Ensuring Knowledge Transfer: The Critical Role of “What-If” Discussions in Virtual Patient Simulation
References
- Kim S, Phillips WR, Pinsky L, Brock D, Phillips K, Keary J. A conceptual framework for developing teaching cases: a review and synthesis of the literature across disciplines. Medical education. 2006;40(9):867–876. DOI: 10.1111/j.1365-2929.2006.02544.x
- Bearman M, Cesnik B, Liddell M. Random comparison of ‘virtual patient’ models in the context of teaching clinical communication skills. Medical education. 2001;35(9):824–832. DOI: 10.1046/j.1365-2923.2001.00999.x
- Tolsgaard MG, Jepsen RM, Rasmussen MB, Kayser L, Fors U, Laursen LC, et al. The effect of constructing versus solving virtual patient cases on transfer of learning: a randomized trial. Perspectives on medical education. 2016;5:33–38. DOI: 10.1007/S40037-015-0242-4
- Van Merriënboer JJ, Kirschner PA. Ten steps to complex learning: A systematic approach to four-component instructional design. Routledge; 2017. DOI: 10.4324/9781315113210
- Masoomi R, Shariati M, Labaf A, Mirzazadeh A. Transfer of learning from simulated setting to the clinical setting: identifying instructional design features. Medical Journal of the Islamic Republic of Iran. 2021;35:90. DOI: 10.47176/mjiri.35.90
- Richmond A, Cooper N, Gay S, Atiomo W, Patel R. The student is key: a realist review of educational interventions to develop analytical and non-analytical clinical reasoning ability. Medical education. 2020;54(8):709–719. DOI: 10.1111/medu.14137
- Perkins DN, Salomon G. Transfer of learning. International encyclopedia of education. 1992;2:6452–6457.
- Eva KW. What every teacher needs to know about clinical reasoning. Medical education. 2005;39(1):98–106. DOI: 10.1111/j.1365-2929.2004.01972.x
- Kassai R, Futo J, Demetrovics Z, Takacs ZK. A meta-analysis of the experimental evidence on the near-and far-transfer effects among children’s executive function skills. Psychological Bulletin. 2019;145(2):165. DOI: 10.1037/bul0000180
- Melby-Lervåg M, Hulme C. Is working memory training effective? A meta-analytic review. Developmental psychology. 2013;49(2):270. DOI: 10.1037/a0028228
- Nokes TJ. Mechanisms of knowledge transfer. Thinking & reasoning. 2009;15(1):1–36. DOI: 10.1080/13546780802490186
- Hajian S. Transfer of learning and teaching: A review of transfer theories and effective instructional practices. IAFOR Journal of education. 2019;7(1):93–111. DOI: 10.22492/ije.7.1.06
- Schmid U, Wirth J, Polkehn K. A closer look at structural similarity in analogical transfer. Cognitive Science Quarterly. 2003;3(1):57–89.
- Winn W. Learning in artificial environments: Embodiment, embeddedness and dynamic adaptation. Technology, Instruction, Cognition and Learning. 2003;1(1):87–114.
- Eva KW, Neville AJ, Norman GR. Exploring the etiology of content specificity: factors influencing analogic transfer and problem solving. Academic Medicine. 1998;73(10):S1–S5. DOI: 10.1097/00001888-199810000-00028
- Botezatu M, Hult H, Fors UG. Virtual patient simulation: what do students make of it? A focus group study. BMC medical education. 2010;10:1–8. DOI: 10.1186/1472-6920-10-91
- Ellaway RH. Virtual patients as activities: exploring the research implications of an activity theoretical stance. Perspectives on Medical Education. 2014;3(4):266–277. DOI: 10.1007/S40037-014-0134-Z
- Li Z, Asoodar M, de Jong N, Keulers T, Liu X, Dolmans D. Perception of enhanced learning in medicine through integrating of virtual patients: an exploratory study on knowledge acquisition and transfer. BMC Medical Education. 2024;24(1):647. DOI: 10.1186/s12909-024-05624-7
- Dubé V, Ducharme F. Reflective practice among nurses working in a teaching hospital: An action research with promising benefits for professional development. Journal of Nursing education and practice. 2014;4(8):9. DOI: 10.5430/jnep.v4n8p9
- Trickett SB, Trafton JG. “What if…”: The use of conceptual simulations in scientific reasoning. Cognitive Science. 2007;31(5):843–875. DOI: 10.1080/03640210701530771
- Tan E, Ng WM, Soh PC, Tan D, Cleland J. ‘But what if you miss something …?’: factors that influence medical student consideration of cost in decision making. BMC Medical Education. 2023;23(1):437. DOI: 10.1186/s12909-023-04349-3
- Chamberland M, Mamede S, Bergeron L, Varpio L. A layered analysis of self-explanation and structured reflection to support clinical reasoning in medical students. Perspectives on medical education. 2021;10(3):171–179. DOI: 10.1007/S40037-020-00603-2
- Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of chiropractic medicine. 2016;15(2):155–163. DOI: 10.1016/j.jcm.2016.02.012
- Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006;3(2):77–101. DOI: 10.1191/1478088706qp063oa
DOI: https://doi.org/10.5334/pme.2363 | Journal eISSN: 2212-277X
Language: English
Page range: 633 - 643
Submitted on: Dec 19, 2025
Accepted on: Apr 29, 2026
Published on: Aug 5, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
© 2026 Zhien Li, Maryam Asoodar, Tom Keulers, Desirée Joosten-ten Brinke, Diana Dolmans, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.