Category Archives: Healthcare simulation

Using Your Voice: Communicating with Virtual Patients

Talking with a patient is one of the best ways for healthcare professionals to hone their communication skills – gathering history, explaining rationale, building rapport, or even having difficult conversations.

These ‘soft skills’ are not only vital for the patient experience but are also notoriously challenging to master without practical experience and feedback. So how can clinicians-of-tomorrow practice communication skills to deliver the highest-quality, most compassionate care possible?

Step into AI-powered VR simulations, where learners can practice speaking with patients in a risk-free & immersive environment; get immediate feedback, repeat until mastery, then put the knowledge learned back into practice with real patients. 

The beauty of AI-powered patients – such as those from OMS – lies in its allowance for error without real-world consequences. Students and clinicians can experiment with various communication styles across a variety of scenarios, learning new lessons from each interaction, with patients adapting dynamically to the questions asked.  

And with the latest OMS release comes 20 new scenarios, many of which are voice-controlled, enabling learners to converse directly with a wide variety of virtual patients. This added layer of authenticity and engagement is an exciting addition to the already vast suite of scenarios! 

Who should use voice control in VR simulation? 

For novice learners or those just beginning their journey into healthcare, modeled communication is often the best way. This involves learners selecting what they want to say from a set structure, hearing an idealized way to ask that question, and the patient responding appropriately. Learners can take this scaffolded structure and expert phrasing with them into practice.

This is a low stress, low cognitive-load, way of interacting that is perfect for junior learners. It can also allow more focus on the decision-making, clinical reasoning, and critical thinking aspects of scenarios, as the focus is actively not on the finer details of communication skills. 

Voice control, however, adds an additional layer of complexity, nuance, and cognitive load to the simulation. It’s one thing to know all of the right questions to ask, but it’s a significantly more complex task to articulate these questions fluently and responsively in the unpredictable flow of human conversation.

Voice-controlled scenarios also allow for more direct interaction with virtual patients, providing an increased level of immersion and realism. Actually having a conversation – asking questions, providing education, or following up – requires adaptability and flexibility on the part of learners that may not be feasible to practice with other types of simulation.  

In everyday life, people don’t always respond how you might expect, and voice control scenarios provide an avenue to practice navigating fluid situations and conversations with patients, caregivers, or relatives. 

virtual patient headache

Which communication skills can you practice in OMS? 

If you know, you know – there are lots of skills that fall under the ‘communication’ umbrella and, in practice, healthcare professionals often need to call on multiple skills throughout the day. OMS have built a suite of scenarios with these disparate skills in mind, including:  

  • Information gathering and building rapport
  • History taking / patient interview
  • Motivational interviewing
  • De-escalation of an angry relative
  • Difficult conversations

Over the coming months, learners will also be able to practice skills that include breaking bad news, shift-to-shift handoffs, and communicating using the SBAR method.

Throughout these scenarios, learners will need to use their communication skills in order to: 

  • Introduce themselves, ask appropriate & relevant questions, and obtain basic patient information
  • Demonstrate active listening and build rapport with patients
  • Treat patients holistically and collaborate with them to solve problems 
  • Engage in difficult conversations and provide education 
  • Communicate with empathy and compassion

Learners can even put these skills to use in a procedural scenario that reinforces concepts like setting expectations for a procedure, gaining appropriate consent, and answering questions about your treatment plan. 

When providing care to patients, it’s not only essential to be able to communicate your thoughts but it’s also vital to understand and empathize to be able to form a therapeutic relationship. This dual-faceted approach is essential for holistic patient care and is central to how OMS scenarios are designed.

If you’d like to see a demonstration of voice control in action, set up a time to speak with us and see the power of using your voice in OMS. 

Interested in trying VR sim? Arrange a free demo with us today.

Case Study: How Carle BroMenn Medical Center is Using VR to Advance Sepsis Management

Carle BroMenn Medical Center

As virtual reality continues to grow and become a mainstay of healthcare education and training, its uses are being continuously iterated and researched. 

Many academic institutions have rapidly adopted this technology and are using it to support students’ knowledge application, prepare them for clinical placements, or assess their skills. 

