JMIR Publications

ABSTRACT

Background:

The practical training course of internal medicine of traditional Chinese medicine (PTC-IMTCM) is primarily based on traditional case teaching, which can be stressful for teachers. The use of virtual standardized patient (VSP) applications could be an alternative; however, there is limited evidence regarding their feasibility and effectiveness.

Objective:

To build a VSP-TCM application according to the characteristics of PTC-IMTCM and the needs of students and to compare its efficacy with traditional teaching in improving TCM clinical competence among students.

Methods:

A pre-questionnaire investigation was conducted before the course, and a VSP-TCM system was developed based on the results of the questionnaire. A randomized trial was then conducted between February 26, 2020, and August 20, 2021. A total of 84 medical students were included and were divided into two groups: the observation group, trained with VSP-TCM (n=42), and the control group, trained with traditional academic training (n=42). Formative and summative assessments were employed to evaluate teaching effectiveness. After completing the course, a questionnaire was administered to the students to self-assess their satisfaction with the course. A questionnaire was also administered to 15 teachers to uncover their perspectives on VSP-TCM.

Results:

All participants in both groups completed the study. In the formative assessment, the VSP-TCM group performed better in the medical interview (7.19±0.63 vs. 6.83±0.81, P=.04), clinical judgment (6.48±0.98 vs. 5.86±1.04, P=.006), and comprehensive ability (6.71±0.59 vs. 6.40±0.58, P=.02) than the control group. Similarly, in the summative evaluation, the VSP-TCM group performed better in the online systematic knowledge test (86.62±2.71 vs. 85.38±2.62, P=.046), application of TCM technology (87.86±3.04 vs. 86.19±3.08, P=.02), TCM syndrome differentiation and therapeutic regimen (90.93±2.42 vs. 89.60±2.86, P=.03), and communication skills (90.67±4.52 vs. 88.24±4.56, P=.02) than the control group. There was no significant difference in medical writing between both groups (75.07±3.61 vs. 75.71±2.86, P=.37). Post-course feedback questionnaire indicated that VSP-TCM can better enhance students’ TCM thinking ability (39 [93%] vs. 37 [88%], P=.002), medical history collection (38 [90%] vs. 30 [72], P=.001), syndrome differentiation and treatment and critical thinking (38 [90%] vs. 37 [88%], P=.046), clinical comprehensive application ability (40 [95%] vs. 36 [86%], P=.009), interpersonal communication skills (36 [86%] vs. 28 [67%], P=.01), and autonomous learning ability (37 [88%] vs. 28 [67%], P=.01) than academic training. Similarly, the teachers held a positive perspective toward VSP-TCM.

Conclusions:

VSP-TCM enhanced the students’ TCM clinical competence and dialectical thinking and improved their ability to work autonomously. Moreover, the VSP-TCM system is feasible, practical, and cost-effective and thus merits further promotion in TCM education.