Objective To design a virtual patient (VP)-based stepwise history-taking training model and to evaluate its effectiveness. Methods Based on the natural progression of history-taking ability training, this study developed a VP-based stepwise training model that transitions from single-symptom history to comprehensive case history. A total of 392 nursing undergraduates participated from March 2020 to June 2022. The grade 2019 of 206 students formed the experimental group and underwent stepwise VP history-taking training: symptom history-taking during the basic health assessment course and case history-taking during the professional internal medicine nursing course. The grade 2018 of 186 students received traditional teaching. Data were collected at the beginning of the health assessment course (T0), the end of the health assessment course (T1), and internal medicine nursing courses (T2). Due to the data not following a normal distribution, Generalized Estimating Equations were used to conduct statistical analysis on the outcome indicators. Results The experimental group's self-assessed history-taking scores increased by 2.24 points at T1 and 3.28 points at T2; the between-group differences in score change were statistically significant at both time points (T1:P =0.04; T2: P=0.03). The experimental group's critical thinking scores increased by 3.26 points at T1 and 4.60 points at T2; the between-group difference in score change was statistically significant only at T2 (T1: P>0.05; T2: P< 0.001). The difference in supportive communication score changes of two groups was not significant at T1 and T2 (P>0.05). Conclusions The stepwise VP history-taking training model can significantly improve students' history-taking skills and critical thinking abilities.
Du Jingrong
,
Wang Juan
,
Wang Ziwen
,
Zheng Jing
,
Zhu Xiaowen
,
Zhao Juanjuan
,
Li Kun
. Design and application of a stepwise nursing history-taking training model based on virtual patients[J]. Chinese Journal of Medical Education, 2026
, 46(1)
: 47
-52
.
DOI: 10.3760/cma.j.cn115259-20250124-00096
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