Virtual humans versus standardized patients: which lead residents to more correct diagnoses?
OBJECTIVE
Medical educators frequently use standardized patient (SP) encounters to bridge the gap between didactic education and practical application. Typically, SPs are healthy adults with no consistent physical findings; however, highly immersive virtual humans (VHs) may enable the consistent presentation of abnormal physical findings to multiple learners across multiple repetitions. Thus, the authors conducted this study to compare how frequently junior anesthesiology residents suspected obstructive sleep apnea (OSA) in preoperative assessments of SPs versus a VH.


METHODS
The authors presented a patient whose case included the historical features of OSA (snoring, daytime fatigue, observed apnea, hypertension, and obesity). Three SPs (in 2008) and one VH (in 2009) were necessary to run the residents through the assessment. The VH appeared morbidly obese and had a neck circumference of 40 cm [corrected]. An airway exam of the VH displayed an image of redundant soft tissue, prominent tongue, and tonsillar hypertrophy. The VH responded to natural speech by recognizing "triggers" in a human's voice. The 849 triggers and 259 VH responses were designed with a technique that collects information from user interactions.


RESULTS
Five of 21 residents (23.8%) suspected OSA after interviewing the SPs, whereas 11 of 13 residents (84.6%) suspected OSA after interviewing the VH (odds ratio of 17.6; 95% CI of 2.9-107).


CONCLUSIONS
Residents suspected OSA much more frequently after interviewing the VH than after interviewing the SPs. The VH provides a unique opportunity to display numerous abnormal physical findings as part of SP encounters.
Department of Anesthesiology, University of Florida College of Medicine, PreSurgical Center, Gainesville, Florida 32610-0254, USA. awendling@anest.ufl.edu
Adam L
AL
Wendling
Shivashankar
S
Halan
Patrick
P
Tighe
Linda
L
Le
Tammy
T
Euliano
Benjamin
B
Lok
D000328:Adult; D000776:Anesthesiology / Q000193:education*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D008954:Models, Biological; D016544:Patient Simulation; D010808:Physical Examination; D018794:Problem-Based Learning / Q000458:organization & administration; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D014584:User-Computer Interface
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