Using Virtual Patients to Teach Empathy: A Randomized Controlled Study to Enhance Medical Students' Empathic Communication

Simulation in Healthcare

Volumn 11, Issue 3, 2016, Pages 181-189

  Foster, Adriana ^a   Chaudhary, Neelam ^c   Kim, Thomas ^d   Waller, Jennifer L ^c   Wong, Joyce ^c   Borish, Michael ^b   Cordar, Andrew ^b   Lok, Benjamin ^b   Buckley, Peter F ^c  

^a FLORIDA INTERNATIONAL UNIVERSITY   (United States)

^b J Crayton Pruitt Family Department of Biomedical Engineering   (United States)

^c MEDICAL COLLEGE OF GEORGIA   (United States)

^d TUFTS MEDICAL CENTER   (United States)

Author keywords

Challenge; Depression; Emotion; Empathic communication; Empathic opportunity; Empathy; Human assisted; Virtual patient

Indexed keywords

ADULT; CONTROLLED STUDY; DOCTOR PATIENT RELATION; EMPATHY; FEEDBACK SYSTEM; FEMALE; HUMAN; INTERPERSONAL COMMUNICATION; MALE; MEDICAL EDUCATION; PROCEDURES; RANDOMIZED CONTROLLED TRIAL; SIMULATION TRAINING;

ADULT; COMMUNICATION; EDUCATION, MEDICAL, UNDERGRADUATE; EMPATHY; FEEDBACK; FEMALE; HUMANS; MALE; PHYSICIAN-PATIENT RELATIONS; SIMULATION TRAINING;

EID: 84956894322     PISSN: 15592332     EISSN: 1559713X     Source Type: Journal    
DOI: 10.1097/SIH.0000000000000142     Document Type: Article

References (38)

