The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics - A Study of Medical Ethics Using Immersive Virtual Reality

Abstract

BackgroundDealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner’s daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor’s response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas.ExperimentTwelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously.ResultsEight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants’ level of presence (together with participants’ feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening.

The Plausibility of a String Quartet Performance in Virtual Reality

“…In the final version of the scenario the bar was made to look like a bar that would be attended by soccer fans. As another example, in [46] the participants were medical doctors who were confronted by virtual patients who inappropriately demanded antibiotics. The doctors complained that in reality their desk would always equipped with a computer screen displaying the medical record of the patient.…”

A Study of Professional Awareness Using Immersive Virtual Reality: The Responses of General Practitioners to Child Safeguarding Concerns

“…Video link: http://www.panxueni.com/gpcave Our previous work used the HMD system where participants (i.e., GPs or trainee GPs) were fully immersed in the virtual interactions with a head-mounted display (Pan et al, 2016). Many participants commented that they found not having access to a computer made the experience less real, as they always relied on a computer during their real-life consultations.…”

Creating Virtual Characters

“…In front of them they could see an audience composed of a small number of animated virtual characters. [14], the London underground [2], the Milgram recreation [16], the virtual bar [11], the socially anxious virtual character [12] and the medical consultation [13].…”

“…Pan's recent work has investigated this possibility for training medical practitioners how to interact with patients [13]. One of the most important medical challenges at the moment is antibiotic resistance.…”

“…This tendency to prescribe is in large part due to pressure from patients. Pan et al [13] conducted an experiment in virtual reality where family doctors were in a consultation session with a virtual woman and her virtual mother who is presented as suffering from an illness that clearly should not be treated with antibiotics. However, the daughter was extremely insistent that her mother should have antibiotics.…”