As those students graduate and head into practice, they may anticipate and increasingly expect healthcare systems to already use this technology as an adjunct to their training programs. In this way, VR can be a helpful addition to the recruitment process, using standardization to assist in decision-making and showing candidates the innovation and support they can expect at the outset. However, the uses of VR in health systems reach far beyond recruitment. 

Carle BroMenn Medical Center spoke with OMS to discuss their implementation of VR to bolster staff education and positively impact patient outcomes (video above). 

Sepsis Case Selection

Sepsis is a serious condition with cases that have been on the rise nationally for many reasons, per The National Institute of General Medical Sciences, which reports that approximately 1.7 million adults develop sepsis yearly and states it is a leading cause of death in hospitals. 

The symptoms of sepsis, particularly in the early stages, can be seen in other, often more common conditions, making it difficult to identify quickly. Additionally, anyone can be affected by sepsis across a hospital system, making it an important piece of clinical knowledge for everyone caring for patients. 

While many people who develop sepsis can have a full recovery, others may have lifelong consequences as a result. The intensity and complexity of treatment can place an increased financial impact on healthcare systems, making sepsis potentially costly for both patients and hospitals. 

While life-threatening, signs of sepsis, when caught and treated early, can mean better potential outcomes for patients. 

In order to support improvements in the recognition and management of sepsis across departments, the team at Carle BroMenn Medical Center decided to utilize virtual reality as an innovative way to provide education and training to their clinical staff on the early recognition and treatment of sepsis. 

Angelia DeWeese, Simulation Education Specialist, said of the choice to target sepsis treatment:

“We are looking for improved patient outcomes. That’s why we’re doing this – the patient is at the center of it.” 

Implementing VR – The Pilot

Following their research on virtual reality for their use case, the team at Carle BroMenn Medical Center chose to work in partnership with Oxford Medical Simulation (OMS) to bring an immersive sepsis case to life for their staff. 

The breadth and depth of the scenario library, the automated feedback, the robust and immediate data provided by the platform, and the collaborative and responsive nature of the OMS team were key features for the team at Carle in selecting their VR partner.

Virtual patient with clamminess

Once a determination had been made about the use case, the teams at Carle BroMenn and OMS worked together to develop the corresponding learning objectives and match the scenario exactly with the protocol of the hospital system, ensuring nurses were receiving standardized, comprehensive training specific to the facility. 

The initial implementation of VR included sepsis training for nurses in both the Emergency Department and the Intensive Care Unit. 

To start their use of OMS, nurses first participated in a pre-brief that included an orientation to the equipment, then completed VR training sessions. While the VR scenarios themselves take approximately 20 minutes to complete, training sessions lasted for up to two hours to accommodate orientation, the potential to repeat scenarios, facilitator feedback, and post-VR surveys.  

The educators at Carle BroMenn decided on a benchmark pass rate for the scenario which they determined would fulfill both goals of demonstrating competency in the management of a sepsis case while providing room for learners to familiarize themselves with the VR modality to facilitate an overall positive experience. 

Learners completed a questionnaire prior to and following the completion of their scenarios. Additionally, between scenarios, learners received immediate, automated feedback from the platform followed by a debrief with a facilitator, so that they were able to take the feedback and immediately implement it back into practice. 

The initiative aimed to bring sepsis training to the forefront of nurses’ minds, with the goal to improve the time to recognition and early treatment of sepsis to positively impact patient outcomes. 

Did sepsis management improve? – The Results & Impact

The team at Carle BroMenn Medical Center looked at several metrics related to the sepsis case.

person in headset holding laptop with VR simulation score

The OMS Score

The scoring system generated by the OMS platform is weighted based on clinical importance of the actions the learner takes, how they have prioritized these actions, and how they’ve worked as a team. For example, if a critical component of care is not completed efficiently or a safety flag is missed, it is not possible to receive a high score for that attempt. 

In addition to the percent score provided by the OMS platform, evidence-based feedback is presented to the learner, as well. This feedback provides learners with insight into the actions they performed well and where there is room for improvement, alongside rationale for processes important to the case. 

