VIRTUAL PATIENTS GROUP
Health Sciences Center Symposium
March 12th, 2010
Interpersonal Scenario Training
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Training people to interact with people is difficult
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Lectures
Role-play
Observe
We propose to add simulation
Goals of Talk
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Motivate
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Simulating Interpersonal Scenarios
Virtual Human Experiences
Typing->Natural Interaction->After Action Review
Mixed Reality
Public Exhibits
Open Issues
 Metrics
 Learning
 Training Transfer
 Role of Technology
Current approaches have
difficulty providing:
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Sufficient opportunities for practice
Exposure to infrequent – yet critical – scenarios
Tailoring for each student
Standardization
Patient variability
Team-based learning
Cultural competency
Feedback
Addressed with virtual patient experiences
Experiences with Virtual Patients
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Students practice communication
+ diagnostic skills
Used in conjunction with
standardized patients
For different level of learners,
different benefits
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Initially, practice and feedback
Later, exposure
Eventually, continuing medical
education
Watch Video
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www.virtualpatientsgroup.com
www.virtualpeoplefactory.com
Virtual Patients Webpage
Virtual Patients Group
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Created technology that provides role-playing
experiences with interacting with virtual people
Students interact with virtual patients to:
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Cover lecture cases in more detail
Be exposed to abnormal findings
Reduce anxiety to intimate exams
Continuum of Experiences
Web Browser
Instant Message
Video Conference
Chat
Second Life
Immersive
Interaction
IPS System
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Inputs
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Outputs
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Natural speech
Tracking head, hands, chair, tools
Video
Speech and animation
Life-size VH
Commercial-off-the-shelf
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2 PCs
2-4 video cameras
Data projector, large-screen TV, or HMD
Wireless microphone
< $6,000(USD)
Virtual Patients Consortium
University of Florida
University of Georgia
Medical College of Georgia
University
Medical
College
ofof
Florida
of Georgia
University
University
of
Central
Georgia
Florida
PIs
PIs
PIs
PIs
Benjamin
D.
Scott
Lind,
Lok, M.D.
Ph.D.
Laura
Kyle
Cuty-Ruiz,
Johnsen,
Ph.D.
Ph.D.
Juan Cendan, M.D.
Rick
Senior
Ferdig,
Personnel
Ph.D. (KSU)
Senior
Students
Personnel
Mike
Adriana
M.D.
Moshe
QianRobinson,
Feldman,
MaFoster, Ph.D.
Ph.D.
Angela
Gucwa, M.D.
Tyler Niles
Senior
Candelario
Personnel
Laserna, M.D.
Staff
Animesh
Thakre
Yong
Brenda
HoRosson,
Hwang, R.N.
Ph.D.
Eakins
University of Central Florida Mike
Peggy
Wagner, Ph.D.
Dan
Sagendorf
Students
Jennifer Carrick
Joon Hao Chuah
Willie
Students
Maddox
Mallory
Steven McManamon
Blackwood
Diego
AshitaRivera-Gutierrez
Gehlot
Andrew
ChandniRobb
Kalaria
Brent
Hevil Rossen
Shah
Shivashankar
Alyssa Wier Halan
Sponsors
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Current support
National Science Foundation
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National Institutes of Health
Association of Surgical Education
Prior Support
University of Florida
Medical College of Georgia
Keele University
Consortium Overview
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Started in Spring 2004
Four universities
33-person team including
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Computer Science
Medicine
Education
Psychology
53 active members
Consortium Overview
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Experiences
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Publications: 9 journal, 16 conference, 18 abstracts
Awards:
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Immersive: 600+
Online: 4700+ (with over 1100+ long conversations)
Public exhibits and demos: 150+
24 scenarios
IEEE VR 2008 Best Paper
Research and Clinical Abstract Awards (Georgia ACS)
$2.8 million in funding (NSF, NIH, and ASE)
Scripts (24) at VPF General
http://vpf.cise.ufl.edu/wiki/index.php/VPF_Script_Tracking
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Anesthesia
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Psychiatry
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Pre-op OSA (UF)
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Failure to thrive (UF)
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Conscious sedation (UF)
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Depression (MCG)
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Bi-polar (MCG)
Cancer
General
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Abnormal mammogram (UF)
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BRCA Pedigree (UCF)
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Breaking bad news (MCG)
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Clinical breast exam (UF/MCG)
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Cranial Nerve (UF)
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Melanoma (MCG)
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Dyspepsia – Pharmacy (UF)
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Gastro-Band (UF)
Pain
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Abdominal Pain (UF)
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GI Hemorrhage (UF)
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Chest pain (UF)
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Meningitis (PCOM)
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Gallstones (UCF)
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Patient-Centered Counseling (USF)
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Lower back pain (UF)
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Post Operative Hemorrhage (UF)
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Lower back pain (PCOM)
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Sexually Transmitted Diseases (UF)
