The goal of this project is to investigate the use of virtual humans (VH) to enhance medical student training with respect to patient ethnicity/race, gender, and age sensitivity issues. As virtual "partners" in interpersonal scenarios, this project implements VHs to augment role-playing and expert-observation for communication skills instruction. Research will be conducted in three stages. First, research will be conducted to effectively characterize a student's VH interaction. This involves tracking the student's primary verbal and non-verbal communication cues (gaze, gesture, posture, words spoken, and audio frequency) and correlating them with medical expert coding of the student-VH interaction. Second, after-action reviews will be developed to visualize the tracked communication cues. Students and instructors will be able to review and replay the student-VH interaction from both the student and the VH's viewpoint. This has the special potential of allowing poor performing students to vicariously experience "what it was like to talk to themselves." The after-action reviews will also be used to study VH interactions, understand how people perceive VHs, and provide educators with tools for identifying students that require remediation. Third, student communication with diverse patients will be investigated through analyzing student interactions with VHs of varied ethnic/race, age, and gender backgrounds. Overall, the system will be used to study if the VH's appearance and demeanor impacts behavior, and provide tools for educators to enhance communication skills towards people of varied backgrounds.
With respect to broader impact, this research with virtual humans has the potential to enhance the communication skills curricula of medical, nursing and physician assistant students. Initially, the VH system will be installed at two Southeast medical schools. As part of a communications skills course, students will interact with virtual humans to learn communication and diversity concepts. As the system evolves, presentations at medical simulation conferences will detail how to replicate the VH system at other medical schools and integrate their results into a database of VH interactions. Prior research has indicated that the majority of students reported that they would practice with such a system weekly. Integration into the medical school curricula has the potential to impact thousands of health care students and educators. The focus on communication skills with diverse patients has the potential to improve both patient care for under-represented minorities as well as within other domains such as customer service, the military, and law enforcement.
This project established that virtual humans - computer generated characters seen in movies and games - can be used as in training simulations to develop interpersonal skills, including empathy and diversity trianing. To this end, computer systems were developed for learners to practice focused conversations with the virtual human to practice communication skills. We applied this technology to help medical students work on patient communication skills. As part of this award, thousands of students have interacted with virtual patients as part of their education at multiple universities. The research-based system is made available online at VirtualPeopleFactory.com. Using this system, educators from many schools (some have never met the research team) have developed their own curricula and coursework for pharmacy and medical student education. The website is provided at no cost to educators and researchers, and to date, thousands of students have used the system to practice communication skills as assignments in their courses. The intellectual property from this award has been licensed by Shadow Health, Inc. Shadow Health (co-founded by the PI) now employs over 45 developers, educators, sales, customer support, QA, and nurses. Under contract is over 105 schools that will require the use of the virtual patient system by over 10,000 students. In the future, the company is expecting to expand to other discplines (medicine, pharmacy, PA), and has already expanded to a 7000 sq. ft. space in downtown Gainesville. The jobs created are high-pay, high-skill (most require a technical college degree) and has helped in the reviatlization of the downtown area. The broader impact is the expanding of computing to address traiing humans on talking to other humans. The work into virtual humans as conversational partners for interpersonal skills communication has developed into a significant research area with research groups in Europe and the US working in this area. Further, commercial entities have begun appearing to train communication skills using virtual humans. We have explore to the extent virtual human technology can be used to help teach empathy, diversity, and complex conversation skills. While there are still significant limitations to the realism of virtual humans, the main finding is that humans do try to treat virtual humans realistically, and it is the congitive exercise of forming questions and processing the virtual human's response that is of significant educational value that is the major insight from this award.
