OSU using VR to train medical residents to take history of patients with limited English proficiency

[The Columbus Dispatch report below describes a new program that uses VR and social presence to train medical residents in an important part of their job; see the original story for a second image, and see coverage from WBNS 10 for a 1:11 minute video news report. –Matthew]

[Image: Douglas Danforth, the academic program director at Ohio State University’s College of Medicine explains a virtual reality program to residents. The program is being used to help residents get the medical history of patients who don’t speak English as a first language. Credit: Ellen Wagner/Dispatch]

Virtual reality patients give Ohio State medical residents hands-on experience

By Ellen Wagner, The Columbus Dispatch
June 19, 2019

Mr. Martinez is a patient at Ohio State University’s Wexner Medical Center who is Hispanic, speaks little English and is suffering from back pain.

He also is not real.

Mr. Martinez is one of 13 virtual reality patients that residents use in training when learning how to take the history of a patient who has limited English proficiency.

The virtual patients are controlled by artificial intelligence and understand most of what the residents ask them as long as it is a reasonable question in a doctor-patient interaction, said Douglas Danforth, Ph.D, academic program director at Ohio State’s College of Medicine.

“It’s kind of like Siri or Alexa, but rather than just getting directions or getting your lights turned on, you can carry on a nuanced conversation,” he said.

On Tuesday, Danforth showed residents what the software looks like on a television screen featuring an animated man in an exam room. The residents then practiced speaking to the virtual patients through a virtual reality headset and an app on an iPad or web browser.

Residents started using the headsets for training about a month ago, and the university is looking to purchase more headsets, Danforth said.

Ohio State applied for funding and is sharing with five other medical schools in Ohio a $5.5 million grant from the Ohio Department of Medicaid, which wants to see virtual reality simulations created to enhance cultural competency in Medicaid providers.

The grant will be used to pay for four virtual training programs: the resident training as well as ones for building empathy for dementia patients, access to dental care for immigrant families and to help providers learn more about unconscious biases such as race, gender or other areas of which they are unaware but can affect their treatment of patients.

Danforth said Ohio State has other virtual reality training for medical students, but the state grant allows Ohio State to start the program for residents.

The virtual patients have various medical issues, such as chest pain or depression, and can have simple or complex medical backgrounds.

The virtual patients speak Spanish because it is the most common non-English language residents will encounter in the Columbus area, Danforth said.

“What they need to practice is speaking with someone whom English is not their first language,” he said. It doesn’t matter what language patients speak, Danforth said, residents just need to learn how to break through the language barrier.

Kellen Maicher, a learning and development consultant at Ohio State’s Arthur G. James Cancer Hospital, helped create the programming of the virtual patients with faculty from different departments at the university.

Motion capture suits were used to record the body movements of the medical students, which were later mapped on to the patients. The virtual patients are also programmed to respond with different emotions such as anger, sadness or confusion.

Danforth said the facial expression and body postures are small but help make the virtual patients seem more realistic.

The system also provides residents with immediate feedback, such as what questions they forgot to ask, and then compares their performance with best practices.

JC Chen, a first-year intern at the Wexner Medical Center, had never used virtual reality before the training.

Chen said the interaction with the virtual patient is good practice, but it’s not the same as reading the facial expressions and body language of a real patient.

“I don’t think it is something that can ever replace human interaction,” he said. “But I do think it does help you get off the ground and get some exposure.”


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