Automated Promotion of Technology Acceptance by Clinicians Using Relational Agents

Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 8108)


Professionals are often resistant to the introduction of technology and can feel threatened if they perceive the technology as replacing some aspect of their jobs. We anticipated some of these problems in the process of introducing a bedside patient education system to a hospital, especially given that the system presents itself as a “virtual discharge nurse” in which an animated nurse agent interacts with patients using simulated face-to-face conversation. To increase acceptance by nursing staff we created a version of the character designed to build trust and rapport through a personalized conversation with them. In a randomized trial, we compared responses after 15 minute in-service briefings on the technology versus responses to the same briefings plus a personalized conversation with the agent. We found that the nurses who participated in briefings that included the personalized conversation had significantly greater acceptance of and lower feelings of being threatened by the agent.


Relational agent embodied conversational agent technology acceptance medical informatics 


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  1. 1.
    Blumenthal, D.: Stimulating the Adoption of Health Information Technology. The New England Journal of Medicine 360, 1477–1479 (2009)CrossRefGoogle Scholar
  2. 2.
    Holden, R., Karsh, B.: The technology acceptance model: its past and its future in health care. Journal of Biomedical Informatics (2009)Google Scholar
  3. 3.
    Davis, F.D.: User acceptance of information technology: System characteristics, user perceptions and behavioral impacts. International Journal of Man-Machine Studies 38, 475–487 (1993)CrossRefGoogle Scholar
  4. 4.
    Bhattacherjee, A., Sanford, C.: Influence Processes for Information Technology Acceptance: An Elaboration Likelihood Model. MIS Quarterly 30, 805–825 (2006)Google Scholar
  5. 5.
    Petty, R., Cacioppo, J.: Attitudes and Persuasion: Classic and Contemporary Approaches. Westview Press, Boulder (1996)Google Scholar
  6. 6.
    Bickmore, T., Pfeifer, L., Jack, B.W.: Taking the Time to Care: Empowering Low Health Literacy Hospital Patients with Virtual Nurse Agents. In: ACM SIGCHI Conference on Human Factors in Computing Systems, CHI (2009)Google Scholar
  7. 7.
    Bickmore, T.W., Pfeifer, L.M., Paasche-Orlow, M.K.: Health Document Explanation by Virtual Agents. In: Pelachaud, C., Martin, J.-C., André, E., Chollet, G., Karpouzis, K., Pelé, D. (eds.) IVA 2007. LNCS (LNAI), vol. 4722, pp. 183–196. Springer, Heidelberg (2007)CrossRefGoogle Scholar
  8. 8.
    Bickmore, T., Picard, R.: Establishing and Maintaining Long-Term Human-Computer Relationships. ACM Transactions on Computer Human Interaction 12, 293–327 (2005)CrossRefGoogle Scholar
  9. 9.
    Bickmore, T., Gruber, A., Picard, R.: Establishing the computer-patient working alliance in automated health behavior change interventions. Patient Educ. Couns. 59, 21–30 (2005)CrossRefGoogle Scholar
  10. 10.
    Cassell, J., Vilhjálmsson, H., Bickmore, T.: BEAT: The Behavior Expression Animation Toolkit. In: SIGGRAPH 2001, Los Angeles, CA, pp. 477–486 (2001)Google Scholar
  11. 11.
    McNeill, D.: Hand and Mind: What Gestures Reveal about Thought. Cambridge University Press, Cambridge (1992)Google Scholar
  12. 12.
    Cassell, J., Nakano, Y., Bickmore, T., Sidner, C., Rich, C.: Non-Verbal Cues for Discourse Structure, pp. 106–115. Association for Computational Linguistics, Toulouse (2001)Google Scholar
  13. 13.
    Bickmore, T., Pfeifer, L., Byron, D., Forsythe, S., Henault, L., Jack, B., Silliman, R., Paasche-Orlow, M.: Usability of Conversational Agents by Patients with Inadequate Health Literacy: Evidence from Two Clinical Trials. Journal of Health Communication 15, 197–210 (2010)CrossRefGoogle Scholar
  14. 14.
    Bickmore, T., Mitchell, S., Jack, B., Paasche-Orlow, M., Pfeifer, L., O’Donnell, J.: Response to a Relational Agent by Hospital Patients with Depressive Symptoms. Interacting with Computers 22, 289–298 (2010)CrossRefGoogle Scholar
  15. 15.
    Nickell, G.S., Pinto, J.N.: The computer attitude scale. Computers in Human Behavior 2, 301–306 (1986)CrossRefGoogle Scholar
  16. 16.
    Venkatesh, V., Morris, M., Davis, G., Davis, F.: User acceptance of information technology: toward a unified view. MIS Quarterly 27, 425–478 (2003)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.College of Computer and Information ScienceNortheastern UniversityBostonUSA
  2. 2.Boston Medical CenterBoston University School of MedicineBostonUSA

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