The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality

• Published in: PloS one 2016-02, Vol.11 (2), p.e0146837-e0146837
• Main Authors: Pan, Xueni, Slater, Mel, Beacco, Alejandro, Navarro, Xavi, Bellido Rivas, Anna I, Swapp, David, Hale, Joanna, Forbes, Paul Alexander George, Denvir, Catrina, Hamilton, Antonia F de C, Delacroix, Sylvie
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antiinfectives and antibacterials; Bacteria; Bayes Theorem; Bayesian analysis; Biology and Life Sciences; Computer and Information Sciences; Computer applications; Computer science; Consultation; Demand; Doctors; Drug resistance; Engineering and Technology; Ethical aspects; Ethics; Ethics, Medical - education; Family physicians; Female; General practitioners; General Practitioners - ethics; General Practitioners - psychology; Human communication; Humans; Immersive virtual reality; Male; Medical ethics; Medical personnel; Medicine and Health Sciences; Middle Aged; Neurosciences; Patients; People and Places; Personality; Physician-Patient Relations - ethics; Physician-patient relationships; Physicians; Practice; Practice Patterns, Physicians' - ethics; Practice Patterns, Physicians' - statistics & numerical data; Realitat virtual; Referral and Consultation - ethics; Relacions metge-pacient; Research and Analysis Methods; Simulation Training - methods; Social Sciences; Statistical analysis; Studies; Surveys and Questionnaires; Technology; Viral infections; Virtual reality; Virtual Reality Exposure Therapy - education; Ètica mèdica
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0146837

Dealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner's daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor's response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas. Twelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously. Eight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants' level of presence (together with participants' feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening.