What do speech pathology students gain from virtual patient interviewing? A WHO International Classification of Functioning Disability and Health (ICF) analysis

Abstract

BackgroundVirtual patients have an established place in medical education but do virtual patient interviews train holistic clinicians or just diagnosticians? This study explored speech pathology students’ virtual patient interviews using WHO International Classification of Functioning Disability and Health (ICF).MethodsEighteen speech pathology students in their final year of training participated. Students interviewed virtual patients with dysphagia (swallowing difficulties) as part of their curriculum. Student questions and patient responses were coded using established ICF coding. Codes were tallied and compared under categories of body structures, body functions, activities/participation and environmental factors. Flesch Reading Ease was calculated as a measure of health literacy.ResultsConversational turns primarily focused on the ICF component—activity and participation in both student questions and virtual patient responses: 0.03% body structures, 30% body functions—swallowing, 7% body functions—associated, 43% activities/participation and 19% environmental factors. Personal factors such as gender, ethnicity, age or socio-economic situation were not mentioned by student or patient. Patients commented on social impact on self and/or family, sometimes in the absence of targeted student questions. Student and virtual patient Flesch Reading Ease scores were congruent.ConclusionSpeech pathology students naturally matched their virtual patient’s health-literacy level and asked a range of medical and daily living questions. Virtual patients readily offered social impact information to student questions. Computer science: healthcare teams should consider creating virtual patients who challenge students to practise asking sensitive questions and in doing so develop holistic thinkers with competent communication skills.

Using Virtual Patients to Support Empathy Training in Health Care Education

“…The Virtual Experiences Research Group at the University of Florida has been developing the virtual patients used in this interview series since 2011. Since their initial development, these virtual patients have been continuously refined in accordance with the Human-Centered Distributed Conversational Modeling framework 31 through their use in research and through feedback from students as well as consultation with patients, caregivers, and educators 27 …”

“…Since their initial development, these virtual patients have been continuously refined in accordance with the Human-Centered Distributed Conversational Modeling framework 31 through their use in research and through feedback from students as well as consultation with patients, caregivers, and educators. 27 In the virtual patient interview series, students were presented with 4 virtual patients (Lilly, Vinny, Marty, Monica) at 3-week intervals over a 12-week semester. Students were given 1 week to interview each virtual patient, in their own time, from their own personal computers.…”

“…However, educators report that simulations are costly, resource intensive, time-limited, difficult to schedule, and can be difficult to standardize 19–21 . In recent years, evidence suggests that intelligent virtual patient simulations may provide an effective and innovative educational tool for communication skills training 22–29 . Virtual patients are low-cost and accessible 19,23 .…”

“…[19][20][21] In recent years, evidence suggests that intelligent virtual patient simulations may provide an effective and innovative educational tool for communication skills training. [22][23][24][25][26][27][28][29] Virtual patients are low-cost and accessible. 19,23 Virtual patients provide students with safe and flexible learning in a low-pressure environment, allowing students to make mistakes without consequences.…”