The Use of Virtual Standardized Patients for Practice in High Value Care

Bond, William F.; Mischler, Matthew; Lynch, Teresa; Ebert-Allen, Rebecca; Mou, Kyle M; Aiyer, Meenakshy; Park, Yoon Soo

doi:10.1097/sih.0000000000000659

Cited by 5 publications

(4 citation statements)

References 44 publications

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“…A recent study by Bond et al 11 studied the use of VSPs for practice in high value care. The authors implemented and created VSPs as an additional opportunity for deliberate practice in novice learners.…”

Section: Discussionmentioning

confidence: 99%

Impact of AI Virtual Standardized Patients (AI-VSP) on performance in a Clinical Skills Examination

Liu,

Martin,

Belousov

et al. 2023

Preprint

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Background: The importance of deliberate practice and feedback to promote transfer of learning is well established. Virtual Standardized Patients (VSPs) are an emerging modality designed to more realistically simulate patient encounter sections (versus traditional e-learning), while providing automatically generated feedback to the learner. This study aims to evaluate the effectiveness of VSPs on the performance of third year medical students in a clinical skills examination. Methods: The study was a post-test design with volunteer third-year medical students from a medical school in a large, urban, metropolitan area in Los Angeles, California. The entire class of medical students was given access to a virtual standardized patient from “Recourse AI” (AI-VSP) and their performance on subsequent clinical examinations (CSEs) was measured. A formative CSE was followed by a summative one three months later. Students were allowed to interact as many times with the AI-VSP as they desired, and received automatically generated feedback from the system. The AI-VSP presented with a chief complaint similar to that presented by a standardized patient (SP) in the clinical exams. We hypothesized that students who utilized the AI-VSP would perform better on that particular case, than those who did not. T-tests were used for statistical analysis. Results: Students who interacted with the AI-VSP before the formative CSE achieved significantly higher scores for the History section in the first clinical examination, when presented with a SP case with a similar chief complaint (p = 0.001). Those students who interacted with an AI-VSP more than once performed better than those who interacted only once. (p = 0.005). Scores on the summative CSE three months after the interaction showed that the history scores were still slightly higher for those who had interacted at least once with AI-VSP, although there was no longer a significant difference. Conclusions: The use of the AI-VSP showed a statistically significant improvement in history-taking skills as measured in a subsequent CSE. The improvement was not as significant in another exam three months later, underscoring the need for repetition and deliberate practice to maintain clinical skills, and maybe an estimation of the time interval required for repetition.

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Section: Discussionmentioning

confidence: 99%

Impact of AI Virtual Standardized Patients (AI-VSP) on performance in a Clinical Skills Examination

Liu,

Martin,

Belousov

et al. 2023

Preprint

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“…During the COVID-19 pandemic, the education of medical students became hindered due to limited social interactions. Medical schools began utilizing virtual standardized patient encounters to mimic telehealth experiences in clinical practice to provide a different educational modality [ 14 ]. This allowed students to still have methods of practicing clinical skills while maintaining social distancing.…”

Section: Discussionmentioning

confidence: 99%

The Use of Mock Standardized/Simulated Patient Encounters in Facilitating Development of Clinical Competence in Medical Students

