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Interactive Clinical Avatar Use in Pharmacist Preregistration Training: Design and Review

Thompson, Jessica; White, Simon; Chapman, Stephen

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Jessica Thompson

Stephen Chapman


Background: Virtual patients are interactive computer-based simulations which are being increasingly used in modern healthcare education. They have been identified as tools that can provide experiential learning and assessment in a standardised and safe environment. However, the study of high fidelity virtual patients, such as interactive clinical avatars, within pharmacy is limited.
Objectives: The aim of this paper is to describe the design and review of three interactive clinical avatar (ICA) simulations as part of pharmacist pre-registration training.
Methods: A multistep design approach was taken to create three interactive clinical avatar simulations on the topics of: (1) emergency hormonal contraception (EHC), (2) calculation of renal function and (3) childhood illnesses. All case studies were reviewed by registered pharmacists to establish content and face validity. The EHC case study and data collection questionnaire were also reviewed by a purposive sample of pre-registration trainees and newly-qualified pharmacists. The questionnaire utilised Likert ranking statements and open-ended questions to obtain users’ feedback
on the design, usability and usefulness of the ICAs as learning tools. Descriptive statistics and content analysis were undertaken on the data.
Results: Ten pre-registration trainees and newly-qualified pharmacists reviewed the EHC ICA and data collection questionnaire. The data collection questionnaire was associated with a high Cronbach’s a score (0.95) demonstrating good reliability. All three ICA simulations were reported as usable and appropriately designed for pre-registration training. Users perceived they were developing skills and knowledge from the simulations. The high-fidelity nature of the avatars and the relevance of the simulations to real-life practice were reported as aspects that encouraged the application of theory to practice. Improvements were suggested to ensure the simulations were more user-friendly.
Conclusions: The design and creation of the three interactive clinical avatar simulations was successful. The multistep review process ensured validity and reliability of the simulations and data collection questionnaire. The in-depth explanation of the design process and the provision of a questionnaire may help widen the usage and evaluation of ICAs, or other simulation tools, in pharmacy education. The ICAs were reported as novel learning tools which promoted experiential
learning and allowed users to feel like they were engaging in real-life scenarios, thus developing transferable knowledge and skills. This may be potentially beneficial for many healthcare training courses as a way to provide standardised experiences which promote active learning and reflection.


Thompson, J., White, S., & Chapman, S. (2020). Interactive Clinical Avatar Use in Pharmacist Preregistration Training: Design and Review. Journal of Medical Internet Research, 22(11), Article e17146.

Journal Article Type Article
Acceptance Date Sep 22, 2020
Publication Date Nov 6, 2020
Publicly Available Date May 26, 2023
Journal Journal of Medical Internet Research
Print ISSN 1438-8871
Publisher JMIR Publications
Peer Reviewed Peer Reviewed
Volume 22
Issue 11
Article Number e17146
Keywords virtual patient, high-fidelity simulation training, patient simulation, pharmacy education, pharmacy practice education, virtual reality
Public URL
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