Elzie Carrie A, Shaia Jacqueline
Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA USA.
Med Sci Educ. 2021 Feb 23;31(2):665-675. doi: 10.1007/s40670-021-01243-9. eCollection 2021 Apr.
Compassionate end-of-life care matters deeply for patients and their caregivers, but studies continue to demonstrate ways in which physicians fall short. Despite specific training during medical school, many patients report lack of empathy in their providers with respect to end-of-life conversations. This is likely because empathy is simply hard to teach. Numerous activities have been tried to combat the decline in empathy during medical training with little to moderate success. However, virtual reality, which allows users to viscerally experience anything from another person's point of view, could be a game changer for building empathy within medicine. This type of perspective-taking has previously shown to improve understanding, reduce biases, facilitate empathy, and promote prosocial behaviors. In this pilot study, virtual reality was used to allow students to "become a patient" virtually embodying their daily activities, symptoms, and interactions with caregivers. Using the Embodied Labs modules, first-year medical students were able to experience first-hand having a terminal illness, being told no further treatments are available and witnessing loved ones' reactions. Data generated through surveys and reflections indicated a high level of place illusion, plausibility, and embodiment of users. This high level of immersion generated an increase in comfortability with talking about end-of-life issues, produced a better understanding of what patients and their families experience, and promoted a change in the way students would approach clinical skills. Analysis of reflections indicated a high level of empathy for the patient and his family members. Overall, the activity was highly received by students as a valuable learning activity. As such, we propose that virtual reality could be a useful pedagogical tool to facilitate empathy and clinical skills within medical education.
临终关怀对患者及其护理人员至关重要,但研究不断揭示医生在这方面存在的不足之处。尽管医学院校提供了专门培训,但许多患者表示,他们的医护人员在临终谈话中缺乏同理心。这可能是因为同理心很难传授。人们尝试了许多活动来应对医学培训中同理心下降的问题,但收效甚微或仅有一定成效。然而,虚拟现实技术能让用户从他人角度切实体验各种情景,它可能会改变医学领域培养同理心的方式。这种换位思考此前已被证明能增进理解、减少偏见、促进同理心并推动亲社会行为。在这项试点研究中,虚拟现实技术被用于让学生“成为患者”,切实体验患者的日常活动、症状以及与护理人员的互动。通过使用Embodied Labs模块,一年级医学生能够亲身体验身患绝症、被告知无法再接受治疗以及目睹亲人的反应。通过调查和反思收集的数据表明,用户具有高度的情境错觉、可信度和沉浸感。这种高度的沉浸感增加了学生谈论临终问题的舒适度,让他们更好地理解患者及其家人的经历,并促使学生改变临床技能的运用方式。对反思内容的分析表明,学生对患者及其家属怀有高度的同理心。总体而言,学生们对这项活动评价很高,认为它是一项有价值的学习活动。因此,我们认为虚拟现实技术可能是一种有用的教学工具,有助于在医学教育中培养同理心和临床技能。