Training Medical Communication Skills with Virtual Patients: Literature Review and Directions for Future Research

Virtual simulation tools for communication skills training in healthcare professionals: an integrative review of the literature (Preprint)

“…Similarly, other reviews have also concluded that the use of virtual patients for clinical communication training has grown exponentially over the last decade (Battegazzorre et al, 2021;Lee et al, 2020), which has been driven by rapid technological advances (Mendez et al, 2020), also providing further evidence of the benefits associated with this type of resource (Lee et al, 2020).…”

“…For example, in their systematic review, Kaplonyi et al (2017) reflected how simulations with the use of standardised patients are considered realistic environments and an effective means for learning communication skills. Indeed, the academic literature proposes that virtual patients can be used as a complementary alternative to work with standardised patients (Maicher, Kellen et al, 2017) and can represent patients in a realistic clinical environment (Battegazzorre et al, 2021) to effectively help students to acquire or improve their communication skills (Lee et al, 2020). Nonetheless, it will be important for future lines of research to use standardised tests to evaluate the beneficial effects of training with this type of virtual tool before fully integrating them into training plans (Lee et al, 2020;Mendez et al, 2020).…”

“…In terms of the fidelity of these tools, increasing the immersion of virtual simulationsdefined as the psychological state of the perception of being inside or surrounded by something (Witmer & Singer, 1998)-by using virtual patients with natural language processing and auditory and visual behaviour (Battegazzorre et al, 2021;Zielke et al, Apr 2017), is positively related to better communication skills performance (Battegazzorre et al, 2021;Peddle et al, 2016). However, we must not forget that realism and authenticity, which are both relevant factors in design, are not only achieved through physical resemblance (physical fidelity) but rather, also require other fidelity factors (Peddle et al, 2016).…”

Creating authentic and effective practice scenarios for digital simulation-based conversation training

“…The sequence of conversational turns follows a protocol appropriate to the type of conversation the learner wants to practice (e.g., a bad news conversation or a negotiation). In most simulation environments, the practice conversation unfolds according to a predetermined script: in each turn, the learner chooses one utterance from a limited number of options, and the response of the virtual character depends on the option chosen by the leaner (Battegazzorre et al, 2020). The fact that the communicative behavior of the virtual character is delineated by the use of a script is generally seen as an advantage by instructors and learners who use SBT for conversation training, as it makes the behavior of the simulated conversation partner more predictable, understandable and explainable (Lala et al, 2017).…”

“…During such trainings, learners do not engage in a conversation with a human interlocutor, but with a virtual character. A recent literature review in the field of medical communication skills (Battegazzorre et al, 2020) shows that there are several systems available that enable learners to practice conversations with virtual patients, some of which are also used for SBT in other professional domains (e.g., Jeuring et al, 2015). When it comes to the effectiveness of such systems, Lee et al (2020) point out that only 4 of the 8 comparative studies included in their literature review found significant increases in attitudes or skills for learners who engaged in practice conversations with virtual characters.…”