Exploring the validity and reliability of a questionnaire for evaluating virtual patient design with a special emphasis on fostering clinical reasoning

Soren Huwendiek, Bas De Leng, Andrzej Kononowicz, Romy Kunzmann, Arno Muijtjens, Cees van der Vleuten, Georg Hoffmann, Burkhard Tonshoff, Diana Dolmans

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    12 Citations (Scopus)

    Abstract

    Background: Virtual patients (VPs) are increasingly used to train clinical reasoning. So far, no validated evaluation instruments for VP design are available. Aims: We examined the validity of an instrument for assessing the perception of VP design by learners. Methods: Three sources of validity evidence were examined: (i) Content was examined based on theory of clinical reasoning and an international VP expert team. (ii) The response process was explored in think-aloud pilot studies with medical students and in content analyses of free text questions accompanying each item of the instrument. (iii) Internal structure was assessed by exploratory factor analysis (EFA) and inter-rater reliability by generalizability analysis. Results: Content analysis was reasonably supported by the theoretical foundation and the VP expert team. The think-aloud studies and analysis of free text comments supported the validity of the instrument. In the EFA, using 2547 student evaluations of a total of 78 VPs, a three-factor model showed a reasonable fit with the data. At least 200 student responses are needed to obtain a reliable evaluation of a VP on all three factors. Conclusion: The instrument has the potential to provide valid information about VP design, provided that many responses per VP are available.

    Original languageEnglish
    Pages (from-to)775-782
    Number of pages8
    JournalMedical Teacher
    Volume37
    Issue number8
    DOIs
    Publication statusPublished - 2015

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  • Cite this

    Huwendiek, S., De Leng, B., Kononowicz, A., Kunzmann, R., Muijtjens, A., van der Vleuten, C., Hoffmann, G., Tonshoff, B., & Dolmans, D. (2015). Exploring the validity and reliability of a questionnaire for evaluating virtual patient design with a special emphasis on fostering clinical reasoning. Medical Teacher, 37(8), 775-782. https://doi.org/10.3109/0142159X.2014.970622