Comparing expert guided training and self-learning with virtual patients in emergency management training: a randomized controlled trial

Virtual patient-based simulation training has become a valuable tool in emergency medical education, particularly for developing clinical reasoning and decision-making skills. This randomized controlled experimental study compared the effectiveness of educator-guided and self-directed virtual patient training among paramedic students. Participants completed identical clinical scenarios using a virtual patient platform, either with real-time instructor support or independently with computer-generated feedback. Findings revealed that educator-guided training led to better performance across several domains of emergency assessment and management, especially in tasks requiring nuanced judgment and real-time decision-making. These results highlight the importance of instructional scaffolding and interpersonal feedback in simulation-based learning. While self-directed training offers flexibility and scalability, a blended approach that combines structured guidance with autonomous practice may provide the most comprehensive educational benefit for paramedic students. The study contributes to the growing evidence base for simulation pedagogy and supports the integration of instructor-led components into virtual patient training programs.