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Virtual Human Standardized Patients for Clinical Training

  • Thomas TalbotEmail author
  • Albert “Skip” Rizzo
Chapter
Part of the Virtual Reality Technologies for Health and Clinical Applications book series (VRTHCA)

Abstract

Since Dr. Howard Barrows (1964) introduced the human standardized patient in 1963, there have been attempts to game a computer-based simulacrum of a patient encounter; the first being a heart attack simulation using the online PLATO system (Bitzer M, Nursing Research 15:144–150, 1966). With the now ubiquitous use of computers in medicine, interest and effort have expended in the area of Virtual Patients (VPs). There are excellent summaries in the literature (Talbot TB, International Journal of Gaming and Computer Mediated Simulations 4:1–19, 2012) that explain the different types of virtual patients along with their best case applications, strengths and limitations.

Keywords

Medical education Medical games Medical simulation Serious games Virtual patient Virtual standardized patient 

References

  1. Adamo, G. (2004). Simulated and standardised patients in OSCEs: Achievements and challenges 2–2003. Medical Teacher, 25(3), 262–270.  https://doi.org/10.1080/0142159031000100300.CrossRefGoogle Scholar
  2. Artstein, R., Gandhe, S., Leuski, A., & Traum, D. R. (2008). Field testing of an interactive question-answering character. In Proceedings of the European language resources association workshop on evaluation (pp. 36–40). Marrakech.Google Scholar
  3. Babu, S., Schmugge, S., Barnes, T., & Hodges, L. (2006). What would you like to talk about? An evaluation of social conversations with a virtual receptionist. In J. Gratch et al. (Eds.), IVA 2006 (pp. 169–180). Berlin: Springer-Verlag.  https://doi.org/10.1007/11821830_14.CrossRefGoogle Scholar
  4. Barrows, H. S., & Abrahamson, S. (1964). The programmed patient: A technique for appraising student performance in clinical neurology. Journal of Medical Education, 39, 802–805.PubMedGoogle Scholar
  5. Benedict, N. (2010). Virtual patients and problem-based learning in advanced therapeutics. American Journal of Pharmaceutical Education, 74(8), 143–148.  https://doi.org/10.5688/aj7408143.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Bickmore, T., & Cassell, J. (2005). Social dialogue with embodied conversational agents. In J. van Kuppevelt, L. Dybkjaer, & N. Bernsen (Eds.), Advances in natural, multimodal dialogue systems. New York: Kluwer Academic.  https://doi.org/10.1007/1-4020-3933-6_2.CrossRefGoogle Scholar
  7. Bickmore, T., & Giorgino, T. (2006). Health dialog systems for patients and consumers. Journal of Bio-medical Informatics, 39(5), 556–571.  https://doi.org/10.1016/j.jbi.2005.12.004.CrossRefGoogle Scholar
  8. Bickmore, T., Pfeifer, L., & Paasche-Orlow, M. (2007). Health document explanation by virtual agents. In Proceedings of the intelligent virtual agents conference, Paris. Springer.Google Scholar
  9. Bitzer, M. (1966). Clinical nursing instruction via the PLATO simulated laboratory. Nursing Research, 15, 144–150.  https://doi.org/10.1097/00006199-196601520-00009.CrossRefPubMedGoogle Scholar
  10. Bogolub, E. B. (1986). Tape recorders in clinical sessions: Deliberate and fortuitous effects. Clinical Social Work Journal, 14(4), 349–360.  https://doi.org/10.1007/BF01892595.CrossRefGoogle Scholar
  11. Campbell, J., Core, M., Artstein, R., Armstrong, L., Hartholt, A., Wilson, C. et al. (2011, March 14–12). Developing INOTS to support interpersonal skills practice. IEEE aerospace conference, big sky, MT.Google Scholar
  12. Cheek, W. (2012) Direct communications with breakaway ltd. via written survey. Retrieved from http://www.breakawayltd.com.
  13. Collins, J. P., & Harden, R. M. (1999). The use of real patients, simulated patients and simulators in clinical examinations. Association for Medical Education in Europe Dundee. Retrieved Jan. 4, 2011, from http://www.medev.ac.uk/resources/features/AMEE_summaries/Guide13summaryMay04.pdf.
