On-screen simulations of clinical settings have been used for educational purposes since the 1970s. Despite this, it is only now that these 'virtual patients' are increasingly forming a part of the medical education mainstream. Enabling factors for these changes include a requirement for more assured clinical encounters, changes in patient availability ( in particular, in tertiary contexts), diminishing technical and cost barriers and ongoing changes in educational practices as a whole. This special edition of Medical Teacher presents a number of papers covering key factors in the development, use and evaluation of virtual patients in contemporary medical education practice.