'Virtual humans' created to train clinicians

Breakthroughs in new technology have led to the development of a computer simulation program allowing clinicians to train with virtual human patients, according to research presented at the 2012 American Psychological Association’s annual meeting.

“The ‘birth’ of intelligent virtual human representations that are sufficiently credible for fostering believable interactions with real humans has occurred,” psychologist and virtual reality technology expert Albert “Skip” Rizzo, PhD, told Healio.com.

Programmed with speech recognition software, virtual humans are highly interactive, artificially intelligent representations of patients who are capable of having fluent conversations with training clinicians. During his presentation, Rizzo showed videos of trainees engaging with virtual patients named “Justin,” a teenager with a conduct disorder who was urged by his family to participate in therapy, and “Justina,” a sexual assault victim presenting with PTSD symptoms.

During an initial test, 15 psychiatry residents were asked to perform a 15-minute interaction with Justina, the more advanced version of the two virtual humans on display. Justina responded to questions during history-taking, after which time the resident was able to make a preliminary diagnosis. Based on this and other related tests, Rizzo and colleagues at the MedVR Lab at the University of Southern California (USC) Institute for Creative Technologies are modifying the program to suit military clinical training, funded by the US Department of Defense in partnership with the USC School of Social Work.

Researchers at the MedVR Lab have also developed SimCoach, a similar technology in which military members can interact online with a virtual human who discusses issues common to military life, provides resources relevant to the user’s reported symptoms and helps to break down barriers to mental health care.

During the American Psychiatric Association’s annual meeting in Philadelphia earlier this year, Rizzo and colleagues showcased two exposure-therapy programs named “Virtual Iraq” and “Virtual Afghanistan,” in which military patients are encouraged to work through their combat trauma in computer-simulated war zones. Based initially on the video game “Full Spectrum Warrior,” the simulations have evolved significantly based on patient feedback and are complete with sights, sounds and even smells of emotionally challenging combat-relevant contexts, according to researchers.

Rizzo said that after years of computer science research and development of key components like graphics, artificial intelligence, natural language processing and face and body gesture animation, it is possible for clinicians to begin to make use of this technology. He added that there has been advancement in the area of “computer vision” that utilizes cameras — similar to Microsoft Kinect for Windows — and microphones to “sense” a user’s behavioral signals, including facial and hand expressions, posture and vocal prosody. This information can be interpreted by the virtual human to promote a higher quality interaction.

Researchers are looking to create a training module that will offer educators and trainees a diverse library of virtual patients with varied diagnoses.

“Although some virtual human agents would never be mistaken for the real thing, a level of fidelity is now possible for producing useful applications in some areas,” Rizzo said. “Of course this work will continue to grow and evolve, but meaningful work in this area is now possible as long as developers keep in mind the target objectives balanced by the ethical considerations that are incumbent in ‘creating’ virtual human agents for human clinical interaction.”

For more information:

Rizzo, A. #2257. Presented at: the 2012 American Psychological Association Annual Meeting. August 2–5, 2012; Orlando.

Disclosure: The researchers report no relevant financial disclosures.