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Patients want to have a say in their medical treatment, especially when it will have a major impact on their life. Research shows that a shared decision-making process does indeed have positive effects. But how can a doctor learn how to approach this properly? The current training lacks sufficient opportunities to practise with patients. A virtual patient could offer a solution.

A medical student talking to a virtual patient
A medical student talking to a virtual patient (photo: Anne Vos)

Professor of Health Communication Julia van Weert of the University of Amsterdam, together with colleagues from her research group, Amsterdam UMC and Delft University of Technology, tested the use of a virtual patient when training medical students. Could a virtual patient help to improve students' communication skills, giving them a more effective way to learn how to make care-related decisions together with the patient? Van Weert describes the results of the pilot as promising. 

Shared decision-making has a positive effect, but practising together was difficult

It is important for a doctor and patient to reach a shared decision about a care situation in which the patient's preferences are taken into account. ‘From research, we know that shared decisions have a positive impact on the treatment and patient satisfaction. It also reduces any subsequent doubts about the decisions made,’ explains Van Weert. However, practising face-to-face during medical training, for example with actors in role-playing situations, is expensive and time-consuming. This method also takes little account of students' different personalities and skill levels, making it difficult to firmly embed interactive practice and training with patients in the degree programme.

A virtual patient offers possibilities

‘A virtual patient would allow students to gather information fairly easily and in a safe environment and learn how to reach a shared decision on the basis of this information,’ explains Van Weert. In the research by Van Weert and her colleagues, Delft University of Technology developed graphic interactive characters that were shown to second-year medical students at Amsterdam UMC on a computer screen and talked to them through the computer speakers. Data from previous studies on cancer treatment choices (chemotherapy or hormonal treatment) were used as the main body of the text for the characters. Computer models then simulated the progress of knowledge building, preference formation and expression of emotion in the Virtual Patient. This gave the students the illusion that they were involved in a natural dialogue. In total, each student took three sessions with different virtual patients.

‘The biggest improvement in communication took place after the first session,’ says Van Weert. In the second session, students made significant improvements in their communication skills and their ability to reach a decision together with the patient. There was less progress in the third session.

Conclusion

On the basis of the pilot, the researchers conclude that the virtual patient certainly offers potential as a valuable learning opportunity for training communication skills, although some improvements are still required. ‘A virtual form of training also ties in very well with the current times, in which we are all taking major steps towards more online education. A Virtual Patient allows clinicians to improve their skills in a highly interactive and compelling way at a time and location of their choice,’ concludes Van Weert. 

This research was funded by the DigiComMethodsLab.

Prof. J.C.M. (Julia) van Weert

Faculty of Social and Behavioural Sciences

CW : Persuasive Communication