International Journal of Healthcare Simulation

Background and aim:

Nottinghamshire Healthcare Medical Education delivers simulation-based learning to over 500 medical students and junior doctors each year. The scenarios for these sessions are co-produced and delivered with a simulated patient actor. In January 2023, we introduced a new type of simulation allowing participants to interact with a digital patient. The AVATr digital patient received good feedback delivered remotely [1], but we intended to use it face to face. Our aim was to find out whether participants found the digital patient more or less useful than the patient actor. A secondary aim was to explore if the digital patient was helpful in preparing for simulation with a patient actor.

Methods:

The digital patient simulation was delivered in the morning of a full-day session to a cohort of F2 doctors. Participants sat on a chair in front of a green screen with a go-pro filming them. Participants were able to see themselves in a third-person perspective on a TV screen and interact with a digital patient. The digital patient was controlled by a facilitator who chose responses from a grid depending on what had been asked and how it had been asked. The participants experienced two scenarios – one around assessing psychosis and one on adult self-harm. The participants also had a simulation later that day with a patient actor. We collected qualitative and quantitative feedback via digital forms and analysed the results.

Results:

Ninety-two participants attended the sessions between January 2023 and March 2023. 70% of participants Agreed or Strongly agreed that the virtual patient was useful, compared to 100% for the patient actor. If facilitator familiarity with technology was adjusted for 68% of participants, Agreed or Strongly agreed the digital patient was useful. Eighty-six per cent of participants believed that digital patient simulation helped them prepare for the patient actor simulation. Total numbers in Figure 1-A17. Reasons participants gave for not finding the digital patient useful fell into four main themes: the limited nature of the responses the patient could give, the artificiality of the arrangement, the awkwardness of the technology and the relevance of being able to see yourself in the third person.

Figure 1-A17:

Clustered bar graph comparing Likert-scale responses to the statements The Virtual Patient was useful and The Patient Actor was useful

Conclusion:

We found that whilst participants overwhelming preferred simulation with a patient actor to simulation with a digital patient, the digital patient played a role in helping prepare participants for simulation with a patient actor.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.