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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. AIM: 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. CONCLUSION: 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.
Johnson et al. (Wed,) studied this question.