On the Internet, No One Knows You’re a Dog: Teaching Communication Skills to Medical Students

• In Event: Affordances and Constraints of Virtual Worlds for Formal and Informal Learning

Abstract

The ability to communicate is a core competency for medical practitioners and role playing is a common tool for teaching communication skills in medical school. However, in-person role plays are time consuming and resource intensive. They are also disliked by the participants (Arnold & Koczwara, 2006; Rosenbaum, Ferguson, & Lobas, 2004). As a result, in recent years medical schools have experimented with using virtual environments as sites for role plays (Lane & Rollnick, 2007; Hulsman, Harmsen, & Fabriek, 2009; Andrade, Bagri, Zaw et al., 2010). This research examines the effectiveness of using virtual role plays to train medical students to communicate in a palliative care environment.
In 2009, [… …], one of the largest free-standing hospice in the country, created a short program to introduce medical students to the principles of palliative care, including an in-person role play using scenarios common to the field. Most students not only did poorly in these role plays, but they disliked them. They were uncomfortable acting in front of their peers and did not like having weaknesses pointed out in public. This led to a decision to move the role plays into Second Life, where the student’s avatar would interact with a patient/family member avatar in a patient’s room in Second Life. It was hoped that the virtual reality environment would remove the anxiety caused by in-person role-plays, allowing the student to focus on the scenario. The affordance of the virtual world was therefore two-fold: on the one hand, it was less embodied than the face-to-face world, but on the other hand, the sense of place (the simulated hospice room) was potentially greater.
Some of the research questions addressed by this study are: (1) Do the students learn the basic principles of communicating to patients/family members better by doing role-plays in Second Life or face-to-face? (2) Are there some aspects of communication that are better learned in Second Life and some that are better learned face to face? (3) Is using Second Life a cost-effective way to teach this type of communication?
Approximately 60 students will go through the program in 2011-2012. Each student plays out three scenarios common to palliative care, randomly assigned to be in-person or face-to-face. A mentor assesses the student in terms of four basic principles of communication for physicians: (1) First find out what the patient/family understands about their situation; (2) Listen at least 50 percent of the time; (3) Use understandable language with no medical jargon; and (4) Show empathy for the patient/family’s situation. In addition, a post-intervention survey evaluates aspects of the student’s satisfaction with the role-playing experience.
Data collected to date suggests that students have the most difficulty listening (they much prefer to talk). They have much more difficulty with some scenarios than others, for reasons that are still unclear, but most improve over the course of the three scenarios. The full paper will further address these differences as well as present the comparison with virtual reality and face-to-face role plays.

Authors

• Susan Lowes, Teachers College, Columbia University

• Gillian Hamilton, The University of Arizona

• Vicki Hochstetler, Hospice of the Valley

• Jennifer Lower, Hospice of the Valley