The participants were randomly assigned into seven groups of four or five. Each group created one VH patient. Each group was provided with a profile for a patient (created by the course instructor) to create. Participants used VPF to iteratively refine the content the VH was able to discuss. The iterative refinement process was divided into three rounds of interactions. For each round, the participants interacted with their own virtual patient, and then interacted with two other team’s virtual patients. By the end of the third round, every participant interacted with everyone else’s virtual patient (six interactions), and interacted with their own virtual patient three times. Participants answered a pre-survey and post-survey at the beginning and end of the semester respectively.