Comparing Expert Guided Training and Self -Directed Learning with Virtual Patients in Emergency Management Training : a Randomized Controlled Trial

Virtual patient-based simulation training is increasingly being used in healthcare and medical education to enhance problem-solving and critical decision-making skills. There are two common approaches in these trainings: instructor-led learning and self-directed learning. In instructor-led virtual patient-based simulation training programs, an experienced subject matter expert guides students through virtual patient simulation activities. The instructor provides feedback, support, and encourages discussion and collaboration among students during the training. This approach is beneficial for students who benefit from structured activities and social support in a group learning environment. However, it can be time-consuming, costly, and may not be suitable for every student.

In self-directed learning, the responsibility for learning lies entirely with the student. Students are given access to virtual patient simulations and are encouraged to work through the cases independently. This approach may be more suitable for students who are self-motivated, enjoy autonomy, and have the discipline to work independently. It also offers a cost-effective and flexible option. However, in this approach, the feedback and support needed for skill development are limited to the feedback reports generated by the computer-based virtual patient software program.

In the literature, studies on the use of virtual patient applications in paramedic students' emergency patient management training are limited. This study aims to contribute to educators who use or plan to use virtual patient simulation by comparing instructor-led virtual patient-based simulation training with self-directed virtual patient-based simulation training to determine which approach is more effective in enhancing students' critical decision-making skills.