A doctor’s interview with a patient can give some very important clues to the diagnosis. Hence a properly conducted interview is an important element of medical care. Virtual Objective Structured Clinical Examination (VOSCE) is a project at the University of Florida, developed to improve communication skills of medical students with patients. From the press release:
The application being developed by Lok and his team uses two virtual characters, DIANA (DIgitial ANimated Avatar) the patient and VIC (Virtual Interactive Character) the expert observer, to simulate doctor-patient diagnostic interactions.
It works like this. Medical students enter a room in which life-sized projections of DIANA and VIC are displayed on a wall. Students interact with DIANA using verbal cues and body language to determine her ailment. DIANA responds to students’ verbal inquiries as well as to eye contact and hand gestures. VIC lets students know how they are doing.
Initial research indicates that medical students interact with these virtual characters in much the same way they interact with standardized patients. On a realism scale of 1 to 10, medical students have rated interaction with DIANA a 7.2, while giving actual standardized patients a realism rating 7.5.
Lok has even witnessed medical students apologizing to DIANA for the pain she simulates. He admits that this “doesn’t make sense” but it is an indication that the line separating the real and the virtual is blurring.
There are several benefits to using virtual characters to supplement medical student interaction with standardized patients. Many of these benefits arise from the large amounts of time and money required to train and employ standardized patients.
Virtual patients allow for a greater number of student-patient interaction experiences and increased patient diversity than traditional methods. The use of virtual patients allows for improved quality control of student-patient interactions compared to the use of standardized patients, which in turn provides for more objective measures of the student’s performance.
Lok’s virtual system provides students with robust feedback regarding the quality of their communication with the virtual patient. The system tracks and records the student’s eye contact with DIANA and relates this information via a head gaze chart showing students exactly where they were looking throughout the interaction. VIC tells students when they have misdiagnosed DIANA and helps them to determine what they did wrong.
The system itself is cost effective and relatively simple. It is built entirely from “off-the-shelf” components – two networked PCs, a data projector, two web cameras, a tablet PC and a microphone. The total cost of the system is less than $10,000.