Random comparison of 'virtual patient' models in the context of teaching clinical communication skills

Aims Two types of virtual patient designs can be distinguished: a 'narrative' structure and a 'problem-solving' structure. This study compares the same virtual patient with two different structures within the domain of communication skills. Methods Two virtual patients were constructed around the same case, one emphasizing a narrative and one a problem-solving model. Use of these packages was trialled with undergraduate medical students over 2 years. Students were randomly assigned to tutorials using the virtual patients, and their communication skills were compared with baseline performance by a separate group. Outcome was assessed by evaluation of an interview with a simulated patient. Results There was no significant difference between the three groups in overall communication skills. However there was a significant improvement in the communication skills of the narrative group when compared only with the problem-solving group. Additionally, various aspects of communication skills, such as use of open-ended questions and appropriate language, showed significant differences between the three groups. Conclusion There is some evidence to support the value of a narrative design for virtual patients which are to be used to teach communication skills, which encourages further investigation.