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Virtual Patients Group

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

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  1. Virtual Patients Group Health Sciences Center Symposium March 12th, 2010

  2. Interpersonal Scenario Training • Training people to interact with people is difficult • Lectures • Role-play • Observe • We propose to add simulation

  3. 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

  4. 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

  5. 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

  6. Watch Video • www.virtualpatientsgroup.com • www.virtualpeoplefactory.com • Virtual Patients Webpage

  7. 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

  8. Continuum of Experiences Web Browser Instant Message Video Conference Chat Second Life Immersive Interaction

  9. 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)

  10. 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

  11. Sponsors • Current support • Prior Support

  12. Consortium Overview • Started in Spring 2004 • Four universities • 33-person team including • Computer Science • Medicine • Education • Psychology • 53 active members

  13. 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)

  14. 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)

  15. 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)

  16. 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

  17. 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)

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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’

  23. 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

  24. 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

  25. 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

  26. Collaborators • Looking to add collaborators • Contact me (lok@cise.ufl.edu) • One-on-one discussions • Demos • Speak to your research group

  27. Virtual Experiences Research Group Thank you!

  28. 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

  29. 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

  30. 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

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