JMIR Publications

ABSTRACT

Background:

Zambia faces a severe shortage of medical professionals, particularly in rural areas. Novel educational programmes and infrastructures are developed to address this gap, but they face significant barriers due to limitations of both physical and human resources. To address these shortages, efforts like an online learning platform and blended learning approaches are employed, with virtual patients (VPs) serving as a tool for fostering interactive learning.

Objective:

The objective was to evaluate the students’ knowledge acquisition and acceptance of two VP cases as a learning tool on a Zambian higher-education e-learning platform.

Methods:

Employing a mixed-methods design, we assessed knowledge acquisition with pre- and post-tests. In a randomised controlled trial setting, students were randomly assigned (1:1) to two medical topics (topic 1: appendicitis; topic 2: severe acute malnutrition (SAM)) and then to four different learning tools within their respective exposure groups: 1) VPs, 2) textbook contents, 3) pre-selected e-learning materials, and 4) self-guided Internet materials. Acceptance was evaluated using a questionnaire with 15 Likert-scaled items.

Results:

A total of n=69 students took part in the study. Our results showed differences in knowledge acquisition for the both topics. We found that VPs were non-inferior to textbook contents, self-guided Internet materials, and pre-selected e-learning materials as learning resources. The SAM-focused test revealed a significant difference between the VP and textbook content arm, but there was no significant difference between the study participants in the intervention groups for the topic of appendicitis, as all four arms demonstrated a similar knowledge increase. The SAM VP was more widely accepted than the appendicitis VP.

Conclusions:

In this low-resource setting, we found VPs to be non-inferior and accepted. VPs can be an engaging learning resource. Their utility seems to be topic-dependent. More research is needed on VPs' acceptance and utility in low-resource contexts. Clinical Trial: The trial was registered with the Pan African Clinical Trials Registry on January 27, 2022 (PACTR, PACTR202211594568574, https://pactr.samrc.ac.za/).