Immersive Virtual Characters for Educating Medical Communication Skills - PowerPoint PPT Presentation

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Immersive Virtual Characters for Educating Medical Communication Skills

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Dept of Surgical Oncology (Medical College of Georgia) ... Previous Work: Technology for Medical Communication Skills. Traditional approaches [Bearman 2003] ... – PowerPoint PPT presentation

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Title: Immersive Virtual Characters for Educating Medical Communication Skills


1
Immersive Virtual Characters for Educating
Medical Communication Skills
  • T. Bernard, C. Oxendine, D. S. Lind, P. Wagner
  • Dept of Surgical Oncology (Medical College of
    Georgia)
  • K. Johnsen, A. Raij, R. Dickerson, R. Wells, B.
    Lok
  • Dept of Comp and Info Science and Eng (College of
    Eng)
  • M. Cohen, A. Stevens
  • Dept of Surgery (College of Med)
  • J. Cendan, M. Duerson, R. Pauly
  • Dept of Community Health and Family Med (College
    of Med) R. Ferdig

2
Previous Work Technology for Medical
Communication Skills
  • Traditional approaches Bearman 2003
  • Narrative
  • Problem Solving
  • Human Patient Simulator Meurs 1997
  • Mechanical simulation
  • Motors and actuators for I/O
  • JUST VR Ponder 2002
  • Immersive approach (Stereo Projection)
  • Trains students to react to emergency situations
  • Uses human instructor to control system
  • Virtual Standardized Patient Hubal 2000
  • Commercial Desktop application by RTI
  • Speech Recognition
  • Natural Language Engine

3
Project Description
  • Simulate a standardized patient encounter
  • Allow repeated interaction with an Immersive,
    interactive virtual patient in a constrained
    scenario
  • Virtual patient, DIANA
  • Virtual instructor, VIC
  • To address issues with SPs
  • Experience diversity
  • Quality Control
  • Feedback
  • Communication skills
  • No physical diagnosis
  • Interpersonal Simulator

4
  • Play Video
  • Things to look for interaction modalities

5
System
  • Low Cost
  • lt 8,000(USD)
  • COTSComponents
  • Potential
  • Every Hospital

6
Natural Interaction Input
  • No Keyboard, No Mouse
  • Speech Recognition
  • Dragon Naturally Speaking 8 Pro
  • Accuracy 90 with 10 minutes training
  • 70 match to database
  • Track Communication Cues
  • Non-Verbal
  • Track head gaze
  • Track left hand
  • Track body lean
  • Verbal
  • Inflection
  • Jargon
  • Gesture Recognition
  • Pointing, handshake

7
Natural Interaction Output
  • DIANA and VIC look at user
  • Life-size characters
  • Animation
  • Hand gestures
  • Head movement
  • Perspective-Correct Rendering
  • Why this works
  • Does not rely on complete sentences
  • Constrained scenario
  • Students trained on specific questions

8
Eight Studies
  • 2004
  • April Project initiated
  • August Prototype (n7) UF
  • October Experts (n3) UF
  • December Pilot Test (n10) UF
  • 2005
  • June Two Institutions (n16) UF/MCG
  • July VP vs SP (n16, n8) UF/MCG
  • October Cultural Bias (n16) MCG
  • October Class Integration (n33) UF
  • n 101
  • Testing Centers
  • Harrell Center at UF
  • Medical College of Georgia
  • Diana was in Exam Room 3 (video)

9
Eight Studies
10
VP ? SP
  • How is experiencing an interpersonal scenario
    with a virtual person similar to and different
    from experiencing an interpersonal scenario
    with a real person?
  • Clearly different
  • But in what important ways?
  • Patient-doctor interview provides a constrained
    scenario
  • The study asks
  • Are post-encounter impressions similar?
  • Are empathy and other emotions and attitudes
    similarly expressed?
  • Which social constructs are followed?
  • These questions must be explored to
  • Determine the extent to which interpersonal
    scenarios can be simulated with virtual humans
  • Identify how component technologies need to
    improve to enable effective interpersonal virtual
    human systems

11
Overall Performance
  • Similar Experiences
  • Same of participants asked key questions
  • Out of 12 6.3 1.7, 5.5 2.1 (a 0.37)
  • Same of participants passed the scenario
  • SP 50, VP 36
  • But
  • Some critical items were not asked at the same
    frequency
  • Sexual activity (SP 0.88, VP 0.44)
  • Nausea (SP0.88, VP0.25)
  • Related to virtual patient expressiveness

