Avatar-Mediated Training in the Delivery of Bad News in a Virtual World
Avatar-Mediated Training in the Delivery of Bad News in a Virtual World
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DOI：
10.1089/jpm.2010.0108
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发表时间：
2010-12-01
影响因子：
2.8
通讯作者：
Ruiz, Jorge G.
中科院分区：
文献类型：
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作者：
Andrade, Allen D.;Bagri, Anita;Ruiz, Jorge G.
背景：向病人传达坏消息是医生必不可少的沟通技巧。教育工作者通常使用标准化病人（SP）来训练医生传达坏消息。由于旅行和日程安排等后勤方面的原因，使用演员的成本很高，而且演员在教学中所能塑造的角色和条件也有限。因此，我们研究了在虚拟世界中创建SP化身来训练医学实习生传递坏消息的可行性。SP头像可以很容易地为不同的场景定制，并适应远程学习。方法：我们招募了10名医学实习生，在三维模拟诊所中与一个标准化的女性化身进行互动，在那里，实习生将告知她新诊断出的乳腺癌。学员通过情感能力评分（ACS）评估其在传递坏消息前后的自我效能。两名姑息治疗专家使用坏消息评估表和绩效ACS评估每位受训人员的表现。结果：学员自我效能ACS评分总体提高，治疗前20 +/- 4分，治疗后24 +/- 3分，p = 0.001（最高评分30分）。所有参与者都认为这是一种积极的体验，并称赞了这种新颖的方法，尽管他们注意到这些虚拟形象无法描绘肢体语言线索。结论：参与者认为，虚拟角色介导的培训是学习如何传递坏消息的一种极好的方法，但认为它不能代替真实的患者互动。然而，参与者的自我效能提高了，这表明在虚拟世界中以化身为媒介的培训是一种可行的传授坏消息技能培训的教育方法。
Background: Delivering bad news to patients is an essential communication skill for physicians. Educators commonly use standardized patient (SP) encounters to train physicians in the delivery of bad news. It is expensive to use actors, for logistical reasons such as travel and scheduling, and there are limits to the characters and conditions an actor can portray in teaching encounters. Thus we studied the feasibility of creating SP avatars in a virtual world for the task of training medical trainees to delier bad news. The SP avatars are easily customized for different scenarios and amenable to distance learning.Methods: We recruited 10 medical trainees to interact with a standardized female avatar in a three-dimensional simulated clinic, where the trainee was to inform the avatar of her newly diagnosed breast cancer. The trainee evaluated his or her self-efficacy in delivering bad news via an affective competency score (ACS) before and after the encounter. Two palliative care specialists evaluated each trainee's performance using the Bad News Assessment Schedule and the performance ACS.Results: The self-efficacy ACS scores of the trainees improved overall: before, 20 +/- 4, versus after, 24 +/- 3, p = 0.001 (maximum score 30). All participants considered the experience positive and commended the novel approach, although noting that the avatars were not able to portray body language cues.Conclusion: Participants viewed the avatar-mediated training as an excellent approach for learning how to deliver bad news but believed it could not substitute for real patient interactions. However, participant self-efficacy improved, which suggests that avatar-mediated training in a virtual world is a viable educational approach for skill training in delivering bad news.