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Virtual Patients Group. Health Sciences Center Symposium March 12 th , 2010. Interpersonal Scenario Training. Training people to interact with people is difficult Lectures Role-play Observe We propose to add simulation. Goals of Talk. Motivate Simulating Interpersonal Scenarios

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virtual patients group

Virtual Patients Group

Health Sciences Center Symposium

March 12th, 2010

interpersonal scenario training
Interpersonal Scenario Training
  • Training people to interact with people is difficult
    • Lectures
    • Role-play
    • Observe
  • We propose to add simulation
goals of talk
Goals of Talk
  • Motivate
    • 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
Current approaches have difficulty providing:
  • 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
Experiences with Virtual Patients
  • Students practice communication + diagnostic skills
  • Used in conjunction with standardized patients
  • For different level of learners, different benefits
    • Initially, practice and feedback
    • Later, exposure
    • Eventually, continuing medical education
watch video
Watch Video
  • www.virtualpatientsgroup.com
  • www.virtualpeoplefactory.com
  • Virtual Patients Webpage
virtual patients group7
Virtual Patients Group
  • Created technology that provides role-playing experiences with interacting with virtual people
  • Students interact with virtual patients to:
    • Cover lecture cases in more detail
    • Be exposed to abnormal findings
    • Reduce anxiety to intimate exams
continuum of experiences
Continuum of Experiences

Web Browser

Instant Message

Video Conference

Chat

Second Life

Immersive Interaction

ips system
IPS System
  • Inputs
    • Natural speech
    • Tracking head, hands, chair, tools
    • Video
  • Outputs
    • Speech and animation
    • Life-size VH
  • Commercial-off-the-shelf
    • 2 PCs
    • 2-4 video cameras
    • Data projector, large-screen TV, or HMD
    • Wireless microphone
    • < $6,000(USD)
virtual patients consortium
Virtual Patients Consortium

University of Florida

PIs

Benjamin Lok, Ph.D.

Juan Cendan, M.D.

Rick Ferdig, Ph.D. (KSU)

Mike Robinson, Ph.D.

Senior Personnel

Yong Ho Hwang, Ph.D.

Students

JoonHaoChuah

Willie Maddox

Mallory McManamon

Diego Rivera-Gutierrez

Andrew Robb

Brent Rossen

ShivashankarHalan

Medical College of Georgia

PIs

D. Scott Lind, M.D.

Senior Personnel

Adriana Foster, M.D.

Angela Gucwa, M.D.

CandelarioLaserna, M.D.

Brenda Rosson, R.N.

Peggy Wagner, Ph.D.

Jennifer Carrick

Students

Steven Blackwood

AshitaGehlot

ChandniKalaria

Hevil Shah

Alyssa Wier

University of Central Florida

PIs

Laura Cuty-Ruiz, Ph.D.

Senior Personnel

Moshe Feldman, Ph.D.

Staff

Mike Eakins

Dan Sagendorf

University of Georgia

PIs

Kyle Johnsen, Ph.D.

