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While the use of virtual characters in medical education is becoming more and more commonplace, an understanding of the role they can play in empathetic communication skills training is still lacking. This paper presents a study aimed at building this understanding by determining if students can respond to a virtual patient's statement of concern with an empathetic response. A user study was conducted at the [blinded] College of Medicine in which early stage medical students interacted with virtual patients in one session and real humans trained to portray real patients (i.e., standardized patients) in a separate session about a week apart. During the interactions, the virtual and ‘real' patients presented the students with empathetic opportunities which were later rated by outside observers. The results of pairwise comparisons indicate that empathetic responses made to virtual patients were rated as significantly more empathetic than responses made to standardized patients. Even though virtual patients may be perceived as artificial, the educational benefit of employing them for training medical students' empathetic communications skills is that virtual patients offer a low pressure interaction which allows students to reflect on their responses.

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Abstract-We describe a between-subjects experiment that compared four different methods of travel and their effect on cognition and paths taken in an immersive virtual environment (IVE). Participants answered a set of questions based on Crook's condensation of Bloom's taxonomy that assessed their cognition of the IVE with respect to knowledge, understanding and application, and higher mental processes. Participants also drew a sketch map of the IVE and the objects within it. The users' sense of presence was measured using the Steed-Usoh-Slater Presence Questionnaire. The participants' position and head orientation were automatically logged during their exposure to the virtual environment. These logs were later used to create visualizations of the paths taken. Path analysis, such as exploring the overlaid path visualizations and dwell data information, revealed further differences among the travel techniques. Our results suggest that, for applications where problem solving and evaluation of information is important or where opportunity to train is minimal, then having a large tracked space so that the participant can walk around the virtual environment provides benefits over common virtual travel techniques.

Our study provides proof of concept that both VP and video module approaches are feasible for teaching students to assess suicide risk, and we present evidence about the role of active learning to improve communication skills. Depending on the learning context, interviewing a VP or observation of a videotaped interview can enhance the students' suicide risk assessment proficiency in an interview with a standardized patient. An interactive VP is a plausible modality to deliver basic concepts of suicide risk assessment to medical students, can facilitate individual preferences by providing easy access and portability, and has potential generalizability to other aspects of psychiatric training.

The demonstration of patient-based cases using automated technology [virtual patients (VPs)] has been available to health science educators for a number of decades. Despite the promise of VPs as an easily accessible and moldable platform, their widespread acceptance and integration into medical curricula have been slow. Here, the authors review the technological underpinnings of VPs, summarize the literature regarding the use and limitations of VPs in the healthcare curriculum, describe novel possible applications of the technology, and propose possible directions for future work.

Any new tool introduced for education needs to be validated. We developed a virtual human experience called the Virtual Objective Structured Clinical Examination (VOSCE). In the VOSCE, a medical student examines a life-size virtual human who is presenting symptoms of an illness. The student is then graded on interview skills. As part of a medical school class requirement, thirty three second year medical students participated in a user study designed to determine the validity of the VOSCE for testing interview skills. In the study, participant performance in the VOSCE is compared to participant performance in the OSCE, an interview with a trained actor. There was a significant correlation (r(33)=.49, p<.005) between overall score in the VOSCE and overall score in the OSCE. This means that the interaction skills used with a virtual human translate to the interaction skills used with a real human. Comparing the experience of virtual human interaction to real human interaction is the critical validation step towards using virtual humans for interpersonal skills education.

Background Previous literature indicates that biases exist in pain ratings. Healthcare professionals have been found to use patient demographic cues such as sex, race, and age when making decisions about pain treatment. However, there has been little research comparing healthcare professionals’ (i.e., physicians and nurses) pain decision policies based on patient demographic cues. Methods The current study used virtual human technology to examine the impact of patients’ sex, race, and age on healthcare professionals’ pain ratings. One hundred and ninety-three healthcare professionals (nurses and physicians) participated in this online study. Results Healthcare professionals assessed virtual human patients who were male and African American to be experiencing greater pain intensity and were more willing to administer opioid analgesics to them than to their demographic counterparts. Similarly, nurses were more willing to administer opioids make treatment decisions than physicians. There was also a significant virtual human-sex by healthcare professional interaction for pain assessment and treatment decisions. The sex difference (male > female) was greater for nurses than physicians. Conclusions Results replicated findings of previous studies using virtual human patients to assess the effect of sex, race, and age in pain decision-making. In addition, healthcare professionals” pain ratings differed depending on healthcare profession. Nurses were more likely to rate pain higher and be more willing to administer opioid analgesics than were physicians. Healthcare professionals rated male and African American virtual human patients as having higher pain in most pain assessment and treatment domains compared to their demographic counterparts. Similarly the virtual human-sex difference ratings were more pronounced for nurses than physicians. Given the large number of patients seen throughout the healthcare professionals’ careers, these pain practice biases have important public health implications. This study suggests attention to the influence of patient demographic cues in pain management education is needed.