High-fidelity virtual patients afford unlimited opportunity for practice in a virtual clinical setting and present multiple design challenges for developers of game-based simulations. Virtual patients allow students the opportunity to experience varied medical conditions as well as interact with patients with wide-ranging socio-economic and cultural factors. Practice with virtual patients also can improve both the accuracy and speed of cognitive, behavioral and psychomotor tasks. Virtual patients can be designed and adapted to simulate high-risk, low-incidence variations of medical conditions as well as altered to reflect regional, social, economic, behavioral and cultural factors. As opposed to simulations that use physical clinical settings and high-fidelity simulators, virtual-patient simulations provide ubiquitous, asynchronous learning and practice opportunities. Game-based simulations can provide instantaneous assessment and debriefing, both individually and in group settings. For these reasons, there is a growing interest in virtual patients for a broad range of applications, including academic, professional and military.

While the technology is promising, the design challenges for virtual patients simulations, however, are numerous and evolving. For example, the visual and auditory fidelity of patient simulations demands precision derived from a broad range of available medical data. This paper explores the complexities of designing virtual patients that incorporate a multitude of patient factors and uses as a reference a current virtual patient simulation developed for the University of Texas at Arlington College of Nursing and a metropolitan free-standing hospital.