Increased medical student understanding of dementia through virtual embodiment

Assessing virtual patients for empathy training in healthcare: A scoping review

OBJECTIVE

A growing body of virtual patients (VPs) generated by computers has been incorporated into medical education that includes empathy training. We sought to uncover the validity and effectiveness of VPs in empathy training.

METHOD

The authors carried out a comprehensive search of all articles published between 1991 and 2023 in the seven databases of literature in the areas of health science and education. In total, 2170 abstracts were reviewed, and ultimately, the final corpus consisted of 44 articles.

RESULTS

Guided by the Computer-as-social-actor framework, this study identified four types of primary social cues presented in current literature to arouse trainees' social responses. Overall, the social cues used across the included studies were similar. However, the efficacy and effectiveness of VPs varied, and we identified four factors that may influence these outcomes. First, technology matters. VPs for VR systems were found to be effective in clinical empathy training, but limited empirical evidence supported web-or-mobile-based VPs. Second, improvement was only observed in the cognitive empathy dimension. Third, studies that have longer interaction duration (over 30 minutes). Last, using self-report measurements were more likely to observe significant improvements. Qualitative findings revealed that VPs for VR systems can create an immersive experience that allows users to understand the needs of patients and put themselves in patients' shoes, while web-or-mobile-based VPs are more convenient for trainees.

PRACTICAL IMPLICATIONS

This review displays evidence supporting the efficacy and effectiveness of VPs in future medical empathy training. Mechanisms and future research agendas were discussed.

CONCLUSION

VPs are promising tools for future empathy training.

Epistemic humility meets virtual reality: teaching an old ideal with novel tools

The pace of scientific advancements in medicine, driven by artificial intelligence as much as by novel biotechnologies, demands an ever-faster update of professional knowledge from physicians and collaboration in interdisciplinary teams. At the same time, the increased heterogeneity of patients' lifeworlds in socially and culturally diverse societies requires healthcare professionals to consider diverging personal and cultural perspectives in their treatment recommendations. Both developments require conveying to students a professional virtue that can be summarised as epistemic humility-a teaching process which, we argue, can and should be supported by novel technologies. By embedding students in realistic scenarios, virtual reality can play a crucial role in teaching medical students a stance of epistemic humility. Such stance implies acknowledging the limitations of one's knowledge as well as taking individual patients' perspectives and experiences seriously. In this sense, epistemic humility can also provide a crucial step towards tackling epistemic injustice and biases in medicine. We discuss how teaching epistemic humility with virtual reality tools can succeed and suggest the development of novel teaching tools that make use of this technology to immersively enable moral growth. Our paper thereby contributes to the emerging field of digital bioethics, calls for more work in the area of experimental bioethics and informs ongoing debates on how medical ethics teaching can prepare future physicians for the challenges of tomorrow's practice of medicine.

Impact of a Virtual Reality Video ("A Walk-Through Dementia") on YouTube Users: Topic Modeling Analysis

Background

Emerging research has highlighted the potential of virtual reality (VR) as a tool for training health care students and professionals in care skills for individuals with Alzheimer disease and related dementias (ADRD). However, there is limited research on the use of VR to engage the general public in raising awareness about ADRD.

Objective

This research aimed to examine the impact of the VR video "A Walk-Through Dementia" on YouTube users by analyzing their posts.

Methods

We collected 12,754 comments from the VR video series "A Walk-Through Dementia," which simulates the everyday challenges faced by individuals with ADRD, providing viewers with an immersive experience of the condition. Topic modeling was conducted to gauge viewer opinions and reactions to the videos. A pretrained Bidirectional Encoder Representations from Transformers (BERT) model was used to transform the YouTube comments into high-dimensional vector embeddings, allowing for systematic identification and detailed analysis of the principal topics and their thematic structures within the dataset.

Results

We identified the top 300 most frequent words in the dataset and categorized them into nouns, verbs, and adjectives or adverbs using a part-of-speech tagging model, fine-tuned for accurate tagging tasks. The topic modeling process identified eight8 initial topics based on the most frequent words. After manually reviewing the 8 topics and the content of the comments, we synthesized them into 5 themes. The predominant theme, represented in 2917 comments, centered on users' personal experiences with the impact of ADRD on patients and caregivers. The remaining themes were categorized into 4 main areas: positive reactions to the VR videos, challenges faced by individuals with ADRD, the role of caregivers, and learning from the VR videos.

Conclusions

Using topic modeling, this study demonstrated that VR applications serve as engaging and experiential learning tools, offering the public a deeper understanding of life with ADRD. Future research should explore additional VR applications on social media, as they hold the potential to reach wider audiences and effectively disseminate knowledge about ADRD.

