Trial reportBMC medical education2020
Learning clinical reasoning: how virtual patient case format and prior knowledge interact.
Trial report in BMC medical education, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- How and When Should Clinical Reasoning Be Taught in Undergraduate Medicine: A Systematic Review and Meta-Analyses.Perspectives on medical education · 2025Pooled it
- Learning Outcomes of Immersive Technologies in Health Care Student Education: Systematic Review of the Literature.Journal of medical Internet research · 2022Pooled it
- The effect of AI-enabled virtual patient simulation on training outcomes and insecurities in psychotherapy education.BMC medical education · 2026Trial
- Web-Based AI-Driven Virtual Patient Simulator Versus Actor-Based Simulation for Teaching Consultation Skills: Multicenter Randomized Crossover Study.JMIR formative research · 2025Trial
- Effectiveness of non-bedside teaching during the COVID-19 pandemic: a quasi-experimental study.BMC medical education · 2022Trial
- The use of immersive technologies in learning about postpartum hemorrhage: Protocol for a systematic review and meta-analysis.PloS one · 2026Article
- Does online case-based learning foster clinical reasoning skills? A mixed-methods study.Future healthcare journal · 2025Article
- Students' perspective on new teaching concepts for medical studies: case- and competency-based learning in radiology.Insights into imaging · 2025Article
- Good teaching practices for organizing and conducting clinical classes in obstetrics and gynaecology for medical undergraduate students at the English Division.BMC medical education · 2024Review
- Virtual reality for assessing emergency medical competencies in junior doctors - a pilot study.International journal of emergency medicine · 2024Article
- Teaching clinical reasoning to medical students: A brief report of case-based clinical reasoning approach.Journal of education and health promotion · 2024Article
- Teaching and learning clinical reasoning skill in undergraduate medical students: A scoping review.PloS one · 2024Article
- Comparing the influence of big data resources on medical knowledge recall for staff with and without medical collaboration platform.BMC medical education · 2023Article
- Evaluating the Effectiveness of Interactive Virtual Patients for Medical Education in Zambia: Randomized Controlled Trial.JMIR medical education · 2023Article
- Promoting medical student's clinical reasoning during COVID-19 pandemic.Korean journal of medical education · 2023Article
- Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review.Discover education · 2023Article
- Article
- Implementing Remote Collaboration in a Virtual Patient Platform: Usability Study.JMIR medical education · 2022Article
- Adaptations of Clinical Teaching During the COVID-19 Pandemic: Perspectives of Medical Students and Faculty Members.Advances in medical education and practice · 2022Article
- Health professions faculty's perceptions of online teaching and learning during the COVID-19 pandemic.PloS one · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
introductionClinical reasoning has been fostered with varying case formats including the use of virtual patients. Existing literature points to different conclusions regarding which format is most beneficial for learners with diverse levels of prior knowledge. We designed our study to better understand which case format affects clinical reasoning outcomes and cognitive load, dependent on medical students' prior knowledge.
methodsOverall, 142 medical students (3 rd to 6 th year) were randomly assigned to either a whole case or serial cue case format. Participants worked on eight virtual patients in their respective case format. Outcomes included diagnostic accuracy, knowledge, and cognitive load.
resultsWe found no effect of case format on strategic knowledge scores pre- vs post-test (whole case learning gain = 3, 95% CI. -.01 to .01, serial cue learning gain = 3, 95% CI. -.06 to .00 p = .50). In both case formats, students with high baseline knowledge (determined by median split on the pre-test in conceptual knowledge) benefitted from learning with virtual patients (learning gain in strategic knowledge = 5, 95% CI .03 to .09, p = .01) while students with low prior knowledge did not (learning gain = 0, 95%CI -.02 to .02). We found no difference in diagnostic accuracy between experimental conditions (difference = .44, 95% CI -.96 to .08, p = .22), but diagnostic accuracy was higher for students with high prior knowledge compared to those with low prior knowledge (difference = .8, 95% CI 0.31 to 1.35, p < .01). Students with low prior knowledge experienced higher extraneous cognitive load than students with high prior knowledge (multiple measurements, p < .01).
conclusionsThe whole case and serial cue case formats alone did not affect students' knowledge gain or diagnostic accuracy. Students with lower knowledge experienced increased cognitive load and appear to have learned less from their interaction with virtual patients. Cognitive load should be taken into account when attempting to help students learn clinical reasoning with virtual patients, especially for students with lower knowledge.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.