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JMIR Med Educ. 2018 Nov 6;4(2):e10088. doi: 10.2196/10088.

Improving Shared Decision Making Between Patients and Clinicians: Design and Development of a Virtual Patient Simulation Tool.

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School of Pharmacy, Keele University, Keele, United Kingdom.
Contributed equally



Shared decision making (SDM) involves the formation of a collaborative partnership between the patient and clinician combining both of their expertise in order to benefit decision making. In order for clinicians to be able to carry out this skilled task, they require practice. Virtual reality, in the form of a virtual patient, could offer a potential method of facilitating this.


The objective of this study was to create a virtual patient that simulated a primary care consultation, affording the opportunity to practice SDM. A second aim was to involve patients in the design of a virtual patient simulation and report the process of the design.


We employed a multistep design process drawing on patient and expert involvement.


A virtual patient, following a narrative style, was built, which allows a user to practice and receive feedback; both clinical and communication skills are required for the simulation. The patient group provided multiple insights, which the academic team had overlooked. They pertained mostly to issues concerning the patient experience.


It is possible to design a virtual patient that allows a learner to practice their ability to conduct SDM. Patient input into the design of virtual patient simulations can be a worthwhile activity.


clinical decision making; education; medical education; mobile phone; pharmacy education; virtual patient; virtual reality

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