Table 2

Characteristics of studies included in the review

Authors, year of publication and study titleStudy settingParticipantsVP design or descriptionOutcomes and study purposeMethodsFindingsLimitations
Bindoff I., Bereznicki L., Westbury J., et al 2014
A Computer Simulation of Community Pharmacy Practice for Educational Use
School of Pharmacy, University of Tasmania, Tasmania, AustraliaPharmacy studentsA computer simulated community pharmacy, using Unity3D game development. Users select patient dialogue resulting in text responses and animations.To investigate a computer-based method for pharmacy practice compared with paper-based scenarios.Pre/post-knowledge quiz and survey.
Paper-based control.
The VP group had better improvements in knowledge and some improved history taking and counselling. The simulation was more fun and engaging. The VP was as effective as paper-based alternatives.Limited sample size due to limited access to students.
Douglass M.A., Casale J.P., Skirvi, et al. 2013
A Virtual Patient Software Program to Improve Pharmacy Student
Learning in a Comprehensive Disease Management Course22
Northeastern University School of Pharmacy, Boston, MassachusettsPharmacy studentsTheraSim, a web-based simulation software for HCPs. Simulations for clinical training. Identify and resolve drug-therapy problems including patient education.To consider the impact of a VP pilot on pharmacy student’s clinical competence skills.Pre/post-VP design.There were significant improvements in the post-test scores. The VP allowed for student assessment and improved learning outcomes.Not discussed
Fleming M., Olsen D.E., Stathes H., et al 2009
Virtual Reality Skills Training for Health Care Professionals in Alcohol Screening and Brief Intervention
School of Medicine and Public Health, University of Wisconsin, MadisonA mixture of HCPs and HCP students including pharmacy studentsA self-contained, ‘off-the-shelf’ virtual reality simulation. Based on SIMmersion. Questions to ask the VP, to conduct counselling or refer additional videoed responses.To improve clinical skills in alcohol screening, brief alcohol intervention and referral. Changes in clinical skills.RCT. ‘Experimental virtual reality simulation program’ vs no education (control)Demonstrated an increase in the alcohol screening and brief intervention skills of HCPs.
Significant increases in the scores of the VP group at 6 months compared with the control for screening and brief interventions.
Volunteer sample may be more motivated. Used SPs but attempted to minimise limitations from this. Not clear how many pharmacy students.
Loke S.K., Tordoff J., Winikoff M.,et al 2011
SimPharm: How pharmacy students made meaning of a clinical case differently in paper/simulation-based workshops
University of OtagoPharmacy studentsSimPharm, a web-based simulation platform with a time-sensitive, persistent world where students are pharmacists. Learners ask patients questions to live through the consequences of their actions.To investigate how students made meaning of their clinical case. Descriptively analyse the group’s activities.Case study, paper-based and simulation workshops. Including some qualitative methods in workshopsFindings identified differences in four areas: framing of the problem; problem-solving steps and tools used; sources and meaning of feedback; and conceptualisation of the patient. These can be used in future evaluations of educational simulations.Limitations not discussed. Qualitative methods used with considerations for reflexivity and qualitative quality.
Shoemaker M.J., De Voest M., Booth A., et al 2015
A virtual patient educational activity to improve interprofessional competencies: A randomized trial
College of Pharmacy, Ferris State UniversityPharmacy, physician assistant and physical therapy graduate studentsA case representing a patient with diabetes via the VirtualPT and DxR Clinician internet-based virtual patient software. Team to complete history and examination and then develop a management plan learning outcomes regarding team communication.Quantitatively determine whether a VP improved interprofessional competencies in various graduate students.RCT.
VP IPE vs control.
The VP group had significantly greater odds of improving various IPEC competencies and RIPLS items. The IPE activity resulted in greater awareness of other professions scopes of practice, what other professions have to offer patients and how different professions can collaborate.The effect of the IPE case without interprofessional collaboration is not known. Participants’ prior training on teamwork was not standardised nor was the instruction provided preceding the VP.
Taglieri C.A., Crosby S.J., Zimmerman K., et al 2017
Evaluation of the Use of a Virtual Patient on Student Competence and Confidence in Performing Simulated Clinic Visits
Massachusetts College of Pharmacy and Health SciencesPharmacy studentsThe Shadow Health VP programme. Aim to improve student communication performance and confidence in mock clinic visits.Assessment of VPs in a pharmacy skills lab. Effects on competence and confidence to conduct real clinic visits.Intervention group accessed the VP before a clinic visit, control used it after. Pre/post-experience surveys.Higher performance reported in the VP group which continued to improve; there was no change in confidence. Increased scores for the ease of use and case realism; helpfulness decreased. VPs enhanced performance.The study only considered one course in one pharmacy school so had limited generalisability. Participation declined and there were changing completion thresholds. Some aspects were compulsory but some were for extra credits.
Zary N., Johnson G., Boberg J., et al 2006
Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment – Web-SP
Karolinska Institute, SwedenMedical, dentistry and pharmacy studentsWeb-SP: simulated patient encounter, students gather and analyse data to diagnose and treat a VP, including asking questions to gather information.Evaluate if it is possible to develop a web-based VP simulation where teachers author the cases.Post-questionnaire (Likert) with some evaluation of system use and observation.Pilot evaluations in HCP courses showed that students regarded Web-SP as easy to use, engaging and of educational value. The system fulfilled the aim of providing a common generic platform for creation, management and evaluation of web-based VPs.Limitations not discussed. Evaluation phase not detailed in depth.
Zlotos L., Power, A., Hill D., et al 2016
A Scenario-Based Virtual Patient Program to Support Substance Misuse Education
NHS Education for Scotland. UKPre-registration pharmacists (preregs)Computer animations using computer graphics technology with dubbed voice actors. Educate on injecting equipment and opiate substitution therapy.Develop and pilot VP cases on injecting equipment and opiate substitution therapyPre/post tests and a 6-month assessment of knowledge and perceived confidence. No control.Perceived confidence and knowledge increase immediately after use and at 6 months. There was a loss of knowledge over time but confidence was sustained.Not all participants completed the follow-up. Use of preregs may limit the generalisability. No assessment of competence.
  • HCPs, healthcare professionals; IPE, Interprofessional education; IPEC, Interprofessional Education Collaborative; RCT, randomised controlled trial; RIPLS, Readiness for Interprofessional Learning Scale; SP, Simulated patient; VP, virtual patients.