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.
We have created You, M.D., an interactive museum exhibit in which users learn about topics in public health literacy while interacting with virtual humans. You, M.D. is equipped with a weight sensor, a height sensor and a Microsoft Kinect that gather basic user information. Conceptually, You, M.D. could use this user information to dynamically select the appearance of the virtual humans in the interaction attempting to improve learning outcomes and user perception for each particular user. For this concept to be possible, a better understanding of how different elements of the visual appearance of a virtual human affects user perceptions is required. In this paper, we present the results of an initial user study with a large sample size (n =333) ran using You, M.D. The study measured users reactions based on the users gender and body-mass index (BMI) when facing virtual humans with BMI either concordant or discordant from the users BMI. The results of the study indicate that concordance between the users BMI and the virtual humans BMI affects male and female users differently. The results also show that female users rate virtual humans as more knowledgeable than male users rate the same virtual humans.
A reflective practicum is a low-pressure, low-risk learning environment. In a reflective practicum a learner is educated in a professional practice and how to use reflection in the setting of that professional practice. An example of a low-pressure and low-risk learning environment is the use of embodied conversational agents (ECAs) in medicine to provide training for interviewing and diagnostic skills. However, such ECA experiences have not been used to teach how to use reflection in the setting of a professional practice. In this paper we present a framework that supports explicit reflective learning for ECA experiences. Using this framework, ECA experiences become a reflective practicum.This framework was applied to an ECA experience called the Neurological Examination Rehearsal Virtual Environment (NERVE), and created a sample experience called the NERVE Reflective Practicum (NERVE-RP). We conducted a user study in which second-year medical students (n = 76) used NERVE-RP and engaged in reflection based on the experience. The results of the user study show that students engage in valuable reflections during the experience including instances of critical reflection.
Abstract:Design-based research examines the role of theory in informing design, and the role of design in advancing theory. During the last year of a five-year NIH grant, a team of physicians, software engineers, and instructional designers at three public universities completed a series of iterative design studies to produce the first public release of NERVE-A virtual patient (VP) simulation created to give medical students standardized experiences in interviewing, examining, and diagnosing patients with cranial nerve disorders. The last year of the project, including the results of two cycles of expert reviews, one-to-one and small group evaluations, and a field test with 119 second-year medical students are reported by Hirumi et al. (2016aHirumi et al. ( , 2016b. This article augments the previous papers by examining the pedagogical foundations of NERVE in greater depth. Specifically, we detail how the InterPLAY instructional theory was applied to design NERVE, and how the development and testing of NERVE lead to advancements in InterPLAY during the last year of research and development.
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