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Open Access Research article

An innovative blended learning approach using virtual patients as preparation for skills laboratory training: perceptions of students and tutors

Ronny Lehmann1*, Hans Martin Bosse2, Anke Simon1, Christoph Nikendei3 and Sören Huwendiek4

Author Affiliations

1 Clinic I – General Paediatrics, Centre for Child and Adolescent Medicine, Im Neuenheimer Feld 430, Heidelberg, 69120, Germany

2 Department of General Paediatrics, Centre for Child and Adolescent Medicine, Moorenstr. 5, Düsseldorf, 40225, Germany

3 Department of Internal Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany

4 Department of Assessment and Evaluation, Institute of Medical Education, Faculty of Medicine, University of Bern, Konsumstrasse 13, Bern, 3010, Switzerland

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BMC Medical Education 2013, 13:23  doi:10.1186/1472-6920-13-23

Published: 12 February 2013



Currently only a few reports exist on how to prepare medical students for skills laboratory training. We investigated how students and tutors perceive a blended learning approach using virtual patients (VPs) as preparation for skills training.


Fifth-year medical students (N=617) were invited to voluntarily participate in a paediatric skills laboratory with four specially designed VPs as preparation. The cases focused on procedures in the laboratory using interactive questions, static and interactive images, and video clips. All students were asked to assess the VP design. After participating in the skills laboratory 310 of the 617 students were additionally asked to assess the blended learning approach through established questionnaires. Tutors’ perceptions (N=9) were assessed by semi-structured interviews.


From the 617 students 1,459 VP design questionnaires were returned (59.1%). Of the 310 students 213 chose to participate in the skills laboratory; 179 blended learning questionnaires were returned (84.0%). Students provided high overall acceptance ratings of the VP design and blended learning approach. By using VPs as preparation, skills laboratory time was felt to be used more effectively. Tutors perceived students as being well prepared for the skills laboratory with efficient uses of time.


The overall acceptance of the blended learning approach was high among students and tutors. VPs proved to be a convenient cognitive preparation tool for skills training.

Medical education; Skills laboratory; Virtual patients; Blended learning