title: The effect of constructing versus solving virtual patient cases on transfer of learning: a randomized trial.
abstract: The purpose of this study was to explore the effect of actively constructing virtual patient (VP) cases compared with solving VP cases on knowledge gains, skills transfer and time spent on cases. Forty-five fourth-year medical students were randomized to constructing (VP-construction, n = 23) or solving (VP-solving, n = 22) four cardiopulmonary VP cases. Whereas the VP-solving group solved the cases, the VP-construction group only received the final diagnosis and had to complete the history, physical findings, and lab results. After a week, participants completed a transfer test involving two standardized patients representing cardiopulmonary cases. Performances on the transfer test were video-recorded and assessed by two blinded raters using the Reporter, Interpreter, Manager, Educator (RIME) framework. Thirty-nine participants completed the transfer test. The VP-construction group spent significantly more time on the VP cases compared with the VP-solving group, p = 0.002. There were no significant differences in RIME scores between the VP-construction group and VP-solving group, p = 0.54.In conclusion, engaging novice students in active VP case construction may be more time consuming than solving VP cases, without resulting in superior skills transfer.
authors.affiliation: Centre for Clinical Education, Capital Region of Denmark and University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. martintolsgaard@gmail.com.|Department of Obstetrics and Gynaecology, Nordsjælland University Hospital, Hillerød, Denmark. martintolsgaard@gmail.com.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Tolsgaard
authors.affiliation: Centre for Clinical Education, Capital Region of Denmark and University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.|Danish Institute for Medical Simulation, Herlev University Hospital, Capital Region of Denmark and University of Copenhagen, Copenhagen, Denmark.
authors.forename: Rikke M H G
authors.initials: RM
authors.lastname: Jepsen
authors.affiliation: Centre for Clinical Education, Capital Region of Denmark and University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors.forename: Maria B
authors.initials: MB
authors.lastname: Rasmussen
authors.affiliation: Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Kayser
authors.affiliation: Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden.
authors.forename: Uno
authors.initials: U
authors.lastname: Fors
authors.affiliation: Department of Pulmonary Medicine, Herlev University Hospital, Herlev, Denmark.
authors.forename: Lars C
authors.initials: LC
authors.lastname: Laursen
authors.affiliation: Department of Cardiology, Department of Clinical Medicine, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen and Danish Arrhythmia Research Centre, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jesper H
authors.initials: JH
authors.lastname: Svendsen
authors.affiliation: Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ringsted
keywords: Learning; Simulation-based medical education; Transfer of learning; Virtual patients