Time Capsule Medicine: A Mixed-Methods Pilot Study on Immersive Simulation for Chronic Disease Education in Medical Students

Abstract

Background: Chronic diseases require long-term and multidimensional care, but traditional medical education has emphasised acute care and episodic interventions. This gap limits the understanding of future clinicians about the complexity of managing chronic conditions over decades. This mix-methods quantitative-qualitative pilot study describes "Time Capsule Medicine", an innovative educational framework in which medical students acted out the progressive challenges that patients with chronic illnesses might face over a continuous period of 20 years. This paper aims to report the outcomes of this innovative educational technique. Methods: Thirty final-year medical students were engaged in the three-phase programme which included preparation, immersive simulation, and reflection and evaluation. The preparation consisted of online workshops in chronic disease progression, age-related changes, and continuity of care, while the immersive simulation featured appropriate role-play exercises in small groups that simulated the chronic disease process across four five-year increments. The reflection and evaluation consisted of debriefing sessions and reflective journals, while pre- and post-simulation questionnaires tested learning outcomes. The physical constraints included weighted garments with visual impairments simulating the age-related limitations. Results: A gender- and ethnically diverse cohort of thirty final-year medical students from three medical schools in North London participated in the programme. The simulation significantly enhanced students' confidence in managing long-term disease trajectories (pre-simulation score: 2.8 ± 0.9; post-simulation score: 4.3 ± 0.6; p < 0.01) and understanding of age-related challenges (from 3.1 ± 1.0 to 4.5 ± 0.5; p < 0.01). Empathy scores increased from 3.0 ± 0.9 to 4.7 ± 0.5 p < 0.01. The qualitative analysis showed an increased appreciation of the continuity of care, recognition of systemic barriers, and insights into the emotional burdens of chronic conditions. For many students, the simulation was transformative, changing the way they approached holistic, patient-centred care. Conclusions: This experiential learning approach has succeeded in effectively addressing one of the most important gaps known in traditional medical education in developing empathy, understanding, and confidence in the long-term management of chronic diseases. The integration of similar simulations into medical curricula may adequately arm future clinicians with the complexities of continuity of care and patient management. Further studies need to be performed exploring scalability and its impact on long-term clinical practice.

Keywords: chronic disease; continuity of patient care; educational measurement; empathy; medical education; simulation training.

Figure 1

This figure outlines the structured phases of the study, demonstrating the integration of quantitative and qualitative methodologies.

Figure 2

The development of confidence, empathy, and understanding across simulation phases. This figure highlights the progression of medical students’ confidence, empathy, and understanding of chronic disease management as they move through the four simulation phases. The gradual increase in scores reflects the effectiveness of the immersive learning experience, demonstrating how the exposure to simulated patient challenges enhances both clinical competence and emotional insight. The data underscore the importance of experiential learning in preparing future clinicians for long-term, patient-centred care.

Figure 3

A comparative heatmap of simulated task difficulties across phases. This heatmap visualises the increasing difficulty of managing medications, navigating appointments, and balancing daily activities across the four simulation phases. Darker colours indicate greater challenges, emphasising the progressive nature of chronic disease impacts on daily life. The visualisation underscores the compounding burdens faced by patients, aligning with the experiential learning outcomes highlighted in this study.

Figure 4

A weighted thematic network of chronic disease management: the prevalence and interconnections. This diagram illustrates the relationships between key themes identified in this study, with node sizes reflecting the prevalence of each theme in student reflections and edge thickness denoting the strength of connections between them. Larger nodes, such as “Empathy for Challenges” and “Continuity of Care”, indicate their central importance, while stronger edges highlight critical interdependencies, such as between “Barriers to Care” and “Continuity of Care”. This visualisation underscores the multifaceted and interconnected nature of managing chronic diseases effectively.