors.initials: S
authors.lastname: Zabar
authors.forename: E K
authors.initials: EK
authors.lastname: Kachur
authors.forename: C
authors.initials: C
authors.lastname: Gillespie
authors.forename: M
authors.initials: M
authors.lastname: Anderson
authors.forename: C
authors.initials: C
authors.lastname: Griesser
authors.forename: M
authors.initials: M
authors.lastname: Lipkin
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003933:Diagnosis; D004190:Disasters; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016544:Patient Simulation; D010808:Physical Examination; D013663:Teaching; D014584:User-Computer Interface