Students

Qian Ma

Tyler Niles

AnimeshThakre

sponsors
Sponsors
  • Current support
  • Prior Support
consortium overview
Consortium Overview
  • Started in Spring 2004
  • Four universities
  • 33-person team including
    • Computer Science
    • Medicine
    • Education
    • Psychology
  • 53 active members
consortium overview13
Consortium Overview
  • Experiences
    • Immersive: 600+
    • Online: 4700+ (with over 1100+ long conversations)
    • Public exhibits and demos: 150+
    • 24 scenarios
  • Publications: 9 journal, 16 conference, 18 abstracts
  • Awards:
    • 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
Scripts (24) at VPF Generalhttp://vpf.cise.ufl.edu/wiki/index.php/VPF_Script_Tracking
  • Anesthesia
    • Pre-op OSA (UF)
    • Conscious sedation (UF)
  • Cancer
    • Abnormal mammogram (UF)
    • BRCA Pedigree (UCF)
    • Clinical breast exam (UF/MCG)
    • Melanoma (MCG)
  • Pain
    • Abdominal Pain (UF)
    • Chest pain (UF)
    • Gallstones (UCF)
    • Lower back pain (UF)
    • Lower back pain (PCOM)
  • Psychiatry
    • Failure to thrive (UF)
    • Depression (MCG)
    • Bi-polar (MCG)
  • General
    • Breaking bad news (MCG)
    • Cranial Nerve (UF)
    • Dyspepsia – Pharmacy (UF)
    • Gastro-Band (UF)
    • GI Hemorrhage (UF)
    • Meningitis (PCOM)
    • Patient-Centered Counseling (USF)
    • Post Operative Hemorrhage (UF)
    • Sexually Transmitted Diseases (UF)
    • Contraceptive Counseling (UF)
getting involved
Getting involved
  • Short term (demo) – a few weeks
    • Create a scenario using Virtual People Factory
      • Use an existing case
      • Saves course time
    • Test with students
    • Publish and demo
  • Long term
    • Develop a deployable teaching unit
    • Integrate into curricula at UF
    • Federal funding (e.g. NIH, NSF)
developing virtual character cognition
Developing Virtual Character Cognition
  • Virtual People Factory
    • Web-based interface
    • End-user creation of content
    • Pharmacy patient
  • In two years
    • 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
NERVE: The Neurological Examination Rehearsal Virtual Environment
  • Virtual multi-tool interface to VH
    • Single input device (Wii Remote) controls multiple virtual tools used in eye exam
    • Gestural and tool input, in addition to speech
  • Medical students can
    • 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
Physical Examinations of Virtual Human Patients
  • Mixed reality humans
    • Passive-haptic interface to life-sized virtual human
    • Applications
      • Clinical breast exam
      • Prostate exam (upcoming)
  • Medical students can
    • Practice merging physical examination and communication skill sets
    • Get real-time feedback of exam performance
      • Coverage
      • Pressure
      • Conversation topics
museum of science and industry
Museum of Science and Industry
  • Science museum in Tampa, FL
  • 5th largest in US (75,000 sq ft.)
  • 1 million guests
  • Integrate a VH interaction
    • The Amazing You exhibit
    • Lifelong wellness information
    • March 2010
  • Inspire, inform
  • Explore race, VH bias
  • Youtube Video
after action review by students
After-Action Review by Students
  • IPSViz
    • 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
After-Action Review by Educators
  • IPSVizn
    • Web-based interface
    • Educators can review completed student interactions
    • Data from study
    • Filter based on user background
      • Level of expertise
      • Gender
      • Educator-defined metrics
  • Experts can
    • Identify trends (mean of class)
    • Identify outliers
slide22
Bias
  • 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 African-American VH had less education and money
  • Identical: animations, words spoken
  • Differences: skin-tone, voice
  • Other biases to study
    • Race/Ethnicity
    • Gender
    • Age
    • Weight
    • Social ‘hot topics’
pain perception
Pain Perception
  • 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
What we think we might know…
  • 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
Consortium Expertise
  • University of Florida
    • Technology development
    • Scenario development
    • Abnormal findings
  • Medical College of Georgia
    • Intimate Exams
  • University of Georgia
    • Patient-centered experiences
  • University of Central Florida
    • Assessment
    • Curricular integration
collaborators
Collaborators
  • Looking to add collaborators
  • Contact me (lok@cise.ufl.edu)
    • One-on-one discussions
    • Demos
    • Speak to your research group
experiences
Experiences
  • 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
Video Conference with a VP
  • All VPF scripts can be experienced video-conference style
  • Interact with 3D VPs using a webcam and typing
  • Enables study of distributed medicine
audiology collaboration with mark billinghurst nz
Audiologycollaboration with Mark Billinghurst (NZ)
  • Students administer audiology exams to VP
  • Exams include:
    • History
    • VP visual examination
    • Hearing screen
    • Testing speech understanding
  • Highlights
    • Procedure and communications skills
    • VP presenting abnormal conditions