Smartphone-Based Virtual Patient Training for Rural Primary Care Providers

Virtual patients (VPs) are considered cost-effective and convenient modalities for clinical education. Following prior work where a tailored smartphone-based VP demonstrated high levels of feasibility and acceptability among rural primary care physicians, investigators initiated a parallel-group, cluster randomized controlled trial in Lintao county, China. The trial aims to evaluate whether smartphone-based VP clinical training improves diagnosis and treatment competence compared with a waitlist control group.

The study protocol utilizes a partially blinded design (masking outcome assessors and data analysts). All 18 township health centers in Lintao county were allocated evenly (9 intervention, 9 control), targeting 150 physicians per arm. Primary care providers in the intervention group receive VP-delivered clinical training, requiring completion of diagnosis and treatment plans for 2 randomly assigned conditions within a 1-month intervention period with detailed feedback, alongside access to 9 optional conditions. The waitlist control group receives no VP access during the 1-month period but gains full access following the 1-month post-baseline (T1) assessment. The primary outcome is overall diagnosis and treatment competence score measured at baseline (T0) and T1, analyzed via an intention-to-treat approach.

Recruitment commenced on August 1, 2026. As of August 15, 2026, 216 physicians completed baseline evaluations, with 121 (56%) allocated to the intervention cohort and 95 (44%) to the control cohort. Recruitment is scheduled through late November 2026, with T1 follow-up starting in September 2026 and full data collection projected to conclude in January 2027.