  14. Cook, D. A., & Triola, M. M. (2009). Virtual patients: A critical literature review and proposed next steps. Medical Education, 43, 303–311.  https://doi.org/10.1111/j.1365-2923.2008.03286.x.CrossRefPubMedGoogle Scholar
  15. Dev, P., & Heinrichs, W. (2012) Direct communications with clinispace/innovations in learning via written survey. Retrieved from https://www.clinispace.com.Google Scholar
  16. Dunne, J. R., & McDonald, C. L. (2010). Pulse!!: A model for research and development of virtual-reality learning in military medical education and training. Military Medicine, 175(s1), 25–27.CrossRefGoogle Scholar
  17. Evans, D., Hearn, M. T., Uhlemann, M. R., & Ivey, A. E. (1989). Essential interviewing: A programmed approach to effective communication (3rd ed.). Pacific Brooks: Brooks/Cole Publishing Company.Google Scholar
  18. Gratch, J., & Marsella, S. (2004). A domain independent framework for modeling emotion. Journal of Cognitive Systems Research, 5(4), 269–306.  https://doi.org/10.1016/j.cogsys.2004.02.002.CrossRefGoogle Scholar
  19. Gratch, J., Rickel, J., Andre, E., Cassell, J., Petajan, E., & Badler, N. (2002). Creating interactive virtual humans: Some assembly required. IEEE Intelligent Systems, 17(4), 54–61.  https://doi.org/10.1109/MIS.2002.1024753.CrossRefGoogle Scholar
  20. Kenny, P., Rizzo, A. A., Parsons, T., Gratch, J., & Swartout, W. (2007). A virtual human agent for training clinical interviewing skills to novice therapists. Annual Review of Cybertherapy and Telemedicine, 5, 81–89.Google Scholar
  21. Kenny, P., Parsond, T., & Garrity, P. (2010, November 29–December 2). Virtual patients for virtual sick call medical training. Interservice/Industry training, simulation, and education conference, Orlando.Google Scholar
  22. Lamb, M. E., Orbach, Y., Hershkowitz, I., Esplin, P. W., & Horowitz, D. (2007). Structured forensic interview protocols improve the quality and informativeness of investigative interview with children: A review of research using NICHD investigative interview protocol. Child Abuse & Neglect, 31(11-39), 1201–1231.  https://doi.org/10.1016/j.chiabu.2007.03.021.CrossRefGoogle Scholar
  23. Leuski, A., & Traum, D. R. (2010, July 11–15). Practical language processing for virtual humans. In Proceedings of the twenty-second annual conference on innovative applications of artificial intelligence (IAAI-10), Atlanta.Google Scholar
  24. Leuski, A., Kennedy, B., Patel, R., & Traum, D. R. (2006, November 27-30). Asking questions to limited domain virtual characters: How good does speech recognition have to be? In Proceedings of the 25th army science conference, Orlando.Google Scholar
  25. Lok, B., Ferdig, R. E., Raij, A., Johnson, K., Dickerson, R., & Coutts, J. (2007). Applying virtual reality in medical communication education: Current findings and potential teaching and learning benefits of immersive virtual patients. Journal of Virtual Reality, 43(3–4), 185–195.  https://doi.org/10.1007/s10055-006-0037-3.CrossRefGoogle Scholar
  26. McCauley, L., & D’Mello, S. (2006, August 21–23). A speech enabled intelligent kiosk. In J. Gratch et al. (Eds.), In Proceedings of the 6th annual intelligent virtual agents conference, Marina del Ray, CA (pp. 47–144). Berlin: Springer.Google Scholar
  27. Morbini, F., DeVault, D., Sagae, K., Nazarian, A., Gerten, J., & Traum, D. R. (2013). FLoReS: A forward looking, reward seeking, dialogue manager. Submitted to the 13th annual SIGDIAL meeting on discourse and dialogue, Seoul.Google Scholar
  28. Morency, L.-P., de Kok, I., & Gratch, J. (2008, October 20–22). Context-based recognition during human interactions: Automatic feature selection and encoding dictionary. In Proceedings of the 10th international conference on multimodal interfaces, Chania.Google Scholar
