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Background Virtual Patients (VPs) may improve cognitive and behavioral skills better than traditional methods do. The aim of this paper was to investigate challenges faced by teachers and students in order to effectively implement VPs across undergraduate and postgraduate curricula. In addition, differences in student and teacher perceptions that could impact curricular integration of VPs were explored. Methods A two-phase descriptive study was performed: 1) evaluation of the VP design process and curricular integration, conducted upon academic medical teachers; 2) evaluation of learning and clinical reasoning experiences with VPs, from the students’ perspective. Results The results of this study document high acceptance of VPs by both medical teachers and students (n = 252).VPs seem to fulfill most needs as set by course directors, while they satisfy student needs and create perceptions of improved knowledge and clinical skills reasoning. Conclusions Medical educators have encountered educational challenges upon transforming the curriculum. To develop VPs, academic institutions have to pay equal attention to the needs of potential adopters and VP authors. Strategic development and use of VPs may motivate more widespread integration of VPs and lead to a high quality medical education system.

Background: Since their inception, virtual patients have provided health care educators with a way to engage learners in an experience simulating the clinician’s environment without danger to learners and patients. This has led this learning modality to be accepted as an essential component of medical education. With the advent of the visually and audio-rich 3-dimensional multi-user virtual environment (MUVE), a new deployment platform has emerged for educational content. Immersive, highly interactive, multimedia-rich, MUVEs that seamlessly foster collaboration provide a new hotbed for the deployment of medical education content. Objective: This work aims to assess the suitability of the Second Life MUVE as a virtual patient deployment platform for undergraduate dental education, and to explore the requirements and specifications needed to meaningfully repurpose Web-based virtual patients in MUVEs. Methods: Through the scripting capabilities and available art assets in Second Life, we repurposed an existing Web-based periodontology virtual patient into Second Life. Through a series of point-and-click interactions and multiple-choice queries, the user experienced a specific periodontology case and was asked to provide the optimal responses for each of the challenges of the case. A focus group of 9 undergraduate dentistry students experienced both the Web-based and the Second Life version of this virtual patient. The group convened 3 times and discussed relevant issues such as the group’s computer literacy, the assessment of Second Life as a virtual patient deployment platform, and compared the Web-based and MUVE-deployed virtual patients. Results: A comparison between the Web-based and the Second Life virtual patient revealed the inherent advantages of the more experiential and immersive Second Life virtual environment. However, several challenges for the successful repurposing of virtual patients from the Web to the MUVE were identified. The identified challenges for repurposing of Web virtual patients to the MUVE platform from the focus group study were (1) increased case complexity to facilitate the user’s gaming preconception in a MUVE, (2) necessity to decrease textual narration and provide the pertinent information in a more immersive sensory way, and (3) requirement to allow the user to actuate the solutions of problems instead of describing them through narration. Conclusions: For a successful systematic repurposing effort of virtual patients to MUVEs such as Second Life, the best practices of experiential and immersive game design should be organically incorporated in the repurposing workflow (automated or not). These findings are pivotal in an era in which open educational content is transferred to and shared among users, learners, and educators of various open repositories/environments. [J Med Internet Res 2014;16(6):e151]