JMIR Publications

ABSTRACT

Background:

Communicating with empathy—attending to the manner of communication—is an important but often overlooked concept to reduce errors, improve patient satisfaction, and perhaps improve cancer patient outcomes. A virtual human-based simulation, MPathic-VR, was developed to train health care providers in empathic communication with patients and in interprofessional settings and evaluated through a randomized controlled trial.

Objective:

This mixed methods study investigated differential effects a virtual human-based simulation developed to train health care providers in empathic patient-provider and interprofessional communication.

Methods:

We employed a mixed methods intervention design, involving comparison of two quantitative measures—MPathic-VR calculated scores and the objective structured clinical exam (OSCE) scores—with qualitative reflections by students about experiences. Students at three medical schools in the United States (n = 206) received simulation to improve empathic communication skills. We conducted analysis of variance, thematic text analysis, and merging mixed methods analysis.

Results:

OSCE scores were significantly improved for learners in the intervention group (M=0.806, SD= 0.201) compared to the control group (M=0.752, SD= 0.198, F(1, 414)=6.09, P=.014). Qualitative analysis revealed three major positive themes for the MPathic-VR group learners: gaining useful communication skills, learning awareness of nonverbal in addition to verbal skills, and feeling motivated to learn more about communication. Finally, the results of the mixed methods analysis indicated most of the variation between high, middle, and lower performers was noted about nonverbal behaviors. Medium and high OSCE scorers most often commented on the importance of nonverbal communication. Themes of motivation to learn about communication were only present in middle and high scorers.

Conclusions:

Virtual humans are a promising strategy for improving empathic communication in cancer care among medical students. Higher performers seemed most engaged to learn, particularly nonverbal skills.