1. HojatM, Louis DZ, Markham FW,Wender R, Rabinowitz C, Gonella JS. Physicians' empathy and outcomes for diabetic patients. Acad Med 2011;86:359-364.
2. Rakel D, Barrett B, Zhang Z, et al. Perception of empathy in the therapeutic encounter: effects on the common cold. Patient Educ Couns 2011;85:390-397.
3. Stepien KA, Baernstein A. Educating for empathy. A review. J Gen Intern Med 2006;21:524-530.
4. Batt-Rawden SA, Chisolm MS, Anton B, Flickinger TE. Teaching empathy to medical students: an updated, systematic review. Acad Med 2013;88:1171-1177.
5. Charon R. The patient-physician relationship. Narrative medicine. A model for empathy, reflection, profession and trust. JAMA 2001;286(15):1897-1902.
6. Chen D, Lew R, Hershman W, Orlander J. A cross-sectional measurement of medical student empathy. J Gen Intern Med 2007;22(10):1434-1438.
7. Newton BW, Savidge MA, Barber L, et al. Differences in medical students' empathy. Acad Med 2000;75:1215.
8. Hojat M, Vergare MJ, Maxwell K, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med 2009;84:1182-1191.
9. Bylund CL, Makoul G. Empathic communication and gender in the physician-patient encounter. Patient Educ Couns 2002;48:207-216.
10. Hojat M, Gonnela JS, Nasca TJ, Mangione S, Veloski JJ, Magee M. The Jefferson Scale of Physician Empathy: further psychometric data and differences by gender and specialty at item level. Acad Med 2002;77(Suppl 10):558-560.
11. DiGioia A, Greenhouse P. Patient and family shadowing: creating urgency for change. J Nurs Adm 2011;41:23-28.
12. DiGioia A 3rd, Lorenz H, Greenhouse PK, Bertoty DA, Rocks SD. A patient-centered model to improve metrics without cost increase: viewing all care through the eyes of patients and families. J Nurs Adm 2010;40(12):540-546.
13. Henry-Tillman R, Deloney LA, Savidge M, Graham CJ, Klimberg VS. The medical student as patient navigator as an approach to teaching empathy. Am J Surg 2002;183:659-662.
14. Wilkes M, Milgrom E, Hoffman JR. Towards more empathic medical students: a medical student hospitalization experience. Med Educ 2002;36:528-533.
15. Moulton CA, Tabak D, Kneebone R, Nestel D, MacRae H, LeBlanc VR. Teaching communication skills using the integrated procedural performance instrument (IPPI): a randomized controlled trial. Am J Surg 2009;197(1):113-118.
16. Stevens A, Hernandez J, Johnsen K, et al. The use of virtual patients to teach medical students history taking and communication skills. Am J Surg 2006;191:806-811.
17. Shah H, Rossen B, Lok B, Londino D, Lind SD, Foster A. Interactive virtual-patient scenarios: an evolving tool in psychiatric education. Acad Psychiatry 2012;36:146-150.
18. Foster A, Chaudhary N, Murphy J, Lok B,Waller J, Buckley PF. The use of simulation to teach suicide risk assessment to health profession trainees-rationale, methodology, and a proof of concept demonstration with a virtual patient. Acad Psychiatry 2015;39(6):620-629.
19. Peden M, Chuah J, Kotranza A, Johnsen K, Lok B, Cendan J. NERVEVA Three Dimensional Patient Simulation for Evaluating Cranial Nerve Function. MedEdPORTAL Publications; 2011. Available at: https://www.mededportal.org/publication/8255 http://dx.doi.org/10.15766/mep-2374-8265.8255. See more at: https://www.mededportal.org/publication/8255#sthash.kNOuklIe.dpuf.
20. Kleinsmith A, Rivera-Gutierrez D, Finney G, Cendan J, Lok B. Understanding empathy training with virtual patients. Comput Human Behav 2015;52:151-158.
21. Deladisma AM, Cohen M, Stevens A, et al. Do medical students respond empathetically to a virtual patient? Am J Surg 2007;193:756-760.
22. Foster A, Harms J, Ange B, et al. Empathic communication in medical students' interactions with mental health virtual patient scenarios: a descriptive study using the Empathic Communication Coding System. Austin J Psychiatry Behav Sci 2014;1(3):6.
23. Borish M, Cordar A, Foster A, Kim T, Murphy J, Lok B. Utilizing real-time human-assisted virtual humans to increase real-world interaction empathy. Kansei Engineering & Emotion Research (KEER'14) 2014:15.
24. McClendon JL, Mack NA, Hodges LF. The use of paraphrase identification in the retrieval of appropriate responses for script based conversational agents. Proceedings of the Twenty-Seventh International Florida Artificial Intelligence Research Society Conference. 2014.
25. Kittur A, Chi EH, Suh B. Crowdsourcing user studies with Mechanical Turk. New York, NY: Proceedings of the SIGCHI conference on human factors in computing systems, ACM; 2008:453-456.
26. Rossen B, Lind S, Lok B. Human-centered distributed conversational modeling: efficient modeling of robust virtual human conversations. In: Intelligent Virtual Agents. Berlin, Germany: Springer; 2009:474-481.
27. Cordar A, Borish M, Foster A, Lok B. Building virtual humans with back stories: training interpersonal communication skills in medical students. In: Bickmore T, et al., eds. Intelligent Virtual Agents 2014, LNAI 8637. Switzerland: Springer International Publishing; 2014;144-153.
28. Holmes EP, Corrigan PW, Williams P, Canar J, Kubiak M. Changing attitudes about schizophrenia. Schizophr Bull 1999;25(3):447-456.
29. Bylund CL, Makoul G. Examining empathy in medical encounters: an observational study using the Empathic Communication Coding System. Health Commun 2005;18(2):123-140.
30. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-174.
31. Goldenberg M, Hamaoka D, Money K, Flanagan Risdal A, Darby E. Standardized patient case: a troubled soldier. MedEdPORTAL 2011. Available at: www.mededportal.org/publication/8597.
32. DSM-IV-TR. Diagnostic and Statistical Manual ofMental Disorders, Text Revision. Arlington, VA: American Psychiatric Association; 2000.
33. Fallucco MD, Hanson MD, Glowinski AL. Teaching pediatric residents to assess adolescent suicide risk with a standardized patient module. Pediatrics 2010;125(5):953-959.
34. Black AE, Church M. Assessing medical student effectiveness from the psychiatric patient's perspective: The Medical Student Interviewing Performance Questionnaire. Med Educ 1998;32(5):472-478.
35. SurveyMonkey. https://www.surveymonkey.com/, accessed July 12, 2015.
36. Wind LA, Van Dalen J,Muijtjens AM, et al. Assessing simulated patients in an educational setting: the MaSP (Maastricht Assessment of Simulated Patients). Med Educ 2004;38(1):39-44.
37. Goodchild CE, Skinner TE, Parkin T. The value of empathy in dietetic consultations. A pilot study to investigate its effect on satisfaction, autonomy and agreement. J Hum Nutr Diet 2005;18:181-185.
38. Davis MH. Measuring individual differences in empathy: evidence for a multidimensional approach. J Pers Soc Psychol 1983;44(1):113-126.