1. VIRTUAL PATIENTS GROUP University of Florida July 20 th, 2009

2. Virtual Patients Consortium University of FloridaMedical College of Georgia University of GeorgiaUniversity of Central Florida University of Florida PIs Benjamin Lok, Ph.D. Juan Cendan, M.D. Rick Ferdig, Ph.D. Mike Robinson, Ph.D. Senior Personnel Yong Ho Hwang, Ph.D. Students Joon Hao Chuah Aaron Kotranza Mallory McManamon Brent Rossen Ethan Blackwelder Shivashankar Halan Medical College of Georgia PIs D. Scott Lind, M.D. Senior Personnel Adriana Foster, M.D. Angela Gucwa, M.D. Candelario Laserna, M.D. Brenda Rosson, R.N. Peggy Wagner, Ph.D. Students Steven Blackwood Ashita Gehlot Chandni Kalaria Hevil Shah Alyssa Wier University of Georgia PIs Kyle Johnsen, Ph.D. Students Qian Ma Tyler Niles Animesh Thakre University of Central Florida PIs Laura Cuty-Ruiz, Ph.D. Senior Personnel Moshe Feldman, Ph.D. Staff Mike Eakins Dan Sagendorf

3. Consortium Overview Started in Spring 2004 Four universities 32-person team including Computer Science Medicine Education Psychology 53 active members

4. Consortium Overview Experiences Immersive: 567 Online: 1000+ Public exhibits and demos: 100s 24 scenarios Publications: 9 journal, 16 conference, 18 abstracts Awards: IEEE VR 2008 Best Paper Research and Clinical Abstract Awards (Georgia ACS) $2.8 million in funding (NSF, NIH, and ASE)

5. Publicity www.virtualpatientsgroup.com www.virtualpeoplefactory.com Virtual Patients Webpage

6. Experiences with Virtual Patients Students practice communication + diagnostic skills Scenarios can be: Repeatable Standardized Feedback Longitudinal learning Abnormal findings Diverse virtual patients Tailored for each student

7. Scripts (24) http://vpf.cise.ufl.edu/wiki/index.php/VPF_Script_Tracking Anesthesia Pre-op OSA (UF) Conscious sedation (UF) Cancer Abnormal mammogram (UF) BRCA Pedigree (UCF) Clinical breast exam (UF/MCG) Melanoma (MCG) Pain Abdominal Pain (UF) Chest pain (UF) Gallstones (UCF) Lower back pain (UF) Lower back pain (PCOM) Psychiatry Failure to thrive (UF) Depression (MCG) Bi-polar (MCG) General Breaking bad news (MCG) Cranial Nerve (UF) Dyspepsia – Pharmacy (UF) Gastro-Band (UF) GI Hemorrhage (UF) Meningitis (PCOM) Patient-Centered Counseling (USF) Post Operative Hemorrhage (UF) Sexually Transmitted Diseases (UF) Contraceptive Counseling (UF)

8. Continuum of Experiences Second Life Immersive Interaction Video Conference Chat Web Browser Instant Message

9. Developing Virtual Character Cognition Virtual People Factory – Web-based interface – End-user creation of content – Pharmacy patient Pharmacy patient In one year – Over 2000 interactions – 24 end-user created scenarios End-user created scripts can reach 85% accuracy

10. NERVE: The Neurological Examination Rehearsal Virtual Environment Virtual multi-tool interface to VH Single input device (Wii Remote) controls multiple virtual tools used in eye exam Gestural and tool input, in addition to speech Medical students can Learn how to use neurological tests to diagnose a patient with a vision disorder Receive additional exposure to patients with abnormal findings (e.g. double vision, lazy eye)

11. Physical Examinations of Virtual Human Patients Mixed reality humans Passive-haptic interface to life-sized virtual human Applications Clinical breast exam Prostate exam (upcoming) Medical students can Practice merging physical examination and communication skill sets Get real-time feedback of exam performance E.g. coverage, pressure

12. Developing a learning experience Short term Faculty member leads medical students to use Virtual People Factory Test with students Publish and demo Long term Develop a deployable teaching unit Integrate into curricula at UF Federal funding (e.g. NIH, NSF)

13. After-Action Review by Students IPSViz – Web-based interface – Students received email with link (automated) – Sample student (Brent/45169) Sample student – Self-directed review of content, video, and feedback Each student can review their performance and compare with experts

14. After-Action Review by Educators IPSViz n – Web-based interface – Educators can review completed student interactions – Data from study Data from study – Filter based on user background Level of expertise Gender Educator-defined metrics Experts can – Identify trends (mean of class) – Identify outliers

15. Experiences 24 Patient-Doc scenarios Intimate Exams Abnormal Findings (Neurological Exam) Conscious Sedation (VP+IPS) Audiology Testing After-Action Reviews You, M.D. Bias studies: Pain perception

16. Video Conference with a VP All VPF scripts can be experienced video- conference style Interact with 3D VPs using a webcam and typing Enables study of distributed medicine

17. Audiology collaboration with Mark Billinghurst (NZ) Students administer audiology exams to VP Exams include: History VP visual examination Hearing screen Testing speech understanding Highlights Procedure and communications skills VP presenting abnormal conditions

18. Pain Perception PI: Mike Robinson Video vignettes of VPs expressing low or high levels (FACS) of pain VPs varied in gender, age, and ethnicities Doctors, nurses, and dentists evaluate perceived levels of pain Identifies variables and weighting of variables that affect healthcare provider’s pain perception

19. Sponsors Current support Prior Support National Science FoundationNational Institutes of HealthAssociation of Surgical Education University of FloridaMedical College of GeorgiaKeele University

20. Consortium Expertise University of Florida Technology development Scenario development Abnormal findings Medical College of Geogia Intimate Exmas University of Georgia Patient-centered experiences University of Central Florida Assessment Curricular integration