Meredith Shatoff, RN, CRRN, recalls feeling nervous coming face-to-face with Tina Jones, a 28-year-old computer-generated patient with symptoms of diabetes and asthma.
Examining an avatar that behaves like a real patient was a new learning experience for Shatoff, a student in the RN-BSN online program at Drexel Universitys College of Nursing and Health Professions, Philadelphia. Any anxiety she had didnt last long.
I learned how to organize a good and thorough assessment, said Shatoff, who interacted with the virtual patient this spring. I really enjoyed working with Tina and I would highly recommend this technology in other classes in the future.
Created by graphic and animation artists, Tina verbalizes statements that depict emotions and has answers to 50,000 questions about her medical history and family background. Shadow Healths avatar software is used by 400 nursing schools nationwide, including Drexel and the University of Pennsylvania in Philadelphia.
We were trying to find a way to support student learning where it could be self-guided and self-directed on their own time when they felt the need to go and do it, said Deborah Becker, PhD, ACNP, BC, chairwoman of the Helene Fuld Pavilion for Innovative Learning and Simulation at UPenns School of Nursing.
Having something that is asynchronous that they can go online and talk to and examine and come up with a care plan was exactly what we were looking for, she added. The technology was piloted this summer for students in UPenns accelerated nursing program.
Students are encouraged to practice skills based on the immediate feedback given by the software. Students take notes on Tinas chart and afterward get a transcript of what they have done along with a critique from their instructors. You can do every exam that you can do on a real person, Becker said.
Tina also has a personality. Place a cold stethoscope on her chest and Tina will say Thats cold, cant you heat that thing up? You can put in an IV and she will react by saying, Ouch, that hurts, Becker said.
Students practice on Tina before and after labs.
We could engage Tina with questions about our pre-lab reading, said UPenn student Sara Wallace-Keeshen. For me it was pretty helpful. I asked her questions about her personal, social and family history and was able to apply the readings to her.
Drexel began piloting the virtual technology in 2013, according to Leland Rocky Rockstraw, PhD, RN, assistant dean of simulation, clinical and technology academic operations, who is credited with bringing Tina to the nursing program. The technology helps students with interpersonal skills, diagnostic reasoning and data collection, he said.
Shadow Healths tool is broken down into 10 modules, each of which correlate with a body system students study in class.
Tina supports a physical assessment course and the initial interpersonal communication to know how to ask questions, gather data and become organized, Rockstraw said. And then it is system specific, cardiovascular, GU, GI, skin, skeleton, muscle, things like that. Those modules are a bit more specific to students learning about body systems.
Part of Tinas appeal, Rockstraw said, is it is interactive, experiential and that helps to break up the learning so a student isnt just sitting there reading notes. That helps to really engage the students from many different aspects, visually, auditorily, tactilely. I think thats really what is making different schools adopt this.
Students at both schools of nursing have reacted positively to Tina, although faculty say sometimes they tried to stump her with questions. Unanswered questions relevant to her health are shared with the software company, which plans to add two more avatar patients this year, an elderly man and a child.
Students say the virtual patient provides them with hands-on practice and specific skill-building without putting real patients at risk when mistakes are made.
Because Tina is not a real, living person who might talk back or get annoyed when I am taking too long to go through systems, I was able to organize myself better to conduct a better systems interview, Shatoff said. I was also able to practice the way I wanted to ask questions, and what was the most important question to ask to gain the most needed information from Tina.
Robin Farmer is a freelance writer.