Evaluation of an Online Analogical Patient Simulation Program

Medulatortrade, a commercial Web-based, variable response, patient simulation application, was modified to test the effect of case sequencing, explicit case comparison, and user-generated case summaries on overall user performance. Senior medical students completed analogous sets of virtual patient cases in different sequences, and their case performance was tracked. A follow-up user satisfaction survey was conducted. A significant effect of case sequencing on analogy transfer was seen only with respect to correct treatment scores (p = . 009). Explicit case comparison had no reliable effect on performance. However, diagnostic accuracy increased (p les .002) while treatment attempts decreased (p = . 05) when subjects were prompted to write case summaries. Satisfaction with the patient simulation program was high. Manipulating case sequences and supporting explicit case comparison yielded mixed results. However, using case summaries as a tool for reflection and proxy for self-explanation led to significant improvement in students' performance