Virtual patient clinical placements improve student communication competence

Abstract

Virtual patient clinical placements improve student communication competence Effective communication is a generic competency essential to clinical practice. However, access to work-integrated placements where such competencies are traditionally developed is diminishing, compelling universities to develop supplementary placement opportunities in the form of simulated learning environments (SLE). Virtual or digital patient (VP) placements are an attractive SLE model, but evidence of their efficacy for developing student communication competence is limited. In the current study, 82 second-year undergraduate speech pathology students completed one half-day placement, requiring them to use conversation interaction skills to build rapport with a VP across two 10-minute interactions, separated by clinical educator (CE) feedback and self-reflection. Each student's interactions were rated by CEs on 25 communication competencies and, following the second interaction, students completed retrospective pre-placement and post-placement self-ratings of their communication skills, knowledge and confidence. CEs' ratings of students' performance were significantly higher following the second interaction than they were following the first (median ηp 2 = .710). Furthermore, the students' post-placement self-ratings were significantly higher than their retrospective pre-placement ratings (median dav = 1.25). These findings suggest that VP placements as simulated clinical learning opportunities support speech pathology education, and may have positive implications for all health professions.

“It’s really exciting to think where it could go”: a mixed-method investigation of clinician acceptance, barriers and enablers of virtual reality technology in communication rehabilitation

“…VR has been applied successfully as a therapeutic modality to train physical and motor skills following stroke [18][19][20][21], in children with cerebral palsy [22], and individuals with Parkinson's disease [23]. VR has also been utilised as an attention-training tool for individuals with mild cognitive impairment and dementia [24], in SLP student training [25], in the treatment of anxiety, phobia and post-traumatic stress disorder [26][27][28][29], and to reduce pain and discomfort for individuals undergoing cancer treatment and other medical procedures [30,31].…”

Embodied Virtual Patients as a Simulation-Based Framework for Training Clinician-Patient Communication Skills: An Overview of Their Use in Psychiatric and Geriatric Care

“…Among the 14 tools (17 articles) using VP simulation presented in this overview, five used simulation models (e.g., prerecorded videos associated with text-based interfaces) that do not allow for realistic human-like conversations (Carpenter et al, 2012;O'Brien et al, 2019;Shah et al, 2012;Cordar et al, 2014;Pantziaras et al, 2014Pantziaras et al, , 2015. By contrast, four tools offer immersive experiences using VPs displayed on human-sized screens and interacting in natural language (Ochs et al, 2017(Ochs et al, , 2019Dupuy et al, 2020;O'Rourke et al, 2020;Robinson et al, 2020). Note that while tools based on web interfaces or pre-recorded videos may lack realism and fluidity, tools based on natural language and speech recognition, are rarely fully autonomous and currently require the intervention of a human WoZ operator.…”

“…Interestingly, a few studies propose a follow-up of learners' knowledge several weeks after the interaction (Pantziaras et al, 2015) or an assessment of the transferability of the training to clinical practice (Liaw et al, 2020). By contrast, it was pointed out that an aspect seldom assessed was the learner's verbal (except, Parsons et al, 2008;Kenny et al, 2009a,b;Pantziaras et al, 2014Pantziaras et al, , 2015Dupuy et al, 2020) andnon-verbal (except, Dupuy et al, 2020;O'Rourke et al, 2020;Liaw et al, 2020;Robinson et al, 2020) behaviors. Non-verbal behaviors play a crucial role in clinician-patient relationships (Henry et al, 2012).…”

“…Interestingly, a study by Robinson et al (2020) focused specifically on training communication skills of 82 speech pathology students in realistic conversations with an elderly VP with behavioral symptoms of dementia and resident of a nursing home (for a full description of the tool, see Quail et al, 2016). The 15-min interaction was based on a predetermined scenario of verbal (e.g., comprehension difficulties, word search, confusion) and non-verbal (e.g., crying, shrugging, chuckling) responses that were representative of dementia.…”

Conception des Interactions avec un Patient Virtuel Alzheimer pour la Formation du Personnel Soignant

“…Malgré la prise en compte des comportements non-verbaux de l'utilisateur, les réponses et réactions sont également produites en suivant un ensemble de situations déterminées à l'avance. En ce qui concerne les patients virtuels Alzheimer, à notre connaissance, il n'existe à l'heure actuelle qu'un seul système permettant à un agent virtuel de simuler les comportements associés à cette pathologie, cependant ceux-ci ne sont pas automatiquement générés et sont encore contrôlés en partie par un expérimentateur humain [35]. Ce système a pour but de former des apprenants soignants à l'utilisation et à l'interprétation du comportement nonverbal face à ce type de patient.…”