Virtual patients improve history-taking competence and confidence in medical students

Klark is a novel online medical education tool (www.klark-cases.com) where students take histories from virtual patients with common presentations from multiple specialities. We investigated whether Klark could enhance student confidence and competence in history-taking, and whether students find Klark helpful. A single cohort of first-year clinical medical students had access to Klark for three weeks. At both ends of the trial, participants were asked to complete feedback forms and participate in two mock Objective Structured Clinical Examination (OSCE) history stations. Outcome measures included self-reported confidence and competence in history-taking, performance in OSCE stations, and qualitative user experience data. Seventy participants successfully completed a case on Klark (mean 18.7), of which 63 (90% user retention) completed  ≥ 2 cases. Self-reported competence (<i>p</i> &lt; 0.001) and confidence (<i>p</i> &lt; 0.001) improved. Participants found Klark to be helpful, impactful, and would recommend it to other students. OSCE scores improved for medical (57% vs. 69%, <i>p</i> &lt; 0.001) and surgical (58% vs. 70%, <i>p</i> &lt; 0.001) histories. Klark improved competence and confidence in history-taking. Students found it helpful and chose to continue using the platform. By developing confidence and competence at their own pace in the Klark simulated environment, students can then maximise benefit from in-person clinical opportunities.

Klark是一款新型在线医学教育工具（官网：www.klark-cases.com），支持医学生针对多专科常见临床表现的虚拟患者采集病史。本研究旨在评估Klark能否提升医学生病史采集的自信心与实操能力，以及学生对该工具的认可程度。本研究纳入单队列一年级临床医学生，允许其使用Klark平台为期三周。在试验的起始与结束阶段，参与者均需填写反馈问卷，并参与两场模拟客观结构化临床考试（Objective Structured Clinical Examination, OSCE）病史采集站考核。本研究的结局指标涵盖自我报告的病史采集自信心与实操能力、OSCE考核站表现，以及质性用户体验数据。共有70名参与者成功完成Klark上的病例（人均完成18.7例），其中63名（用户留存率为90%）完成了至少2例病例。自我报告的实操能力（*p* < 0.001）与自信心（*p* < 0.001）均显著提升。参与者均认可Klark具有实用性与影响力，并愿意将其推荐给其他同学。内科（57% vs. 69%，*p* < 0.001）与外科（58% vs. 70%，*p* < 0.001）相关病史采集的OSCE得分均有所提升。本研究证实Klark可有效提升医学生病史采集的自信心与实操能力，学生认可其实用性并愿意持续使用该平台。学生可在Klark的模拟环境中按自身节奏提升自信心与实操能力，从而在后续的线下临床实践中最大化获益。