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Contraceptive Counseling (UF)
Getting involved
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Short term (demo) – a few weeks
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Create a scenario using Virtual People Factory
 Use
an existing case
 Saves course time
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Test with students
Publish and demo
Long term
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Develop a deployable teaching unit
Integrate into curricula at UF
Federal funding (e.g. NIH, NSF)
Developing Virtual Character Cognition
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Virtual People Factory
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In two years
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Web-based interface
End-user creation of
content
Pharmacy patient
Over 4700 interactions
24 end-user created
scenarios
End-user created
scripts can reach 85%
accuracy
UCF integrated into
curriculum
NERVE: The Neurological Examination
Rehearsal Virtual Environment
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Virtual multi-tool interface to
VH
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Single input device (Wii
Remote) controls multiple
virtual tools used in eye exam
Gestural and tool input, in
addition to speech
Medical students can
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Learn how to use neurological
tests to diagnose a patient
with a vision disorder
Receive additional exposure
to patients with abnormal
findings (e.g. double vision,
lazy eye)
Physical Examinations of Virtual Human
Patients
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Mixed reality humans
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Passive-haptic interface to
life-sized virtual human
Applications
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Clinical breast exam
Prostate exam (upcoming)
Medical students can
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Practice merging physical
examination and
communication skill sets
Get real-time feedback
of exam performance
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Coverage
Pressure
Conversation topics
Museum of Science
and Industry
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Science museum in Tampa, FL
5th largest in US (75,000 sq
ft.)
1 million guests
Integrate a VH interaction
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The Amazing You exhibit
Lifelong wellness information
March 2010
Inspire, inform
Explore race, VH bias
Youtube Video
After-Action Review by Students
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IPSViz
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Web-based interface
Students received email
with link (automated)
Sample student
(10158/00000)
Self-directed review of
content, video, and
feedback
Each student can review
their performance and
compare with experts
After-Action Review by Educators
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IPSVizn
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Web-based interface
Educators can review
completed student
interactions
Data from study
Filter based on user
background
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Level of expertise
Gender
Educator-defined
metrics
Experts can
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Identify trends (mean
of class)
Identify outliers
Bias
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Interact with either a Caucasian or
African-American VH
Experts rated empathy
Empathy was correlated to psychology
measures of skin-tone bias
VHs can elicit racial biases
People reported that the AfricanAmerican VH had less education and
money
Identical: animations, words spoken
Differences: skin-tone, voice
Other biases to study
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Race/Ethnicity
Gender
Age
Weight
Social ‘hot topics’
Pain Perception
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PI: Mike Robinson
Video vignettes of VPs expressing low or high levels
(FACS) of pain
VPs varied in gender, age, and ethnicities
Doctors, nurses, and dentists evaluate perceived
levels of pain
Identifies variables and weighting of variables that
affect healthcare provider’s pain perception
What we think we might know…
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Does not matter if people believe the virtual human is
real or virtual
Apply communication skills training until technology
proves them wrong
Valid interaction
Potential benefits above real humans
If people see benefits, they overlook technology
faults
People want to play along
Consortium Expertise
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University of Florida
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Medical College of Georgia
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Intimate Exams
University of Georgia
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Technology development
Scenario development
Abnormal findings
Patient-centered experiences
University of Central Florida
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Assessment
Curricular integration
Collaborators
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Looking to add collaborators
Contact me (lok@cise.ufl.edu)
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One-on-one discussions
Demos
Speak to your research group
Virtual Experiences Research Group
Thank you!
Experiences
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24 Patient-Doc scenarios
Intimate Exams
Abnormal Findings (Neurological Exam)
Conscious Sedation (VP+IPS)
Audiology Testing
After-Action Reviews
You, M.D.
Bias studies: Pain perception
Video Conference with a VP
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All VPF scripts can be
experienced videoconference style
Interact with 3D VPs
using a webcam and
typing
Enables study of
distributed medicine
Audiology
collaboration with Mark Billinghurst (NZ)
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Students administer audiology
exams to VP
Exams include:
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History
VP visual examination
Hearing screen
Testing speech understanding
Highlights
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Procedure and communications skills
VP presenting abnormal conditions