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News / July 22, 2008

Virtual patients help dental students

by Guy Hiscott

Dental students at Case Western Reserve University are to be part of a new research project, enabling them to develop their communication skills with live actors and virtual patients.

The students will meet Masha, a dental patient in Second Life’s virtual dental office, whose oral health problems will continually change.

The middle-aged avatar is an integral part of a new research project of the Case Western Reserve University School of Dental Medicine and the College of Arts and Sciences department of communication sciences to teach and give students practice time to communicate with mock patients.

Kristin Z. Victoroff from the dental medicine’s department of community dentistry will direct the three-year Innovative Dental Assessment Research and Development (IDEA) Grant project from the American Dental Association’s Joint Commission on National Dental Examinations. She will develop patient communication scenarios for simulated education and test their effectiveness in preclinical training for students.

‘More dental schools are experimenting with simulation as a way to teach,’ said Victoroff. Roma Jasinevicius and Catherine Demko from the dental school faculty will join her in the research project in testing and implementing simulations in dental education at the university.

Since 2001, the Case Western Reserve dental school has been on the forefront in using simulations in teaching the physical dexterity skills by using a technology called DentSim. DentSim is a simulated and computerized training system that uses a simulated dental patient. Jasinevicius spearheaded the school’s use of the technology in dental education.

The attention has now turned from that technology to developing simulated experiences for communicating with patients.

Victoroff enlisted virtual reality experts and Art and Sciences’ communication disorder scientists Stacy Williams, who directs the Virtual Immersion Center for Simulation Research (VICSR), and Kyra Rothenberg, director of the health communications minor.

They will take three approaches to simulated communications training – live actors, the immersion theatre where students interact with a virtual patient in a 180-degree surround theatre, and with avatars, like Masha, in Second Life.

Of the three simulation methods, Victoroff is interested in using the immersion theatre and Second Life. She noted that paper-based, live actors and real patients present limitations from ethical issues to logistical challenges. Meanwhile, the interactive theatre and Second Life have capabilities to assess competencies in a convenient, standardized and cost-effective situation.

The research project focuses on developing scenarios that aid and test students in taking patient histories, providing oral health education like tobacco cessation counselling for smokers, explaining procedures, talking about healthcare options and obtaining informed consent, and working through situations that present ethical dilemmas.

‘Ideally it is not that we are out to prove that virtual worlds or the VICSR system is better than standard instruction, but that they are of equal value,’ said Williams, adding that students should be able to walk away learning the same types of knowledge they can learn from working with live patients.

Students are very accepting of the VICSR environment and put a lot of reflection in their voices when they are talking to the animated characters, said Williams.

Rothenberg will piece together students’ motivations and perceptions when using this technology for their education.

According to Rothenberg who works in health communications, VICSR is already showing positive results from communication science students and patients using the virtual theatre for their education and speech therapy.

‘Virtual patients have much to offer in training healthcare providers, and it is equally important to explore how interactive virtual reality technology can enhance assessment of competency,’ said Victoroff.