Publications

Medical Publications

 

Improving Clinical Dysphagia Interviewing Skills by Virtual Patient Creation

Crary MA Sia I, Halan S, Lok B (2014) Improving Clinical Dysphagia Interviewing Skills by Virtual Patient Creation

To evaluate the impact of creating virtual patients on improving clinical dysphagia interviewing skills.

Development of a Therapeutic Virtual Grocery Store to Treat Cognitive and Emotional Dysfunction in Mild Traumatic Brain injury ( mTBI ) and Post-Traumatic Stress Disorder ( PTSD ): Prototype Progress Report Virtual Environments / Virtual Humans Methods an

Benjamin C. Lok Charles E. Levy, Shivashankar Halan, David Omura, Vaishnavi Krishnan, Aaron Kotranza, James Oliverio (2011) Development of a Therapeutic Virtual Grocery Store to Treat Cognitive and Emotional Dysfunction in Mild Traumatic Brain injury ( mTBI ) and Post-Traumatic Stress Disorder ( PTSD ): Prototype Progress Report Virtual Environments / Virtual Humans Methods an(c), p. 3

Description of web-enhanced virtual character simulation system to standardize patient hand-offs.

Lori Filichia, Shivashankar Halan, Ethan Blackwelder, Brent Rossen, Benjamin Lok, James Korndorffer, Juan Cendan (2011) Description of web-enhanced virtual character simulation system to standardize patient hand-offs. 166(2), p. 176-81, Elsevier Inc

The 80-h work week has increased discontinuity of patient care resulting in reports of increased medication errors and preventable adverse events. Graduate medical programs are addressing these shortcomings in a number of ways.

Virtual humans versus standardized patients: which lead residents to more correct diagnoses?

Adam L Wendling, Shivashankar Halan, Patrick Tighe, Linda Le, Tammy Euliano, Benjamin Lok (2011) Virtual humans versus standardized patients: which lead residents to more correct diagnoses? 86(3), p. 384-8

Medical educators frequently use standardized patient (SP) encounters to bridge the gap between didactic education and practical application. Typically, SPs are healthy adults with no consistent physical findings; however, highly immersive virtual humans (VHs) may enable the consistent presentation of abnormal physical findings to multiple learners across multiple repetitions. Thus, the authors conducted this study to compare how frequently junior anesthesiology residents suspected obstructive sleep apnea (OSA) in preoperative assessments of SPs versus a VH.

Virtual Patient with Cranial Nerve Injury Augments Physician-Learner Concern for Patient Safety

Aaron Kotranza, Juan C Cendan, Kyle Johnsen, Benjamin Lok (2010) Virtual Patient with Cranial Nerve Injury Augments Physician-Learner Concern for Patient Safety 6(11), p. 25-34

We have created the Neurological Exam Rehearsal Virtual Environment (NERVE), a virtual patient based simulation targeted to train medical students in the diagnosis of abnormal fi ndings in the neurological examination. In NERVE, a learner communicates with and performs a physical examination of a life-sized virtual character experiencing double vision as a result of a cranial nerve palsy. NERVE affords verbal communication through natural speech and gestures, and affords physical interaction through manipulation of virtual tools such as an ophthalmoscope. Creation of NERVE is motivated by the limited quantity and depth of current medical education and simulation approaches to providing learners with exposure to abnormal physical fi ndings in the context of a doctor-patient interaction. NERVE not only provides an immersive and on-demand learning opportunity, but provides students with the opportunity to experience the patient’s double vision in the fi rst person in a “Patient Vision Feedback” (PVF) session. PVF allows the learner to experience how the world looks to the virtual patient, providing an opportunity for enhanced perspective taking and empathy. Thirty-two medical students have examined a virtual patient in NERVE. Twenty-nine of these students were able to correctly diagnose the virtual patient’s cranial nerve palsy, demonstrating content validity of NERVE. A subset of eight medical students experienced Patient Vision and, as a result, demonstrated improved concern for the patient’s wellbeing. NERVE is able to augment a neurology curriculum by providing increased exposure to abnormal fi ndings and providing students with a unique insight into how the disease affects the patient’s wellbeing.

A PILOT STUDY TO EVALUATE THE USE OF AN ONLINE VIRTUAL PATIENT SYSTEM TO TEACH INTERVIEWING SKILLS TO FIRST-YEAR MEDICAL STUDENTS

Brent Rossen, Ashita Gehlot, Hevil Shah, Joseph Fox, Adeline M. Deladisma, Benjamin Lok, D. Scott Lind(2009) A PILOT STUDY TO EVALUATE THE USE OF AN ONLINE VIRTUAL PATIENT SYSTEM TO TEACH INTERVIEWING SKILLS TO FIRST-YEAR MEDICAL STUDENTS, p. 58

A PILOT STUDY TO INVESTIGATE THE EFFICACY OF A NOVEL INTERACTIVE WEB-BASED VIRTUAL CLINICAL SCENARIO SYSTEM ( VIRTUAL PEOPLE FACTORY ) IN MEDICAL EDUCATION Hevil

Hevil Shah, P Joseph, Brent Rossen, Adeline Deladisma, Ashita Gehlot, Teresa Lord, Angela Gucwa, Amira Mouna, John Beatty, Brenda Rosson, Benjamin Lok, D Scott Lind (2009) A PILOT STUDY TO INVESTIGATE THE EFFICACY OF A NOVEL INTERACTIVE WEB-BASED VIRTUAL CLINICAL SCENARIO SYSTEM ( VIRTUAL PEOPLE FACTORY ) IN MEDICAL EDUCATION Hevil 38, p. 78

A Study to Investigate the Efficacy of a Novel Interactive Web-Based Virtual Clinical Scenario System ( Virtual People Factory ) in Medical Education .

