The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project implemented a major shift in residency education in 2001 by moving to a competency-based format. This created a challenge for programs to develop strategies to measure and document resident performance in the core competencies. An often-used approach has been direct observation of residents and the use of standardized patients. We explored the use of a virtual patient (VP) to augment our assessment of resident skills. The variety of VP programs is vast; many are used to practice medical procedures, fewer for practicing interviewing and diagnostic skills. VP technology ranges from showing images and texts on a computer screen to having a patient-image projected on a screen, with some programs accepting oral questions from the learner, recognizing key words in the question, and then producing a verbal answer. Also, some programs use video and audio clips, including heart sounds, MRIs, and X-rays.
