As time goes by: Stakeholder opinions on the implementation and use of a virtual patient simulation system

BACKGROUND: Stakeholder opinions on the implementation of a particular virtual patient application might prove important for decision-making and implementation efforts in general. This study aimed to capitalize on experiences originated from two post-implementation settings of Web-based Simulation of Patients (Web-SP). METHOD: We conducted a cross-sectional survey of stakeholder opinions (39 students, teachers, course directors, and university leaders) on the implementation and use of Web-SP in Colombia and Sweden, using a mixed method approach. RESULTS: The respondents did not show equal preference in rating the ranking of the order of importance included in the variables (Friedman's Chi square: 26.5 to 115.1, df = 6, p < 0.001, Kendall's coefficient of concordance ranging from 0.11 to 0.50). The answers provided as free comments supported the statistical findings on the importance of end-user customization, need for authenticity in software design, and use of virtual patient simulations in a curricular context, for clinical reasoning development. CONCLUSIONS: Virtual Patient design should allow extensive editing, support case authenticity and enhance clinical reasoning abilities, in an effort for ensuring accountability and sustainable development of the field.