Nav: Home

Virtual humans help aspiring doctors learn empathy

April 26, 2017

ANN ARBOR, Mich. - For medical student Katie Goldrath, the first time delivering difficult health news came when she had to tell a young woman named Robin and her mom, Delmy, that Robin had leukemia.

As she broke the news, Goldrath was conscious of not only her words but also her body language: Was she leaning in, looking the patient in the eye and expressing empathy?

The conversation, though, was just for practice.

Robin and Delmy were virtual humans on a computer screen -- lifelike beings that are intelligent and conversational and have the capacity to interact using a wide range of communication behaviors shared in typical face-to-face dialogue.

Such intuitive interactions could help aspiring doctors better prepare for difficult and emotionally charged encounters with patients and hospital colleagues, according to a study recently published by researchers from Medical Cyberworlds Inc. and the University of Michigan in the international journal Patient Education and Counseling.

"Communication is the most important part of the doctor-patient relationship," says lead author Frederick Kron, M.D., adjunct research faculty in the department of family medicine at the U-M Medical School and founder of Medical Cyberworlds, the company that developed the virtual reality program.

"We found that virtual human simulation was an engaging and effective tool to teach medical students advanced communication skills and, very importantly, that skills in the simulation transferred into a more realistic clinical situation."

Research shows that poor clinician communication skills may contribute to lower levels of patient satisfaction, poorer health outcomes, and higher risk of complaints and malpractice claims. Poor communication is consistently among the most frequently identified root causes for sentinel events in hospital settings -- events that can lead to preventable patient harm or even death.

"Finding an effective way to assess and teach advanced health care communication skills has been a long-standing challenge," says co-author and U-M family medicine professor Michael Fetters, M.D.

"Medical learners have a great need for practical, innovative methods to help them master the complexities of health care communication and develop excellent communication skills -- both verbal and nonverbal. Ours is the first-ever research showing that it can be done effectively with virtual reality."

Researchers addressed this challenge using revolutionary virtual human technology called MPathic-VR. This Medical Cyberworlds application allows learners to talk with emotive, computer-based virtual humans who can see, hear and react to them in real time. The virtual humans use a full range of behaviors expected between two people talking together.

The system assesses learners' body language, facial expressions and communication strategies, then uses this information to produce real-time responses from the virtual human and provide personalized suggestions based on the learners' strengths or weaknesses. Learners also see their interactions with the virtual human on video, then get the chance to apply what they've learned.

The carefully designed structure of the learning experience, including the repeat interactions, improved the students' communication skills, the findings suggest.

The study was conducted among 421 students at three U.S. medical schools. Half the group used virtual reality, half used more traditional computer-based learning.

Goldrath, now in her fourth year of medical school at Michigan, says she benefited from the opportunity to practice scenarios in virtual reality, and the video feedback helped her understand how others might perceive her role and reactions.

"Many times, patients don't initially absorb a doctor's explanations because of shock, denial, fear or other emotions," she says. "Factors like whether the doctor was standing over you or leaning in to comfort you, or whether he or she read from a piece of paper or looked you in the eye, leave a lasting impact on the patient. These actions represent to the patient what kind of support system the provider will be to him or her during these difficult times."

Current teaching methods typically include small groups of learners and focus on role-playing with each other or with simulated patients. But this method, the study's authors note, is very resource intensive, and different trainers may lead to discrepancies between groups.

Improving outcomes

As part of the study, students also practiced their interprofessional communication to learn the importance of effective dialogue on health care teams.

In that scenario, learners had to manage an interaction with a virtual oncology nurse who was angry that the student inadvertently omitted her from a family meeting with a patient she was caring for.

The virtual human communication system underscores the value of clear dialogue between and across health care teams in providing safe, effective patient care, the authors say.

"Health care has long needed innovative learning methods to better engage students in constructing knowledge and produce better learning outcomes," says research collaborator Tim Guetterman, Ph.D., of U-M Family Medicine. "We are hopeful that, through our work, we have taken a significant step in that direction."

Disclosures: Frederick Kron serves as president and Michael Fetters has stock options in Medical Cyberworlds Inc., the entity receiving grant funds for this project.
-end-


Michigan Medicine - University of Michigan

Related Health Care Articles:

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.
Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.
Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.
MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).
Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.
International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.
The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .
Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.
High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.
Medical expenditures rise in most categories except primary care physicians and home health care
This article was published in the July/August 2017 issue of Annals of Family Medicine research journal.
More Health Care News and Health Care Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Warped Reality
False information on the internet makes it harder and harder to know what's true, and the consequences have been devastating. This hour, TED speakers explore ideas around technology and deception. Guests include law professor Danielle Citron, journalist Andrew Marantz, and computer scientist Joy Buolamwini.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.