Virtual patients improve history-taking competence and confidence in medical students

Med Teach. 2024 May;46(5):682-688. doi: 10.1080/0142159X.2023.2273782. Epub 2023 Dec 12.

Abstract

Purpose: Klark is a novel online medical education tool (www.klark-cases.com) where students take histories from virtual patients with common presentations from multiple specialities. We investigated whether Klark could enhance student confidence and competence in history-taking, and whether students find Klark helpful.

Methods: A single cohort of first-year clinical medical students had access to Klark for three weeks. At both ends of the trial, participants were asked to complete feedback forms and participate in two mock Objective Structured Clinical Examination (OSCE) history stations. Outcome measures included self-reported confidence and competence in history-taking, performance in OSCE stations, and qualitative user experience data.

Results: Seventy participants successfully completed a case on Klark (mean 18.7), of which 63 (90% user retention) completed ≥ 2 cases. Self-reported competence (p < 0.001) and confidence (p < 0.001) improved. Participants found Klark to be helpful, impactful, and would recommend it to other students. OSCE scores improved for medical (57% vs. 69%, p < 0.001) and surgical (58% vs. 70%, p < 0.001) histories.

Conclusions: Klark improved competence and confidence in history-taking. Students found it helpful and chose to continue using the platform. By developing confidence and competence at their own pace in the Klark simulated environment, students can then maximise benefit from in-person clinical opportunities.

Keywords: Teaching and Learning; communication skills; decision making; instructional design; learning outcomes; phase of education; simulation; undergraduate.

MeSH terms

  • Clinical Competence*
  • Education, Medical, Undergraduate / methods
  • Educational Measurement / methods
  • Female
  • Humans
  • Male
  • Medical History Taking* / standards
  • Patient Simulation
  • Students, Medical* / psychology