Virtual patient simulation in undergraduate emergency medicine education during COVID-19: Randomized controlled trial

Objective: To examine whether a 2-week or 4-week virtual patient simulation program can improve clinical competence for undergraduate emergency medicine education during COVID-19. Methods: This randomized controlled trial was conducted between October and December 2021. Final-year medical students were randomized into a 2-week short exposure group and a 4-week long exposure group on a 1:1 allocation. They were assessed using a virtual case with structured scoring system before and after the virtual patient simulation learning program. An end-of-program questionnaire on learners' perceptions was also administered. Results: A total of 138 students were recruited. After the virtual patient simulation program, the virtual case score increment in the long exposure group was significantly higher than in the short exposure group with a mean score difference of 18/100 (95% confidence interval = 9.8 to 26.3). Questionnaire showed generally positive perceptions toward the use of virtual patient simulation program for emergency medicine teaching. Conclusion: Virtual reality learning of 2 and 4 weeks' duration may be beneficial for improving emergency medicine clinical competence for final-year medical students, especially during periods of limited clinical exposure like the COVID-19 pandemic. A longer 4-week virtual patient simulation program may produce a better learning effect on clinical competence.