title: Virtual patients--what are we talking about? A framework to classify the meanings of the term in healthcare education.
abstract: BACKGROUND
  The term "virtual patients" (VPs) has been used for many years in academic publications, but its meaning varies, leading to confusion. Our aim was to investigate and categorize the use of the term "virtual patient" and then classify its use in healthcare education.
  
  
  METHODS
  A literature review was conducted to determine all articles using the term "virtual patient" in the title or abstract. These articles were categorized into: Education, Clinical Procedures, Clinical Research and E-Health. All educational articles were further classified based on a framework published by Talbot et al. which was further developed using a deductive content analysis approach.
  
  
  RESULTS
  536 articles published between 1991 and December 2013 were included in the study. From these, 330 were categorized as educational. Classifying these showed that 37% articles used VPs in the form of Interactive Patient Scenarios. VPs in form of High Fidelity Software Simulations (19%) and Virtual Standardized Patients (16%) were also frequent. Less frequent were other forms, such as VP Games. Analyzing the literature across time shows an overall trend towards the use of Interactive Patient Scenarios as the predominant form of VPs in healthcare education.
  
  
  CONCLUSIONS
  The main form of educational VPs in the literature are Interactive Patient Scenarios despite rapid technical advances that would support more complex applications. The adapted classification provides a valuable model for VP developers and researchers in healthcare education to more clearly communicate the type of VP they are addressing avoiding misunderstandings.
authors: Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden. andrzej.kononowicz@ki.se.|Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland. andrzej.kononowicz@ki.se.
authors: Andrzej A
authors: AA
authors: Kononowicz
authors: Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden. Nabil.Zary@ki.se.
authors: Nabil
authors: N
authors: Zary
authors: Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden. Samuel.Edelbring@ki.se.
authors: Samuel
authors: S
authors: Edelbring
authors: School of Medicine at the University of Colorado Denver in Denver, Colorado, USA. jktworek@gmail.com.
authors: Janet
authors: J
authors: Corral
authors: Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, Ziemssenstr 1, 80336, München, Germany. inga.hege@med.uni-muenchen.de.
authors: Inga
authors: I
authors: Hege
mesh_terms: D003194:Computer-Assisted Instruction; D004501:Education, Medical; D006801:Humans; D008953:Models, Anatomic; D066230:Patient-Specific Modeling; D000066908:Simulation Training; D014584:User-Computer Interface
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