What do speech pathology students gain from virtual patient interviewing? A WHO International Classification of Functioning Disability and Health (ICF) analysis.

Background: Virtual patients have an established place in medical education but do virtual patient interviews train holistic clinicians or just diagnosticians? This study explored speech pathology students' virtual patient interviews using WHO International Classification of Functioning Disability and Health (ICF).
Methods: Eighteen speech pathology students in their final year of training participated. Students interviewed virtual patients with dysphagia (swallowing difficulties) as part of their curriculum. Student questions and patient responses were coded using established ICF coding. Codes were tallied and compared under categories of body structures, body functions, activities/participation and environmental factors. Flesch Reading Ease was calculated as a measure of health literacy.
Results: Conversational turns primarily focused on the ICF component-activity and participation in both student questions and virtual patient responses: 0.03% body structures, 30% body functions-swallowing, 7% body functions-associated, 43% activities/participation and 19% environmental factors. Personal factors such as gender, ethnicity, age or socio-economic situation were not mentioned by student or patient. Patients commented on social impact on self and/or family, sometimes in the absence of targeted student questions. Student and virtual patient Flesch Reading Ease scores were congruent.
Conclusion: Speech pathology students naturally matched their virtual patient's health-literacy level and asked a range of medical and daily living questions. Virtual patients readily offered social impact information to student questions. Computer science: healthcare teams should consider creating virtual patients who challenge students to practise asking sensitive questions and in doing so develop holistic thinkers with competent communication skills. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.