Article Text

Download PDFPDF

Virtual patient educational intervention for the development of shared decision-making skills: a pilot study
  1. Simon Jacklin,
  2. Stephen Chapman,
  3. Neal Maskrey
  1. School of Pharmacy, Keele University, Keele, UK
  1. Correspondence to Mr Simon Jacklin, School of Pharmacy, Keele University, Keele ST5 5BG, UK; s.jacklin{at}


Background Shared decision-making (SDM) involves a healthcare professional and a patient forming a congruent partnership, within which information is shared and decisions are made which align with the patient’s values. SDM does not occur to the extent it ought to; SDM requires practice. Virtual reality could help facilitate this practice.

Objective To pilot an interactive, high-fidelity virtual patient (VP) who simulates SDM within a primary care consultation.

Method Academic pharmacists and doctors were recruited from the Keele University. Participants completed prequestionnaires and postquestionnaires.

Results 18 participants (14 pharmacists and 4 medical doctors) completed the study. 89% (n=16) suggested the VP was ‘enjoyable’ or ‘highly enjoyable’ to use and 72% (n=13) suggested it was ‘very accessible’. There were diverse views about the way in which the user made their reply to the VP with ratings ranging from ‘very poor’ (n=2) to ‘very good’ (n=5); the modal rating was indifference (n=7). It seemed the multiple choice system caused the participants to feel restricted but it was unclear why those who liked the system did so.

Conclusions The VP was found to be enjoyable and thought-provoking. The data suggest that this type of intervention could be useful at many different stages of a professional’s career although the multiple-choice conversation style may be too restrictive for more experienced consulters.

  • shared decision-making
  • virtual patient
  • communication
  • education

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors SJ, NM and SC designed the study. SJ managed the data collection. SJ, NM and SC were involved in the data analysis. SJ wrote the first draft. SJ, NM and SC wrote the final version of the paper. SJ, NM and SC are all equal contributing authors. All authors reviewed the manuscript, added appropriate revisions, agreed to submission for publication, and approved the final version. The corresponding authors attest that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

  • Funding This study was funded by National Institute for Health and Care Excellence, Joint collaboration between NICE and Keele University.

  • Disclaimer Brian Smith is not an actual patient. Any resemblance to a real person living or deceased is coincidence.

  • Competing interests The VP described in this paper is not licensed for commercial sale; none of the authors will therefore receive any monetary gain from the tool. SC is one of two patent holders for the technology. Keele University School of Pharmacy makes virtual patient products similar to the one described in this paper for a range of external commercial clients. NM is a former Programme Director of the Medicines and Prescribing Centre at NICE and a current member of the NICE Shared Decision-Making Collaborative. SJ’s PhD is funded by a joint collaboration between NICE and Keele University. NICE had no input or control over the design of the virtual patient or the writing of this paper.

  • Ethics approval Keele University Ethical Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.