To Örebro University

Objective: To explore medical students' perceptions towards the integration of basic science into virtual patient (VP) cases and to evaluate the impact on self-perceived clinical reasoning (CR) ability.

Methods: We conducted a qualitative and explorative study involving 14 medical students during their clinical placement within rheumatology. Basic science elements were integrated into five VP scenarios using the virtual interactive case simulator. Students' perceptions were explored through the analysis of semi-structured interviews with seven students, followed by Malterud's systematic text condensation.

Results: The analysis yielded five themes: (i) appreciation of basic science knowledge, (ii) ambiguity towards basic science as an obstacle for integration, (iii) the effect of integration on self-perceived clinical reasoning, (iv) engaging design of the basic science integration, and (v) low knowledge of clinical reasoning concepts. Despite positive perceptions, students demonstrated low motivation for independent engagement in practice. The students who completed the intervention reported enhanced self-perceived CR abilities, as evidenced by more comprehensive thinking processes.

Conclusions: Basic science integration into VP cases was positively perceived and appeared to enhance self-perceived CR abilities. However, students' reluctance to independently engage posed implementation challenges. Early introduction of CR learning objectives and CR as a conceptual framework may improve motivation and provide coherence for the integration of basic science in the clinical components of medical education.