Using Virtual Patients to Train Clinical Interviewing Skills

Virtual patients are viewed as a cost-effective alternative to standardized patients for role-play training of clinical interviewing skills. However, training studies produce mixed results. Students give high ratings to practice with virtual patients and feel more self-confident, but they show little improvement in objective skills. This confidence-competence gap matches a common cognitive illusion, in which students overestimate the effectiveness of training that is too easy. We hypothesize that cost-effective training requires virtual patients that emphasize functional and psychological fidelity over physical fidelity. We discuss 12 design decisions aimed at cost-effective training and their application in virtual patients for practicing brief intervention in alcohol abuse. Our STAR Workshop includes 3 such patients and a virtual coach. A controlled experiment evaluated STAR and compared it to an easier E-Book and no-training Control. E-Book subjects displayed the illusion, giving high ratings to their training and self-confidence, but performing no better than Control subjects on skills. STAR subjects gave high ratings to their training and self-confidence and scored better higher than E-Book or Control subjects on skills. We invite other researchers to use the underlying Imp technology to build virtual patients for their own work.