Evaluation of pharmacy student empathy toward patients living with Alzheimer's disease and related dementias and caregivers following a dementia simulation

Alzheimer's Disease and Related Dementias (ADRD) is a leading cause of death in the United States, with national goals in place to improve the quality of care provided to this population. With little available literature on empathy training for pharmacy students in caring for patients living with ADRD, this study outlined the implementation process of an immersive sensory experience, the Virtual Dementia Tour (VDT), into a Doctor of Pharmacy curriculum and evaluated the impact of the experience on pharmacy students' empathy for persons living with ADRD. After completing the VDT, quantitative analysis demonstrated a significant reduction in the pharmacy students' ability to capably complete tasks and relax, and a positive change in their perceptions of the need for improved care for persons living with ADRD. Qualitative analytical approaches identified themes of "Empathy," "Patient Care and Advocacy," "Education," as well as the cognitive, mental, and physical impact of the experience. Valuable lessons learned while providing ADRD empathy training to Doctor of Pharmacy students includes reallocation of faculty resources, curricular development of an innovative empathy-building experience for students, and improved experience delivery efficiency. Overall, a significant change in pharmacy students' empathy toward patients living with ADRD was observed.

Exploring self-experience practices in dementia care: A scoping review

BACKGROUND

Recognised as essential for high-quality dementia service, person-centred care aims to understand and respect the unique needs of each individual. Self-experience practices may offer caregivers an opportunity to acquire knowledge, empathy, and skills related to person-centred care, especially through recreating experiences similar to dementia. Given the need to enhance the understanding of self-experience practices in dementia care, a more comprehensive investigation of these training interventions for (future) caregivers is needed.

METHODS

We conducted a scoping review to map the evidence on the use of self-experience practices in dementia training. We systematically searched Cochrane Library, MEDLINE via PubMed, CINAHL, and Web of Science. We also searched for grey literature, as well as registry entries, and conducted backward citation tracking of included reviews. We analysed data on intervention characteristics, factors influencing the implementation, and learning outcomes based on Kirkpatrick's model.

RESULTS

We included 44 reports across 30 intervention programmes. The majority of reports (91%) were published from 2016 onwards, with 32% originating from the USA and 25% from the UK. We identified passive, interactive, immersive, and multicomponent self-experience interventions in dementia education and training. Learning outcomes based on Kirkpatrick's model were fairly distributed across all identified modalities. Both consumers and providers emphasised aspects related to the development and implementation of practices, particularly organisational-related considerations such as temporal and spatial planning of trainings.

CONCLUSIONS

Our review highlights diverse interventions incorporating self-experience practices, with an increasing role for technological tools. While self-experience interventions engage participants, the impact on individuals with dementia and organisational levels remain largely unreported. Our overview, informed by current literature, underscores unique considerations and challenges associated with dementia-related self-experience practices. Implementing and evaluating complex training interventions using self-experience practices should consider ethical aspects.

TRIAL REGISTRATION

Registry: Registered within the Open Science Framework (available at https://osf.io/fycxa/).

In their shoes: Health care professionals walking a day in the life of patients with short bowel syndrome & intestinal failure

BACKGROUND & AIMS

Short bowel syndrome leading to intestinal failure (SBS-IF) is a condition characterised by the inability of the gut to absorb the amount of water, nutrients and micronutrients needed to survive and requires long term home parenteral nutrition (HPN) to sustain life. Health care professionals (HCPs) working with patients with SBS-IF are aware of the daily challenges patients face. However, few have experienced the condition first-hand and put themselves 'in the shoes' of their patients. In Their Shoes (ITS) is an immersive simulation delivered through a smartphone application (app), in which participants experience the typical real-life challenges that somebody with SBS-IF will experience over a 24-h period, including social and psychological challenges. This study evaluated the impact of ITS simulation on HCPs working with adults with SBS-IF.

METHODS

A representative sample of 27 multi-disciplinary team (MDT) members working on an Intestinal Failure Unit completed the ITS simulation over a 24-h period. A mixed methods design was used, which included participants completing a survey pre- and post-ITS experience, followed by focus groups and in-depth qualitative interviews. Pre- and post-intervention questions were analysed quantitively via paired t-tests and qualitative data arising from the focus groups and interviews were analysed using inductive thematic analysis.

RESULTS

25 participants (93%) completed 80% of the ITS challenges whilst 27 (100%) completed more than 50% challenges. Participants reported a 16% increase in knowledge, 18% increase in being able to talk to others about SBS and a 2% increase in empathy between pre- and post-simulation. Nineteen team members participated in focus groups and 10 in-depth interviews; qualitative analysis of digital recordings comprised four overarching themes: empathy; admiration and respect; empathy fatigue; learning experience. Despite the small and insignificant increase in empathy scores quantitatively, analysis of open-ended questions and qualitative data found that 74% of participants reported an increase in empathy levels whereas 26% felt it stayed the same.

CONCLUSIONS

As a simulation-based learning method, ITS can have a positive impact on HCPs working into the SBS-IF setting. Positive benefits in clinical practice include increased levels of empathy, admiration and respect for patients amongst HCPs. Immersing into the ITS experience also allows HCPs to recognise the function and benefits to MDT working, both in terms of ensuring holistic patient centred care and managing HCP empathy fatigue.