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Table 1 Inclusion and exclusion criteria

From: The effectiveness of using virtual patient educational tools to improve medical students’ clinical reasoning skills: a systematic review

Key Concepts Criteria
Population Undergraduate medical students
Excluded: health professionals, postgraduate students, other health students
Intervention Interventions that describe an educational method that explicitly teaches clinical reasoning skills and is an interactive computer simulation of real-life clinical scenarios between ‘physicians’ and ‘patients’. The student should emulate the role of a clinician by undertaking various reasoning activities such as gathering data from the patient, interpreting information, or making diagnostic decisions [9]. Patient information could be presented in text or videos on the computer
Excluded: high fidelity simulators, manikins, standardised patients, and decision support tools
Comparator Teaching as usual e.g., no explicit clinical reasoning teaching or a comparison to an alternative method of delivering explicit clinical reasoning teaching e.g., tutorials, problem-based learning discussion groups often involving paper-based instruction
Excluded: alternative formats e.g., comparing different types of virtual patient cases
Outcome Clinical reasoning skills are the thought processes required to identify likely diagnoses, formulate appropriate questions and reach clinical decisions [2]. Interventions that provided sufficient detail to establish whether it improved clinical reasoning skills in a written, oral, or practical test. Commonly used synonyms for clinical reasoning were accepted e.g., clinical decision-making, clinical reasoning, problem-solving, critical thinking, and clinical judgement skills
Study type(s) RCTs, crossover trials, quasi-experimental studies, and observational studies
Excluded: qualitative designs
Publication type(s) Peer reviewed articles including theses
Excluded: conference papers, editorials letters, notes, comments, and meeting abstracts. Articles not in English
Time Articles from the year 1990, as this was when online learning was beginning to be described [14]