12
Behavioral Measures
  • Empathy
  • Empathetic moment Im scared, can you help
    me?
  • Expressed the same and same of times (SP
    2.2, VP 1.3)
  • But
  • Appears less genuine (very robotic)
  • Conversation flow is rapid-fire
  • Confirmatory phrases statistically different (SP
    20, VP 3.5)

13
Lessons Learned
  • Overall experiences similar
  • Questions asked
  • Global measures
  • Education goals met
  • Students rated educational merits similarly
  • Students rated difficulty similarly
  • Global measures of realism do not work
  • Battery of specific measures more accurate
  • Practice tool in addition to SPs
  • Diana rated a 6.36(.85) on a 1 to 10 scale
    (Average is a 7.47 for real SPs)
  • VR works out of the lab

14
Papers
  • Computer Science
  • Raij,et al., Interpersonal Scenarios
    VirtualReal?, IEEE Virtual Reality 2006
  • Johnsen, et al., Evolving an Immersive Medical
    Communication Skills Trainer, Journal on
    Presence Teleoperators and Virtual Environments
  • Dickerson, et al., Virtual Patients Assessment
    of Synthesized Versus Recorded Speech, Medicine
    Meets Virtual Reality 14
  • Johnsen, et al., Experiences in Using Immersive
    Virtual Characters to Educate Medical
    Communication Skills, IEEE Virtual Reality 2005
  • Dickerson, et. al., Evaluating a Script-Based
    Approach to Simulating Patient-Doctor
    Interaction, SCS 2005 Intl Conf on HCI Adv for
    Modeling and Sim
  • Medicine
  • Stevens, et al., The Use of Virtual Patients to
    Teach Medical Students History Taking and
    Communication Skills, American Journal of
    Surgery
  • Lind and Lok, The Role of Virtual Patients in
    Medical Education Teaching Tool Versus
    Technological Trend, FOCUS on Surgical Education
  • Stevens, et al., Implementing a Virtual Patient
    into the Medical School Curriculum at the
    University of Florida, Southern Group on
    Education Affairs 2006 (pres.)
  • Cohen, et al., Do Health Professions Students
    Respond Empathetically to a Virtual Patient?,
    Southern Group on Education Affairs 2006 (pres.)
  • Bernard, et al. A Multiinstitutional Pilot Study
    to Evaluate the Use of Virtual Patients to Teach
    Health Professions Students History-Taking and
    Communication Skills, Society of Medical
    Simulation 2006
  • Stevens, et al., The Use of Virtual Patients to
    Teach Medical Communication Skills, Assoc of
    Surg Educ 2005, Southern Group on Educational
    Affairs 2005 (pres.)

15
Current Work
  • Incorporation into the classroom
  • UF Essentials of Patient Care
  • n34 students this year
  • n135 next year
  • MCG Patient Communication
  • n200 each year
  • Study
  • Real Speech vs. Synethsized Speech
  • Immersive vs. Non-immersive

16
Do people carry real world biases into the
virtual world?
17
Do people carry real world biases into the
virtual world?
18
The Use of a Virtual Scenario to Teach
Communication Skills for Geriatric Patients
19
Patient Diversity
  • Measures
  • Eye gaze
  • Body Lean
  • Vocal Inflection
  • Time
  • Interruptions
  • Do students treat different virtual patients
    similarly?

20
Communication Skills
  • Fundamental to clinical practice.
  • Patient physician satisfaction.
  • Patient understanding adherence.
  • Healthcare outcomes.
  • Malpractice litigation.
  • Learned skill experiential learning alone is
    insufficient.

21
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24
Virtual Objective Structured Exam(VOSCE)
NBME
25
Curriculum integration
26
Virtual Patient Teams
  • T. Bernard, C. Oxendine, D. S. Lind, P. Wagner
  • Dept of Surgical Oncology (Medical College of
    Georgia)
  • K. Johnsen, A. Raij, R. Dickerson, R. Wells, B.
    Lok
  • Dept of Comp and Info Science and Eng (College of
    Eng)
  • M. Cohen, A. Stevens
  • Dept of Surgery (College of Med)
  • J. Cendan, M. Duerson, R. Pauly
  • Dept of Community Health and Family Med (College
    of Med) R. Ferdig
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