Shorey Shefaly, Ang Emily, Yap John, Ng Esperanza Debby, Lau Siew Tiang, Chui Chee Kong
Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore.
Information Techonology, National University of Singapore, Singapore, Singapore
J Med Internet Res. 2019 Oct 29;21(10):e14658. doi: 10.2196/14658.
The ability of nursing undergraduates to communicate effectively with health care providers, patients, and their family members is crucial to their nursing professions as these can affect patient outcomes. However, the traditional use of didactic lectures for communication skills training is ineffective, and the use of standardized patients is not time- or cost-effective. Given the abilities of virtual patients (VPs) to simulate interactive and authentic clinical scenarios in secured environments with unlimited training attempts, a virtual counseling application is an ideal platform for nursing students to hone their communication skills before their clinical postings.
The aim of this study was to develop and test the use of VPs to better prepare nursing undergraduates for communicating with real-life patients, their family members, and other health care professionals during their clinical postings.
The stages of the creation of VPs included preparation, design, and development, followed by a testing phase before the official implementation. An initial voice chatbot was trained using a natural language processing engine, Google Cloud's Dialogflow, and was later visualized into a three-dimensional (3D) avatar form using Unity 3D.
The VPs included four case scenarios that were congruent with the nursing undergraduates' semesters' learning objectives: (1) assessing the pain experienced by a pregnant woman, (2) taking the history of a depressed patient, (3) escalating a bleeding episode of a postoperative patient to a physician, and (4) showing empathy to a stressed-out fellow final-year nursing student. Challenges arose in terms of content development, technological limitations, and expectations management, which can be resolved by contingency planning, open communication, constant program updates, refinement, and training.
The creation of VPs to assist in nursing students' communication skills training may provide authentic learning environments that enhance students' perceived self-efficacy and confidence in effective communication skills. However, given the infancy stage of this project, further refinement and constant enhancements are needed to train the VPs to simulate real-life conversations before the official implementation.
护理专业本科生与医疗服务提供者、患者及其家属进行有效沟通的能力对其护理职业至关重要，因为这会影响患者的治疗结果。然而，传统的通过讲授式讲座进行沟通技能培训效果不佳，使用标准化病人又不节省时间和成本。鉴于虚拟病人能够在安全环境中模拟互动性和真实性的临床场景且可进行无限次训练尝试，虚拟咨询应用程序是护理专业学生在临床实习前磨练沟通技能的理想平台。
本研究旨在开发并测试使用虚拟病人，以便更好地让护理专业本科生在临床实习期间与现实生活中的患者、其家属及其他医疗服务专业人员进行沟通做好准备。
虚拟病人的创建阶段包括准备、设计和开发，在正式实施前还有一个测试阶段。最初的语音聊天机器人使用自然语言处理引擎谷歌云的Dialogflow进行训练，之后使用Unity 3D将其可视化成三维（3D）虚拟形象形式。
虚拟病人包括四个与护理专业本科生各学期学习目标相符的案例场景：（1）评估孕妇的疼痛情况；（2）询问抑郁症患者的病史；（3）将术后患者的出血情况上报给医生；（4）对一位压力过大的护理专业四年级同学表示同情。在内容开发、技术限制和期望管理方面出现了挑战，可通过应急计划、开放沟通、持续的程序更新、完善和培训来解决。
创建虚拟病人以辅助护理专业学生的沟通技能培训可能会提供真实的学习环境，增强学生对有效沟通技能的自我效能感和信心。然而，鉴于该项目尚处于初期阶段，在正式实施前还需要进一步完善和不断改进，以使虚拟病人能够模拟现实生活中的对话。
