Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial

Frederick W Kron; Michael D Fetters; Mark W Scerbo; Casey B White; Monica L Lypson; Miguel A Padilla; Gayle A Gliva-McConvey; Lee A Belfore 2nd; Temple West; Amelia M Wallace; Timothy C Guetterman; Lauren S Schleicher; Rebecca A Kennedy; Rajesh S Mangrulkar; James F Cleary; Stacy C Marsella; Daniel M Becker

doi:10.1016/j.pec.2016.10.024

Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial

Patient Educ Couns. 2017 Apr;100(4):748-759. doi: 10.1016/j.pec.2016.10.024. Epub 2016 Oct 29.

Authors

Frederick W Kron¹, Michael D Fetters², Mark W Scerbo³, Casey B White⁴, Monica L Lypson⁵, Miguel A Padilla⁶, Gayle A Gliva-McConvey⁷, Lee A Belfore 2nd⁸, Temple West⁹, Amelia M Wallace¹⁰, Timothy C Guetterman¹¹, Lauren S Schleicher¹², Rebecca A Kennedy¹³, Rajesh S Mangrulkar¹⁴, James F Cleary¹⁵, Stacy C Marsella¹⁶, Daniel M Becker¹⁷

Affiliations

¹ Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104, USA. Electronic address: fredkron@umich.edu.
² Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104, USA. Electronic address: mfetters@umich.edu.
³ Department of Psychology, Old Dominion University, Norfolk, VA, 23529, USA. Electronic address: mscerbo@odu.edu.
⁴ Department of Medical Education, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA. Electronic address: cw4xz@virginia.edu.
⁵ Department of Internal Medicine, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, 48104, USA. Electronic address: mlypson@med.umich.edu.
⁶ Department of Psychology, Old Dominion University, Norfolk, VA, 23529, USA. Electronic address: mapadill@odu.edu.
⁷ Sentara Center for Simulation and Immersive Learning, Eastern Virginia Medical School, Norfolk, VA, 23501, USA. Electronic address: glivaga@evms.edu.
⁸ Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, VA, 23529, USA. Electronic address: lbelfore@odu.edu.
⁹ Sentara Center for Simulation and Immersive Learning, Eastern Virginia Medical School, Norfolk, VA, 23501, USA. Electronic address: westt@evms.edu.
¹⁰ Sentara Center for Simulation and Immersive Learning, Eastern Virginia Medical School, Norfolk, VA, 23501, USA. Electronic address: wallacam@evms.edu.
¹¹ Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104, USA. Electronic address: tguetter@umich.edu.
¹² Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104, USA. Electronic address: lschlei@med.umich.edu.
¹³ Department of Psychology, Old Dominion University, Norfolk, VA, 23529, USA. Electronic address: rkenn014@odu.edu.
¹⁴ Department of Internal Medicine, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, 48104, USA. Electronic address: rajm@umich.edu.
¹⁵ Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, 53706, USA. Electronic address: jfcleary@wisc.edu.
¹⁶ Department of Computer Science, Department of Psychology, Northeastern University, Boston, MA, 02115, USA. Electronic address: marsella@ccs.neu.edu.
¹⁷ Department of Medicine, University of Virginia Health System, Charlottesville, VA, 22908, USA. Electronic address: dmb2y@hscmail.mcc.virginia.edu.

Abstract

Objectives: To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences.

Methods: A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes.

Secondary outcomes: student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning.

Results: MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters.

Conclusions: MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation.

Practice implications: MPathic-VR's virtual human simulation offers an effective and engaging means of advanced communication training.

Keywords: Breaking bad news; Communication training; Computer simulation; Computer-based conversational agent; Cultural competence; Doctor-patient relationship; Healthcare communication; Human-computer interaction; Intelligent tutoring systems; Inter-professional communication; Intercultural communication; Knowledge transfer; Mindful practice; Mixed methods research; Nonverbal communication; Reflection in action; Reflection on action; Simulation; Training transfer; Virtual Human.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Adult
Clinical Competence*
Communication*
Computer Simulation*
Curriculum
Education, Medical
Female
Humans
Male
Patient Simulation*
Physician-Patient Relations
Single-Blind Method
Students, Medical / psychology*
User-Computer Interface

Abstract

Publication types

MeSH terms

Grants and funding