Background: Virtual patient cases are an increasingly utilized and compelling pedagogical strategy for medical education informatics. They provide educators with the opportunity to develop richly layered, multidimensional teaching situations for their learners. However, 'virtual patients are notoriously difficult to author, adapt and exchange' (MedBiquitous Virtual Patient Specification, Virtual Patient Working Group 2007), and case creation can be daunting. Authors may be uncertain about the process of virtual patient case development and this can translate into ambiguity and hesitation.

Aims: This installment of the '12 tips' presents specific guidelines that are intended to provide medical educators with guidelines to facilitate the development of virtual patient cases.

Methods: These 12 tips are based upon comprehensive, research-based, theory-grounded and criterion-referenced guidelines and founded in pedagogical principles, theories of cognition, and recognition of current technology and availability of authoring applications.

Results: It is anticipated that the 12 tips will provide medical educators interested in authoring virtual patient cases one set of useful guidelines to facilitate the process.

Conclusions: Virtual patient cases provide medical educators with an innovative tool for medical education. These guidelines will assist authors in case development.