Tran¹,

Thomas²,

Haverkamp³

et al. 2023

Cureus

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Background Standardized patient (SP) encounters are used in medical school to mimic clinical practice by exposing students to possible clinical situations they may encounter in future practice. SP includes trained individuals who portray the roles of patients to help medical students practice recording medical histories, physical exam skills, communication skills, and typing a subjective, objective, assessment and plan (SOAP) note. The goal of SP is to prepare medical students adequately during their didactic years before beginning clerkships. SP encounters have become standard in medical school curriculums, but the option for a mock SP encounter has not. Methods In this study, a total of 34 participants completed an eight-question survey before a mock SP experience and after their graded SP encounters to assess the students' confidence levels and preparedness. Each question addressed a different aspect of the student’s satisfaction and attitude regarding the SP encounters. The answers were measured on a Likert scale from 1 (not prepared) to 5 (very prepared). The central tendency (mean) was analyzed using a T-test with Welch's method. The standard deviation was analyzed using Bonett's test. A Cronbach’s alpha was used to show the reliability of the survey used. Results The first four questions addressed the student’s satisfaction with their mock SP experience. The mean student satisfaction with being able to ask questions to improve their knowledge and understanding improved, with a p-value of < 0.001. Student satisfaction with having the opportunity to record a patient’s history improved, with a p-value of < 0.001. The overall satisfaction with having a chance to practice physical exam skills improved, with a p-value of < 0.001. Mean student satisfaction with practicing treatment and counseling of patients improved, with a p-value of <0.001. The final four questions addressed the students' attitudes regarding their experience. The mean confidence of students improved, with a p-value of <0.001. Students also reported an improved attitude towards the feedback they received, with a p-value of <0.001. The final two questions did not show a statistically significant difference in answers. Students rated the final two questions equally before and after the mock SP experience, with p-values > 0.05. These questions addressed whether mock SP encounters would be beneficial and asked if they wanted additional mock simulation opportunities built into the curriculum. Conclusions The students showed improved confidence, attitudes, and satisfaction surrounding standardized patient encounters. The results supported the hypothesis that there would be a difference between the responses before and after the SP encounter. The questionnaire showed that the students reported subjective changes in their competence following the encounter.

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“…Often, studies have shown how hard it is to make valid, direct comparisons between AI-driven VPs and human SPS. For example, in one study [ 39 ] that used a randomized crossover design, medical students were taught about the delivery of high-value care to both kinds of patients. The investigators found that working with VPs seemed to preferentially enhance students’ skills for interviewing and delivering treatment.…”

Section: Reviewmentioning

confidence: 99%

Artificial Intelligence and Healthcare Simulation: The Shifting Landscape of Medical Education

Hamilton

2024

Cureus

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The impact of artificial intelligence (AI) will be felt not only in the arena of patient care and deliverable therapies but will also be uniquely disruptive in medical education and healthcare simulation (HCS), in particular. As HCS is intertwined with computer technology, it offers opportunities for rapid scalability with AI and, therefore, will be the most practical place to test new AI applications. This will ensure the acquisition of AI literacy for graduates from the country's various healthcare professional schools. Artificial intelligence has proven to be a useful adjunct in developing interprofessional education and team and leadership skills assessments. Outcome-driven medical simulation has been extensively used to train students in imagecentric disciplines such as radiology, ultrasound, echocardiography, and pathology. Allowing students and trainees in healthcare to first apply diagnostic decision support systems (DDSS) under simulated conditions leads to improved diagnostic accuracy, enhanced communication with patients, safer triage decisions, and improved outcomes from rapid response teams. However, the issue of bias, hallucinations, and the uncertainty of emergent properties may undermine the faith of healthcare professionals as they see AI systems deployed in the clinical setting and participating in diagnostic judgments. Also, the demands of ensuring AI literacy in our healthcare professional curricula will place burdens on simulation assets and faculty to adapt to a rapidly changing technological landscape. Nevertheless, the introduction of AI will place increased emphasis on virtual reality platforms, thereby improving the availability of self-directed learning and making it available 24/7, along with uniquely personalized evaluations and customized coaching. Yet, caution must be exercised concerning AI, especially as society's earlier, delayed, and muted responses to the inherent dangers of social media raise serious questions about whether the American government and its citizenry can anticipate the security and privacy guardrails that need to be in place to protect our healthcare practitioners, medical students, and patients.

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The Use of Virtual Standardized Patients for Practice in High Value Care

Cited by 5 publications

References 44 publications

Impact of AI Virtual Standardized Patients (AI-VSP) on performance in a Clinical Skills Examination

Impact of AI Virtual Standardized Patients (AI-VSP) on performance in a Clinical Skills Examination

The Use of Mock Standardized/Simulated Patient Encounters in Facilitating Development of Clinical Competence in Medical Students

Artificial Intelligence and Healthcare Simulation: The Shifting Landscape of Medical Education

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