Enhancing Empathy: a Role for Virtual Reality?

• Published in: Academic psychiatry 2018-12, Vol.42 (6), p.747-752
• Main Authors: Louie, Alan K., Coverdale, John H., Balon, Richard, Beresin, Eugene V., Brenner, Adam M., Guerrero, Anthony P. S., Roberts, Laura Weiss
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; Audiovisual Aids; Behavior; Cancer; Cognition & reasoning; Computer & video games; Control Groups; Editorial; Editorials; Educational Objectives; Emotions; Empathy; Experiential Learning; Humans; Intervention; Learning; Longitudinal Studies; Medical Education; Medical students; Medicine; Medicine & Public Health; Mindfulness; Outcomes of Education; Parent Role; Patients; Physician-Patient Relations; Psychiatry; Psychiatry - education; Systematic review; Teaching; Teaching Methods; Thinking Skills; Virtual Reality
• ISSN: 1042-9670; 1545-7230
• DOI: 10.1007/s40596-018-0995-2

The physician’s experience of empathy in patient care has been described as “a sequence of emotional engagement, compassion, and an urge to help the patient” produced by a “doctor’s awareness of the patient’s concerns” [1]. Limitations included the following: the use of different scales and subjective measures of empathy across studies; several studies with very few subjects and without control groups; no follow-up measures of sustained changes in empathy; lack of proof of generalizability beyond the study setting; no measures of impact on practice behaviors or patient outcomes; and no comparison to other interventions aimed at increasing empathy. Sample of educational interventions thought to increase empathy in psychiatry Study Intervention Metrics Trainees Number of participants in experimental condition Number of participants in control condition Design Deen et al. 2010 [9] Write first-person narrative of three patient experiences, with supervision Self-report, supervisor’s evaluation GME (psychiatry PGY1) 1 N/A Qualitative Baker and Brenner 2018 [12] Work in student-run, free medical clinic Field notes, semi-structured interview of students UME (psychiatry clerks) 10 N/A Qualitative (grounded theory) Aggarwal and Guanci 2014 [10] Recount personal experiences and roleplay in a one-time seminar Self-report UME (psychiatry clerks) > GME (medicine) 86 N/A Post-evaluation Bentley et al. 2018 [13] Train in mindfulness and empathy HRQ GME (psychiatry PGY1) 7 N/A Pre- and post-evaluation Chen et al. 2018 [14] Interactive video game JSPE (modified) UME (psychiatry clerks) 84 N/A Pre- and post-evaluation Crisafio et al. 2018 [11] Watch 5-min video on SBIRT Interview of student, standardized patient UME (psychiatry clerks) 96 94 Historical controls (1 year before intervention year) Bunn and Terpstra 2009 [8] Listen to simulated auditory hallucinations (40 min) JSPE UME (psychiatry clerks) 100 50 RCT, pre- and post-evaluation UME, undergraduate medical education; GME, graduate medical education; PGY1, postgraduate year 1; SBIRT, screening, brief intervention, and referral for treatment; JSPE, Jefferson Scale of Physician Empathy; HRQ, Helpful Response Questionnaire; RCT, randomized controlled trial; N/A, not applicable A Role for Virtual Reality in Empathy Training? The power of the virtual experimental environment is the ability to program and thus control almost every detail of the experimental condition.