title: Virtual patient simulations and optimal social learning context: a replication of an aptitude-treatment interaction effect.
abstract: BACKGROUND
  Virtual patients (VPs) offer valuable alternative encounters when live patients with rare conditions, such as cranial nerve (CN) palsies, are unavailable; however, little is known regarding simulation and optimal social learning context.
  
  
  OBJECTIVE
  Compare learning outcomes and perspectives between students interacting with VPs in individual and team contexts.
  
  
  METHODS
  Seventy-eight medical students were randomly assigned to interview and examine four VPs with possible CN damage either as individuals or in three-person teams, using Neurological Examination Rehearsal Virtual Environment (NERVE). Learning was measured through diagnosis accuracy and pre-/post-simulation knowledge scores. Perspectives of learning context were collected post-simulation.
  
  
  RESULTS
  Students in teams submitted correct diagnoses significantly more often than students as individuals for CN-IV (p = 0.04; team = 86.1%; individual = 65.9%) and CN-VI (p = 0.03; team = 97.2%; individual = 80.5%). Knowledge scores increased significantly in both contexts (p < 0.001); however, a significant aptitude-treatment interaction effect was observed (p = 0.04). At pre-test scores ≤25.8%, students in teams scored significantly higher (66.7%) than students as individuals (43.1%) at post-test (p = 0.03). Students recommended implementing future NERVE exercises in teams over five other modality-timing combinations.
  
  
  CONCLUSIONS
  Results allow us to define best practices for integrating VP simulators into medical education. Implementing NERVE experiences in team environments with medical students in the future may be preferable.
authors.affiliation: University of Central Florida , USA .
authors.forename: Teresa R
authors.initials: TR
authors.lastname: Johnson
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lyons
authors.forename: Regis
authors.initials: R
authors.lastname: Kopper
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Johnsen
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Lok
authors.forename: Juan C
authors.initials: JC
authors.lastname: Cendan
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003389:Cranial Nerve Diseases / Q000175:diagnosis; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006126:Group Processes; D006801:Humans; D007858:Learning; D008297:Male; D012931:Social Environment; D014584:User-Computer Interface
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