Georgia Regents University
Medical Grand Rounds, May 14th, 2015

I have a financial interest in Shadow Health, Inc. Shadow Health, Inc.
develops virtual patient software for nursing education.
 Existing approaches to communication skills training
 New training approaches with virtual patients
 Learning Outcomes:
 Define virtual patients
 Identify virtual patient research
 Identifying how you can benefit from simulation today
 Identifying your part in shaping the future of education

Humans
 Lecture
 Role-playing
 Standardized patients – “gold standard”








Sufficient opportunities for practice
Exposure to infrequent – yet critical –
scenarios
Tailoring for each student
Standardization
Patient variability
Team-based learning
Cultural competency
Feedback
 Mannequin simulation
 Serious Games
 Using game technologies
to simulate experiences
 Virtual Patients
 Simulations of patient
interactions
Human Patient Simulator – image
from Samsun Lampotang

Simulation wings
 UF-Jacksonville has dedicated
24,000 sq. ft.
 UF-Jacksonville 55 simulators
 Basic understanding of
integration into curriculums

[Huang 2007] Virtual patients
 Ad-hoc (26 of 108 schools
building cases)
 Still images and video (83% of
virtual patients)
 Expensive (each case $10,000$50,000, 1-2 years to develop)

Known education potential
 Compliments classrooms
Human Patient Simulator – image
from Samsun Lampotang



Interactive training exercises
Using computer game engines and the Internet
https://www.youtube.com/watch?v=65e9KgM7
E-E
Image from Breakaway Ltd.
Engineeredcare.com
 Timothy Bickmore, Northeastern
University
 RED Educator
 Virtual patient advocate
discusses discharge with patient
 Touch screen
 Benefits:
 Standardization
 Tailoring (based on medical
history)
 Testing of patient knowledge

Image from Engineeredcare.com

Computer simulations that simulate patient
interactions

Users make decisions on communication,
physical exams, and documentation

Most model an interactive case study

Misconception: virtual patients would replace
standardized patients or real patients in medical
curricula

Complements standardized patient encounters
 Repeated practice with individualized feedback
 Presentation of abnormal findings (e.g. cranial
nerves)
 Vulnerable populations (e.g. pediatrics, mental
health)
 Practice before seeing SPs (e.g. intimate exams)
Passive – multimedia
presentation of information
https://research.bidmc.harvard.
edu/vptutorials/cases/mental.ht
m
“Choose your own
adventure”
http://www.virtualpatients.eu/ref
eratory/



www.virtualpatientsgroup.com
Developed VPs for 11 years
Collaboration
 UF, GRU, UCF, UGA, Drexel, UVA
 Over 100 healthcare educators, computer
scientists and educators have contributed)

Support
 National Science Foundation
 National Institutes of Health

Publications
 Over 60 journal and conference publications in
computer science, medicine, nursing,
pharmacy, education, etc.
Dr. Gregory House
Good with medical knowledge
Not so good with interacting with people
DerekRoss
Shepherd
Dr. Doug
Good with medical knowledge
Good with interacting with people

Eliciting important
information
 E.g. “What brings you
into the clinic today?”

Developing
communication skills
 Organization of
inquiry
 Diagnostic reasoning

Early medical school
 Practice (interview,
documentation, decision
making)

Advanced learners





Abnormal findings
Intimate Exams
Team training
Protected populations
Post medical school
 New procedures and
conditions

Throughout the
continuum
 Cultural Competency
 Patient Centered
Care
 Standardization of
experiences
 Immediate Feedback
 Safe place to fail



VPs present abnormal findings
Curricular exposure to significant, yet rarely
seen conditions
Freely available for instructor use


Depression
http://vpf2.cise.ufl.edu/Classic/Interaction/Public
/63?consent=1&skiprails=1&stats=0


Bipolar Manic Episode
http://vpf2.cise.ufl.edu/Classic/Interaction/Public
/13111?consent=1&skiprails=1&stats=0


Bipolar - Handling a Crisis
http://vpf2.cise.ufl.edu/Classic/Interaction/Public
/13112?consent=1&skiprails=1&stats=0

Clinical Breast Exam
Prostate Exam

Practice and evaluate

 Social
 Cognitive
 And Psychomotor skills
Team Training

Repositories of Virtual Patients

Authoring systems for virtual patients

Commercial virtual patients

MedEdPORTAL
 Peer reviewed medical education resource

http://www.virtualpatients.eu/referatory/

USC Virtual Patient Studio

VPSim

iHuman

VirtualPeopleFactory.com

Virtual Heroes

iHuman

Breakaway Games





A decade ago, researchers thought this was
not possible
Now there are entire conferences dedicated
to virtual patients
Virtual patients are being used to teach
intimate exams and communication skills
Commercial realization
Educators are quantifying benefit
Visit: www.virtualpatientsgroup.com
Contact: lok@cise.ufl.edu
Support: National Science Foundation and National Institutes of
Health