Nantha Surkunalingam, Jeremy Walker, Christopher Taranto, Samantha Mccaskill, Christopher Blanchard, D Scott Lind, Benjamin Lok, Brent Rossen (2009) A Study to Investigate the Efficacy of a Novel Interactive Web-Based Virtual Clinical Scenario System ( Virtual People Factory ) in Medical Education .(29), p. 2009

We have created the Neurological Exam Rehearsal Virtual Environment (NERVE), a virtual patient based simulation targeted to train medical students in the diagnosis of abnormal fi ndings in the neurological examination. In NERVE, a learner communicates with and performs a physical examination of a life-sized virtual character experiencing double vision as a result of a cranial nerve palsy. NERVE affords verbal communication through natural speech and gestures, and affords physical interaction through manipulation of virtual tools such as an ophthalmoscope. Creation of NERVE is motivated by the limited quantity and depth of current medical education and simulation approaches to providing learners with exposure to abnormal physical fi ndings in the context of a doctor-patient interaction. NERVE not only provides an immersive and on-demand learning opportunity, but provides students with the opportunity to experience the patient’s double vision in the fi rst person in a “Patient Vision Feedback” (PVF) session. PVF allows the learner to experience how the world looks to the virtual patient, providing an opportunity for enhanced perspective taking and empathy. Thirty-two medical students have examined a virtual patient in NERVE. Twenty-nine of these students were able to correctly diagnose the virtual patient’s cranial nerve palsy, demonstrating content validity of NERVE. A subset of eight medical students experienced Patient Vision and, as a result, demonstrated improved concern for the patient’s wellbeing. NERVE is able to augment a neurology curriculum by providing increased exposure to abnormal fi ndings and providing students with a unique insight into how the disease affects the patient’s wellbeing.

A Pilot Study to Evaluate the Use of an Interactive Virtual Patient with Depression to Teach History-Taking Skills in a Psychiatry Clerkship

Benjamin Lok, Amy House, DS Lind, Adriana Foster, Hevil Shah (2009) A Pilot Study to Evaluate the Use of an Interactive Virtual Patient with Depression to Teach History-Taking Skills in a Psychiatry Clerkship, p. 75

Do medical students respond empathetically to a virtual patient?

Adeline M. Deladisma, Marc Cohen, Amy Stevens, Peggy Wagner, Benjamin Lok, Thomas Bernard, Christopher Oxendine, Lori Schumacher, Kyle Johnsen, Robert Dickerson, Andrew Raij, Rebecca Wells, Margaret Duerson, J. Garrett Harper, D. Scott Lind (2007) Do medical students respond empathetically to a virtual patient? 193(6), p. 756-760

Examined the quantity and quality of empathetic responses to virtual patient initiated challenges.

Virtual Patients Reduce Anxiety and Enhance Learning When Teaching Medical Students Sexual-history Taking Skills

D Mack, A Deladisma, T Bernard (2007) Virtual Patients Reduce Anxiety and Enhance Learning When Teaching Medical Students Sexual-history Taking Skills 2(1), p. 58

Talking to a virtual patient about a breast complaint reduces physiological measures of anxiety (blood pressure and heart rate) when then talking to a standardized patient about a breast complaint.

The use of virtual patients to teach medical students history taking and communication skills.

Amy Stevens, Jonathan Hernandez, Kyle Johnsen, Robert Dickerson, Andrew Raij, Cyrus Harrison, Meredith DiPietro, Bryan Allen, Richard Ferdig, Sebastian Foti, Jonathan Jackson, Min Shin, Juan Cendan, Robert Watson, Margaret Duerson, Benjamin Lok, Marc Cohen, Peggy Wagner, D Scott Lind (2006) The use of virtual patients to teach medical students history taking and communication skills. 191(6), p. 806-11

BACKGROUND: At most institutions, medical students learn communication skills through the use of standardized patients (SPs), but SPs are time and resource expensive. Virtual patients (VPs) may offer several advantages over SPs, but little data exist regarding the use of VPs in teaching communication skills. Therefore, we report our initial efforts to create an interactive virtual clinical scenario of a patient with acute abdominal pain to teach medical students history-taking and communication skills. METHODS: In the virtual scenario, a life-sized VP is projected on the wall of an examination room. Before the virtual encounter, the student reviews patient information on a handheld tablet personal computer, and they are directed to take a history and develop a differential diagnosis. The virtual system includes 2 networked personal computers (PCs), 1 data projector, 2 USB2 Web cameras to track the user's head and hand movement, a tablet PC, and a microphone. The VP is programmed with specific answers and gestures in response to questions asked by students. The VP responses to student questions were developed by reviewing videotapes of students' performances with real SPs. After obtaining informed consent, 20 students underwent voice recognition training followed by a videotaped VP encounter. Immediately after the virtual scenario, students completed a technology and SP questionnaire (Maastricht Simulated Patient Assessment). RESULTS: All participants had prior experience with real SPs. Initially, the VP correctly recognized approximately 60% of the student's questions, and improving the script depth and variability of the VP responses enhanced most incorrect voice recognition. Student comments were favorable particularly related to feedback provided by the virtual instructor. The overall student rating of the virtual experience was 6.47 1.63 (1 = lowest, 10 = highest) for version 1.0 and 7.22 1.76 for version 2.0 (4 months later) reflecting enhanced voice recognition and other technological improvements. These overall ratings compare favorably to a 7.47 1.16 student rating for real SPs. CONCLUSIONS: Despite current technological limitations, virtual clinical scenarios could provide students a controllable, secure, and safe learning environment with the opportunity for extensive repetitive practice with feedback without consequence to a real or SP.

The Virtual Experiences Research Group

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