Data amalgamated by the platform gives information to both learners and facilitators about individual or group-based performance – educators at Carle BroMenn reported that OMS was easy to use, and they utilized the automated data provided by the platform to identify trends or gaps, and continue to adjust their education to close any gaps in knowledge. 

From the first attempt to the last attempt, learners demonstrated an improvement in scores by approximately 22%, going from an average first score of nearly 61% to an average final score of just above 83%. 

Self-perceived Confidence & Competence 

Additionally, nurses reported an increase in their levels of confidence and competence in caring for a patient with sepsis. 

Angela Turner, a Nursing Professional Development Specialist at Carle BroMenn, said of the impact that VR has had for learners:

“[VR] allowed [learners] to not only practice taking care of patients in a safe environment, but also allowed them to try a different modality, make mistakes within it, but know it’s safe and they’re not actually doing patient harm.”

On a 10-point scale, learners reported an average self-perceived level of confidence at 6.6 before engaging in VR simulations. After learners had the opportunity to conduct VR scenarios around sepsis, the average level of self-perceived confidence increased to 8.4.

With regard to self-perceived competence, learners reported an average score of 6.8 out of 10, pre-VR. Following the experience with VR simulation, learners later reported an average of 8.4 in their scores – nearly a 2-point increase in each category. 

One participant, Sarah Huber, Quality Outcomes Coordinator Surgical Nursing, said of her confidence in managing sepsis after using OMS, “…Doing the VR did make me feel more confident in treating sepsis, and…the biggest reason is because of the feedback.”

Another learner, Kim Poling, RN2 on the Progressive Care Unit, noted that she took away a better understanding of roles of other nurses in different departments, stating, “As an inpatient nurse…there are steps that I don’t usually see that I think I would be more aware of because of the sepsis training.”

Overwhelmingly, learners enjoyed the VR experience and reported increased levels of self-perceived confidence and competence in caring for patients with sepsis, learning interventions they can implement as soon as they return to the floor.  

Facility Metrics

As this work was focused on improving patient outcomes, the team at Carle BroMenn also looked at a set of real world measures that provided a percentage score for the management of sepsis across the hospital. The goal set was 75% for the facility.

During the months of February and March, performance scores averaged 49.5%. Following the use of VR within the Carle sepsis initiative, April and May showed scores of 88.7% and 89.0 % respectively. 

As a Nursing Professional Development Specialist, Angela Turner, noted in conversation with learners following the use of OMS: 

“Their scores moved, but it was bigger than that. Even in conversations with our learners after doing VR, as we were talking through, ‘What does sepsis really look like in real life?’…They could speak to, ‘These are all the things I would do’…and that’s what we were ultimately after – is that it translated.”

Medical chart guidelines displayed next to virtual nurse

What’s Next for the team at Carle Health?

Learners were able to make mistakes in a safe environment that allowed them to effectively improve their processes and practices while engaging in the critical thinking needed to effectively manage emerging conditions like sepsis. 

Just because nurses may work in the same hospital or facility does not mean they will have matching responsibilities, and with the completion of a holistic scenario around sepsis management, learners could walk away with a deeper understanding of the entire process of care, from start to finish. 

With VR, learners are able to practice their skills in alignment with hospital policies and best practices in a safe environment, and have another learning experience to ultimately impact patient care. 

With such positive results, the team at Carle BroMenn has already expanded the use of OMS for other initiatives, including catheterization training with the urology clinic, and the team has plans to continue VR sepsis training with Carle Foundation, at a system-wide level.  

As Simulation Education Specialist, Angelia DeWeese, notes: 

“This was also a system initiative for Carle Health, so I am excited that we have done this at a facility level, but also it’s opened up the door for our system to be looking at this too. For that opportunity to impact…outcomes from a system perspective is exciting.”

Additionally, Carle BroMenn Medical Center is excited to expand their use of VR with additional scenarios that they may use with new graduates, including other clinical topics to bolster continued education of new healthcare professionals. 

Interested in trying VR sim? Arrange a free demo with us today.