Technology Simulates Patient Interaction

doctor stacy kaltmanWe’re always on the lookout for innovations in medical education, so when I found out about one happening right under my nose at Georgetown University (my alma mater–go Hoyas!), I had to check it out.

Medical schools are incorporating technology to enrich students’ experience in many ways, but Dr. Stacey Kaltman, Professor in the Department of Psychiatry and a clinical psychologist, is tackling possibly one of the most challenging: teaching students to communicate well with patients.

I recently chatted with Dr. Kaltman to find out more about what she is working on.

JL: What made you decide to use technology to help your students learn to talk to patients?

SK: There were a couple of reasons. First, we wanted to provide more opportunities to practice and receive feedback than our early medical students were getting working with only real patients. We break students up into small groups, watch them during patient interactions, and give live feedback. But we couldn’t control whether a patient was super talkative or in a lot of pain and not wanting to talk. It wasn’t a consistent experience.

Second, we have a relatively large class of medical students and wanted to add more instruction time while also being mindful of our faculty’s times. We wanted to find a way to teach patient communication that didn’t rely so heavily on us. Not to replace live feedback, but to supplement it.

JL: How did you choose which technology to use for your simulations?

SK: Well, what we really wanted was a responsive system using natural language processing that would truly be interactive, responding to students based on what they say. But when we started this project in 2013, that type of thing just wasn’t available at a price we could afford. So we took the best thing that was.

JL: And what was that?

SK: We started with a software program called Articulate Storyline. It’s an e-learning authoring tool that we used off-the-shelf for basic communication skills.

I worked with Georgetown’s Center for New Designs in Learning and Scholarship (CNDLS). I provided the content knowledge and they provide all of the technical and pedagogical expertise.

The simulations were developed as sort of a “choose your own adventure.” Students saw a prompt that said something like “I’ve been having headaches,” and the student had a free text box to write what they would say back. The next screen gave 10 potential responses, and they chose the one that most closely matched theirs. The simulation would continue in that way down one of the five or so possible paths. We created videos with feedback from faculty that would pop up at logical points or at the end of a path.

CNDLS developed a program that allowed us to pull data out to see how individuals and the class as a whole performed. The first year students still work with the simulations right when they begin medical school.

JL: Only first years? Why not all students?

SK: The first set of simulations we developed focused on very basic communication skills, the types of things that we work on in the first days of medical school. Once those were complete, we wanted both to see if we could develop simulations on more complex communication skills and if there were other platforms that would increase the immersive quality of the simulations.

JL: So what do you use for second and third years?

SK: It’s still a work in progress, but we’re using a cooler-looking interactive video platform called Interlude. The patients look more “live” in these simulations. For instance, they look at their watch if a student doesn’t respond in a timely way. Students tell us they like working with the simulations.

JL: What’s in store in the future?

SK: We are continuing to evaluate the effectiveness of the simulations. It only makes sense to continue using them if they lead to actual skill development. We also hope to continue exploring increasingly more sophisticated platforms for deploying the simulations.

JL: What advice would you give someone reading this who wants to create a similar program?

SK: Coming up with the content for the simulations is the easiest part. Building a team with the technical expertise is essential.

For more information about this project you can visit: