Advances in Health Sciences Education

, Volume 16, Issue 3, pp 331–345 | Cite as

Experiencing virtual patients in clinical learning: a phenomenological study

  • Samuel Edelbring
  • Maryam Dastmalchi
  • Håkan Hult
  • Ingrid E. Lundberg
  • Lars Owe Dahlgren


Computerised virtual patients (VPs) are increasingly being used in medical education. With more use of this technology, there is a need to increase the knowledge of students’ experiences with VPs. The aim of the study was to elicit the nature of virtual patients in a clinical setting, taking the students’ experience as a point of departure. Thirty-one students used VPs as a mandatory part of an early clinical rotation in rheumatology. Using the qualitative approach of phenomenology, we interviewed these students and then analysed data regarding their experiences of VPs as a learning activity. The result shows that students perceived VP activities in relation to actual patients, the clinical context and other learning activities. The VPs represented typical clinical cases which encouraged clinical reasoning and allowed for decision making. The students experienced the activities as integrating biomedical knowledge and clinical experience, providing structure that prepared for the unstructured clinical environment and patient encounters under unstressful conditions. However, the VPs were experienced as lacking the emotional interactivity and complexity of actual patients. Theoretical frameworks of clinical reasoning and experiential learning are suggested as foundations for further educational integration of VPs in the clinical environment. VP activities during clinical rotations provide experiences of clinical reality and allow students to solve problems actively. These features are dependent on VP technology but are also contingent on the surrounding environment.


Clinical reasoning Clinical workplace learning Experiential learning Life-world perspective Phenomenology Research interview Computerised virtual patients 



We would like to thank Marika Kvarnström who managed the rotations and facilitaded the interview sessions. The first author wishes to acknowledge the constructive feedback on earlier drafts given by C. Van der Vleuten and J. Van Merriënboer at Maastricht University and at the CME doctoral seminar at Karolinska Institutet. Part of the analysis was presented at the AMEE conference in Malaga in 2009. This study has been made possible through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Samuel Edelbring
    • 1
  • Maryam Dastmalchi
    • 2
  • Håkan Hult
    • 3
  • Ingrid E. Lundberg
    • 2
  • Lars Owe Dahlgren
    • 3
  1. 1.Department of Learning, Informatics, Management and EthicsKarolinska InstitutetStockholmSweden
  2. 2.Rheumatology Unit, Department of MedicineKarolinska University Hospital, Solna, Karolinska InstitutetStockholmSweden
  3. 3.Department of Behavioural Science and LearningLinköping UniversityLinköpingSweden

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