title: Optimal learning in a virtual patient simulation of cranial nerve palsies: the interaction between social learning context and student aptitude.
abstract: BACKGROUND
  Simulation in medical education provides students with opportunities to practice interviews, examinations, and diagnosis formulation related to complex conditions without risks to patients.
  
  
  OBJECTIVE
  To examine differences between individual and team participation on learning outcomes and student perspectives through use of virtual patients (VPs) for teaching cranial nerve (CN) evaluation.
  
  
  METHODS
  Fifty-seven medical students were randomly assigned to complete simulation exercises either as individuals or as members of three-person teams. Students interviewed, examined, and diagnosed VPs with possible CN damage in the neurological exam rehearsal virtual environment (NERVE). Knowledge of CN abnormalities was assessed pre- and post-simulation. Student perspectives of system usability were evaluated post-simulation.
  
  
  RESULTS
  An aptitude-treatment interaction (ATI) effect was detected; at pre-test scores ≤ 50%, students in teams scored higher (83%) at post-test than did students as individuals (62%, p = 0.02). Post-simulation, students in teams reported greater confidence in their ability to diagnose CN abnormalities than did students as individuals (p = 0.02; mean rating = 4.0/5.0 and 3.4/5.0, respectively).
  
  
  CONCLUSIONS
  The ATI effect allows us to begin defining best practices for the integration of VP simulators into the medical curriculum. We are persuaded to implement future NERVE exercises with small teams of medical students.
authors.affiliation: University of Central Florida, Orlando, FL 32827, USA.
authors.forename: Teresa R
authors.initials: TR
authors.lastname: Johnson
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lyons
authors.forename: Joon Hao
authors.initials: JH
authors.lastname: Chuah
authors.forename: Regis
authors.initials: R
authors.lastname: Kopper
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Lok
authors.forename: Juan C
authors.initials: JC
authors.lastname: Cendan
mesh_terms: D000328:Adult; D001076:Aptitude; D015510:Clinical Medicine / Q000193:education; D003198:Computer Simulation; D003389:Cranial Nerve Diseases / Q000175:diagnosis*; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D005431:Florida; D006801:Humans; D008297:Male; D013337:Students, Medical / Q000523:psychology*; D014584:User-Computer Interface; D055815:Young Adult