Background/Purpose: Digital education, also known as e-learning, comprises several different learning modalities e.g. virtual patient (VP) simulations. VPs have been proposed to be an effective way of exposing health profession students to greater quantities of patient cases, also ensuring that students encounter diagnoses and presentations that serve the needs of their learning outcomes, regardless of the patients they happen to encounter during clinical rotations.

Our aim was to explore medical students’ perceptions and emotions towards integration of basic science aspects in VP cases within rheumatology, and evaluate their self-perceived acquirement of clinical reasoning (CR) skills. A secondary aim was to collect information that would be utilised for the development of a model, with concepts and strategies for how to integrate basic science concepts into case-based CR training platforms.

Methods: We performed an interventional, explorative phenomenological study, with medical students recruited from a one-week long clinical placement in rheumatology. The integration was implemented in five VP scenarios. During the last day of the week, the VP cases were discussed during a seminar, together with discussion of the basic science integration. The VP cases had been created with Virtual interactive case simulator (VIC). Students’ perceptions and emotions of basic science as well as CR skills were explored through thematic content analysis of transcribed interviews. Transcriptions were coded and analysed using Malterud’s systematic text condensation. Transcriptions were read by the entire research team. Next, condensations and themes were presented to the research team to discuss internal validity of the material. Quotes and condensations were then translated to English. Finally, all transcriptions were re-read one last time to ensure that the themes and general concepts still corresponded to the material.

Results: A total of 14 students were tasked to complete five basic science-enhanced VP cases. After data analysis, we identified five themes, illustrating students’ perceptions of basic science integration into VP cases and its possible impact on the self-perception of their CR ability: (i) appreciation of basic science knowledge and the role in future work; (ii) ambiguity towards basic science in practice as an obstacle for integration; (iii) the effect of basic science integration on self-perception of CR; (iv) an attractive design of basic science integration; (v) low knowledge of the concept of CR.

Overall, student’s perceptions towards basic science were positive but their motivation for performing the integrative activity themselves was low. Students reported enhanced CR ability after having performed the activity. They also reported a value of continuous integration of basic science during rotations in the hospital environment. However, this was hindered by a fear of asking senior colleagues questions related to basic science, as they perceived that they “should have known this themselves”.

Conclusion: Our results suggest that student’s are positive to basic science integration within educational activities at the medical programme, accompanied by the fact that it might improve their CR abilities.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/integration-of-basic-science-into-virtual-patient-cases-to-enhance-clinical-reasoning-skills/