Virtual reality to help physicians better communicate with their patients
VIDEO-A virtual reality device has been developed by French researchers to train doctors to deliver bad news to their patients.
A complication that occurred during an operation, poor results of examinations, a medical error… So many delicate elements that a doctor may have to announce to his patients one day. Whether from the perspective of the issuer or the receiver, these statements are always difficult to understand. To help doctors in these situations, the Laboratoire Parole et Langage (LPL), the Laboratoire des Sciences de l’information et des Systèmes (LSIS) of the CNRS / Université Aix-Marseille have developed with several partners (1) a system reproducing a virtual patient to whom we must announce bad news. A pioneering device in the field of the doctor-patient relationship.
Chat with a virtual patient
Lying in a bed in the recovery room, a patient wants to know how his operation went. The doctor must then explain that a complication has occurred during the procedure. This is the setting planted by ACORFORMed, the research project led by Philippe Blache (CNRS researcher, LPL) and Magalie Ochs (LSIS) funded by the ANR (Agence Nationale de la Recherche). Developed by computer scientists, linguists, cognitive scientists and doctors, this avatar is able to interact with the health professional but also analyze his words and gestures.
To build this virtual patient, the researchers used video recordings from training sessions at the CHU d’Angers and the Paoli Calmettes Institute where actors played the role of a patient in front of a doctor. Gestures, looks, vocabulary used: all these elements have been integrated into computer programs in order to produce a model of behavior and reasoning of patients. The avatar thus reacts to what the doctor tells him (by a recognition of keywords) but also according to the movements produced by him (nodding, smiling…). For the moment, the patient model tested is of the “conciliatory” type, non-aggressive, seeking to understand what went (wrong), why and the consequences to come. It thus leads the doctor to address in a “complete” way the problem that has occurred.
When this tool is actually implemented in hospitals, doctors will be able to talk with an expert about how they have interacted with the patient (vocabulary too complex, gestures and reassuring words well used or not…).
Improving the quality of doctor-patient exchanges: a medical and human challenge
The project of this device was conceived following a report published in 2008 by the High Authority of Health (HAS). intended to make health workers think about how to break bad news.
For now, this system is only designed for adult patients. “But the device was developed with a view to being able to use it with other interlocutors” says Magalie Ochs, professor-researcher at LSIS. “It can also be programmed for a discussion between a doctor and the patient’s relatives in the event of a death announcement or to play the role of a younger patient, such as a child. Since the behaviors of an adult and a child are different, it will take upstream work to produce a child-type patient model.»
Until today, five doctors have told the virtual patient bad news along with 20 other non-physician users in order to test the chat protocol. The results are “rather convincing” according to Magalie Ochs. The doctors considered this device very interesting, realistic and very immersive.
The researchers hope to advance the doctor-patient dialogue, which is sometimes overlooked in medical practice. A study published in April 2014 had also shown that these exchanges had an influence on the results of medical treatments given to patients.
(1) The Institut des sciences du mouvement Etienne Jules Marey, the Centre de réalité virtuelle de la Méditerranée, the LTCI-Telecom ParisTech, the Institut Paoli-Calmettes, the CHU d’Angers and the Immersion company.