Knowledge-Driven Design of Virtual Patient Simulations

Two methods are traditionally used in medical education to enhance the realism of learning with simulated scenarios. In these methods, students interact either with human actors trained to mimic the symptoms of a disease or injury or with computer-controlled mannequins that mechanically mimic such symptoms. In scenarios involving either kind of "patient," students apply classroom knowledge while engaging in experiential learning (Kolb and Kolb 2005). Although such simulated scenarios offer many advantages over strict textbook learning, their use must be limited due to the expense and difficulty of mimicking a wide variety of ailments and situations with either kind of simulated patient. Multiuser virtual environments (MUVEs) represent a potential solution to these limitations as they allow instructors to replace physical patients with virtual ones. Like computer-based flight simulators, virtual patient simulators can provide a variety of scenarios that can be repeated as often as necessary to reinforce medical concepts and procedures. In this article, we discuss the design and evaluation of virtual patient simulations in the context of the Mr. Toma Medical Simulation, which has been the subject of multiple studies to assess its effectiveness and usability.