  29. Parsons, T. D., Kenny, P., Ntuen, C. A., Pataki, C. S., Pato, M. T., & Rizzo, A. A. (2008). Objective structured clinical interview training using a virtual human patient. Studies in Health Technology and Informatics, 132, 357–362.PubMedGoogle Scholar
  30. Prendinger, H., & Ishizuka, M. (2004). Life-like characters – Tools, affective functions, and applications. Berlin: Springer.  https://doi.org/10.1007/978-3-662-08373-4.CrossRefGoogle Scholar
  31. Rickel, J., Gratch, J., Hill, R., Marsella, S., & Swartout, W. (2001, March 25–27). Steve goes to bosnia: Towards a new generation of virtual humans for interactive experiences. In Proceedings of the AAAI spring symposium on AI and interactive entertainment, Stanford University.Google Scholar
  32. Rizzo, A. A., Kenny, P., & Parsons, T. (2011a). Intelligent virtual humans for clinical training. International Journal of Virtual Reality and Broadcasting, 8(3). Retrieved from http://www.jvrb.org/8.2011/.
  33. Rizzo, A. A., Lange, B., Buckwalter, J. G., Forbell, E., Kim, J., & Sagae, K. (2011b). An intelligent virtual human system for providing healthcare information and support. Studies in Health Technology and Informatics, 163, 503–509.PubMedGoogle Scholar
  34. Rossen, B., Cendan, J., & Lok, B. (2010, September 20-22). Using virtual humans to bootstrap the creation of other virtual humans. In Allbeck et al (Ed.), Proceedings of the international conference on virtual agents 2010, Philadelphia (LNAI6356, pp. 392–398).Google Scholar
  35. Stevens, A., Hernandez, J., & Johnsen, K. (2005). The use of virtual patients to teach medical students communication skills. American Journal of Surgery, 191, 806–811.  https://doi.org/10.1016/j.amjsurg.2006.03.002.CrossRefGoogle Scholar
  36. Swartout, W., Gratch, J., Hill, A. W., Marsella, S., Rickel, J., & Traum, D. (2006). Toward virtual humans. AI Magazine, 27(1), 96–108.Google Scholar
  37. Swartout, W., Traum, D. R., Artstein, R., Noren, R., Debevec, P., Bronnenkant, K., et al. (2010). Ada and Grace: Toward realistic and engaging virtual museum guides. Intelligent Virtual Agents, 286–300.Google Scholar
  38. Talbot, T. B. (2013). Balancing physiology, anatomy & immersion: How much biological fidelity is necessary in a medical simulation? Journal of Military Medicine.Google Scholar
  39. Talbot, T. B., Sagae, K., John, B., & Rizzo, A. A. (2012). Sorting out the virtual patient: How to exploit artificial intelligence, game technology and sound educational practices to create engaging role-playing simulations. International Journal of Gaming and Computer Mediated Simulations., 4(4), 1–19.CrossRefGoogle Scholar
  40. Thiebaux, M., Marshall, A., Marsella, S., Fast, E., Hill, A., Kallmann, M., et al. (2008, May 12-73) Smart body: Behavior realization for embodied conversational agents. In Proceedings of the Inter-national conference on autonomous agents and multi-agent systems (AAMAS), Estoril.Google Scholar
  41. Traum, D. R., Marsella, S., Gratch, J., Lee, J., & Hartholt, A. (2008a, September 1–3). Multi-party, multi-issue, multi-strategy negotiation for multi-modal virtual agents. In Proceedings of the 8th international conference on intelligent virtual agents, Tokyo.Google Scholar
  42. Traum, D. R., Marsella, S., Gratch, J., Lee, J., & Hartholt, A. (2008b). Multi-party, multi-issue, multi-strategy negotiation for multi-modal virtual agents. In Proceedings of the conference on intelligent virtual agents (pp. 117–130).Google Scholar
  43. Triola, M., Feldman, H., Kalet, A. L., Zabar, S., Kachur, E. K., & Gillespie, C. (2006). A randomized trial of teaching clinical skills using virtual and live standardized patients. Journal of General Internal Medicine, 21, 424–426.  https://doi.org/10.1111/j.1525-1497.2006.00421.x.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University of Southern California Institute for Creative TechnologiesLos AngelesUSA

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