Effect of Online Training Modules and Virtual Patients on First-Year Physician Assistant Students' Confidence Levels.

Purpose: Pilot study assessing impact of virtual patients (VPs) and online modules on first-year physician assistant (PA) student confidence in documentation performance.

Methods: Five VP cases (head, eyes, ears, nose, and throat; musculoskeletal; abdominal; neurological; and comprehensive history and physical examination) and one module (cardiac sounds) were implemented to complement the core PA curriculum.

Results: A VP-based protocol significantly improved student confidence for taking a history, performing a physical examination, and undertaking clinical reasoning as well as providing overall documentation confidence. These 3 subscales explain nearly half (49%) of overall pretraining confidence, increasing to nearly two-thirds (63%) of overall posttraining confidence. Stepwise regression finds confidence in clinical reasoning to be the only unique predictor of overall pretraining confidence. In contrast, confidence in history taking and physical exams uniquely predicts overall posttraining confidence.

Conclusions: Virtual patient cases and online modules help improve overall and dimension-specific documentation confidence, with different dimensions driving overall confidence pre- and posttraining. Implications for job efficacy are discussed.