title: Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial.
abstract: To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences.
  
  
  
  A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes.
  
  
  
  student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning.
  
  
  
  MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters.
  
  
  
  MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation.
  
  
  
  MPathic-VR's virtual human simulation offers an effective and engaging means of advanced communication training.
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104, USA. Electronic address: fredkron@umich.edu.
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Kron
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104, USA. Electronic address: mfetters@umich.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Fetters
authors.affiliation: Department of Psychology, Old Dominion University, Norfolk, VA, 23529, USA. Electronic address: mscerbo@odu.edu.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Scerbo
authors.affiliation: Department of Medical Education, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA. Electronic address: cw4xz@virginia.edu.
authors.forename: Casey B
authors.initials: CB
authors.lastname: White
authors.affiliation: Department of Internal Medicine, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, 48104, USA. Electronic address: mlypson@med.umich.edu.
authors.forename: Monica L
authors.initials: ML
authors.lastname: Lypson
authors.affiliation: Department of Psychology, Old Dominion University, Norfolk, VA, 23529, USA. Electronic address: mapadill@odu.edu.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Padilla
authors.affiliation: Sentara Center for Simulation and Immersive Learning, Eastern Virginia Medical School, Norfolk, VA, 23501, USA. Electronic address: glivaga@evms.edu.
authors.forename: Gayle A
authors.initials: GA
authors.lastname: Gliva-McConvey
authors.affiliation: Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, VA, 23529, USA. Electronic address: lbelfore@odu.edu.
authors.forename: Lee A
authors.initials: LA
authors.lastname: Belfore
authors.affiliation: Sentara Center for Simulation and Immersive Learning, Eastern Virginia Medical School, Norfolk, VA, 23501, USA. Electronic address: westt@evms.edu.
authors.forename: Temple
authors.initials: T
authors.lastname: West
authors.affiliation: Sentara Center for Simulation and Immersive Learning, Eastern Virginia Medical School, Norfolk, VA, 23501, USA. Electronic address: wallacam@evms.edu.
authors.forename: Amelia M
authors.initials: AM
authors.lastname: Wallace
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104, USA. Electronic address: tguetter@umich.edu.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Guetterman
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI, 48104, USA. Electronic address: lschlei@med.umich.edu.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Schleicher
authors.affiliation: Department of Psychology, Old Dominion University, Norfolk, VA, 23529, USA. Electronic address: rkenn014@odu.edu.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Kennedy
authors.affiliation: Department of Internal Medicine, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, 48104, USA. Electronic address: rajm@umich.edu.
authors.forename: Rajesh S
authors.initials: RS
authors.lastname: Mangrulkar
authors.affiliation: Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, 53706, USA. Electronic address: jfcleary@wisc.edu.
authors.forename: James F
authors.initials: JF
authors.lastname: Cleary
authors.affiliation: Department of Computer Science, Department of Psychology, Northeastern University, Boston, MA, 02115, USA. Electronic address: marsella@ccs.neu.edu.
authors.forename: Stacy C
authors.initials: SC
authors.lastname: Marsella
authors.affiliation: Department of Medicine, University of Virginia Health System, Charlottesville, VA, 22908, USA. Electronic address: dmb2y@hscmail.mcc.virginia.edu.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Becker
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003142:Communication; D003198:Computer Simulation; D003479:Curriculum; D004501:Education, Medical; D005260:Female; D006801:Humans; D008297:Male; D016544:Patient Simulation; D010817:Physician-Patient Relations; D016037:Single-Blind Method; D013337:Students, Medical / Q000523:psychology*; D014584:User-Computer Interface
keywords: Breaking bad news; Communication training; Computer simulation; Computer-based conversational agent; Cultural competence; Doctor-patient relationship; Healthcare communication; Human-computer interaction; Intelligent tutoring systems; Inter-professional communication; Intercultural communication; Knowledge transfer; Mindful practice; Mixed methods research; Nonverbal communication; Reflection in action; Reflection on action; Simulation; Training transfer; Virtual Human