• clinical clerkship;
  • computer-assisted instruction;
  • randomized controlled trials;
  • user–computer interface

Background:  This study aims to clarify the effects of implementing a series of virtual patients in undergraduate surgery education on various dimensions of skills as applied to clinical problems.

Methods:  In a randomized controlled trial 48 surgery clerks were assigned to an intervention group who worked on 14 simulated cases of abdominal pain during 7 weeks in a computer lab and a control group without access to software. At the end of the intervention, both groups were tested by a structured, seven-part paper-based exam evaluating certain areas of competence.

Results:  Forty-five students took the exam. Results showed a significant improvement in history taking (P < 0.001) and no improvement in scores related to appropriate use of radiology and lab tests, proposing differential diagnoses and management plans and factual knowledge. From the intervention group, 20 students completed a virtual case exam whose results had a poor correlation with the written exam.

Conclusion:  Overall, our findings indicate that virtual patients are strong tools in enhancing history-taking skills of students, but they do not affect other areas of competence significantly. Educators are recommended to be sceptical about enthusiastic reports on various computer applications and avoid falling into false expectations of their implementation.