Patrick G. Kenny

Virtual Patients for Clinical Therapist Skills Training

Virtual humans offer an exciting and powerful potential for rich interactive experiences. Fully embodied virtual humans are growing in capability, ease, and utility. As a result, they present an opportunity for expanding research into burgeoning virtual patient medical applications. In this paper we consider the ways in which one may go about building and applying virtual human technology to the virtual patient domain. Specifically we aim to show that virtual human technology may be used to help develop the interviewing and diagnostics skills of developing clinicians. Herein we proffer a description of our iterative design process and preliminary results to show that virtual patients may be a useful adjunct to psychotherapy education.

Virtual Reality Goes to War: A Brief Review of the Future of Military Behavioral Healthcare

Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in returning OEF/OIF military personnel is creating a significant healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. Virtual Reality delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. This article details how virtual reality applications are being designed and implemented across various points in the military deployment cycle to prevent, identify and treat combat-related PTSD in OIF/OEF Service Members and Veterans. The summarized projects in these areas have been developed at the University of Southern California Institute for Creative Technologies, a U.S. Army University Affiliated Research Center, and this paper will detail efforts to use virtual reality to deliver exposure therapy, assess PTSD and cognitive function and provide stress resilience training prior to deployment.

Evaluation of Justina: A Virtual Patient with PTSD

Recent research has established the potential for virtual characters to act as virtual standardized patients VP for the assessment and training of novice clinicians. We hypothesize that the responses of a VP simulating Post Traumatic Stress Disorder (PTSD) in an adolescent female could elicit a number of diagnostic mental health specific questions (from novice clinicians) that are necessary for differential diagnosis of the condition. Composites were developed to reflect the relation between novice clinician questions and VP responses. The primary goal in this study was evaluative: can a VP generate responses that elicit user questions relevant for PTSD categorization? A secondary goal was to investigate the impact of psychological variables upon the resulting VP Question/Response composites and the overall believability of the system.

An Intelligent Virtual Human System For Providing Healthcare Information And Support

Abstract Over the last 15 years, a virtual revolution has taken place in the use of Virtual Reality simulation technology for clinical purposes. Shifts in the social and scientific landscape have now set the stage for the next major movement in Clinical Virtual Reality with the “birth” of intelligent virtual humans. Seminal research and development has appeared in the creation of highly interactive, artificially intelligent and natural language capable virtual human agents that can engage real human users in a credible fashion. No longer at the level of a prop to add context or minimal faux interaction in a virtual world, virtual humans can be designed to perceive and act in a 3D virtual world, engage in spoken dialogs with real users and can be capable of exhibiting human-like emotional reactions. This paper will present an overview of the SimCoach project that aims to develop virtual human support agents to serve as online guides for promoting access to psychological healthcare information and for assisting military personnel and family members in breaking down barriers to initiating care. The SimCoach experience is being designed to attract and engage military Service Members, Veterans and their significant others who might not otherwise seek help with a live healthcare provider. It is expected that this experience will motivate users to take the first step – to empower themselves to seek advice and information regarding their healthcare and general personal welfare and encourage them to take the next step towards seeking other, more formal resources if needed.

Virtual humans for assisted health care

There is a growing need for applications that can dynamically interact with aging populations to gather information, monitor their health care, provide information, or even act as companions. Virtual human agents or virtual characters offer a technology that can enable human users to overcome the confusing interfaces found in current human-computer interactions. These artificially intelligent virtual characters have speech recognition, natural language and vision that will allow human users to interact with their computers in a more natural way. Additionally, sensors may be used to monitor the environment for specific behaviors that can be fused into a virtual human system. As a result, the virtual human may respond to a patient or elderly person in a manner that will have a powerful affect on their living situation. This paper will describe the virtual human technology developed and some current applications that apply the technology to virtual patients for mental health diagnosis and clinician training. Additionally the paper will discuss possible ways in which the virtual humans may be utilized for assisted health care and for the integration of multi-modal input to enhance the virtual human system.

INFLUENCE OF AUTONOMIC SIGNALS ON PERCEPTION OF EMOTIONS IN EMBODIED AGENTS

Specific patterns of autonomic activity have been reported when people experience emotions. Typical autonomic signals that change with emotion are wrinkles, blushing, sweating, tearing, and respiration. This article explores whether these signals can also influence the perception of emotion in embodied agents. The article first reviews the literature on specific autonomic signal patterns associated with certain affective states. Next, it proceeds to describe a real-time model for wrinkles, blushing, sweating, tearing, and respiration that is capable of implementing those patterns. Two studies are then described. In the first, subjects compare surprise, sadness, anger, shame, pride, and fear expressed in an agent with or without blushing, wrinkles, sweating, or tears. In the second, subjects compare excitement, relaxation, focus, pain, relief, boredom, anger, fear, panic, disgust, surprise, startle, sadness, and joy expressed in an agent with or without typical respiration patterns. The first study shows a statistically significant positive effect on perception of surprise, sadness, anger, shame, and fear. The second study shows a statistically significant positive effect on perception of excitement, pain, relief, boredom, anger, fear, panic, disgust, and startle. The relevance of these results to artificial intelligence and intelligent virtual agents is discussed.

Real-time expression of affect through respiration

Realistic character animation requires elaborate rigging built on top of high quality 3D models. Sophisticated anatomically based rigs are often the choice of visual effect studios where life-like animation of CG characters is the primary objective. However, rigging a character with a muscular-skeletal system is very involving and time-consuming process, even for professionals. Although, there have been recent research efforts to automate either all or some parts of the rigging process, the complexity of anatomically based rigging nonetheless opens up new research challenges. We propose a new method to automate anatomically based rigging that transfers an existing rig of one character to another. The method is based on a data interpolation in the surface and volume domain, where various rigging elements can be transferred between different models. As it only requires a small number of corresponding input feature points, users can produce highly detailed rigs for a variety of desired character with ease. Copyright

Virtual patients as novel teaching tools in psychiatry.

Effective interviewing skills are an essential core competency of psychiatric training, especially when eliciting sensitive clinical information from child and adolescent psychiatric patients. Since it is not always possible to interview patients with the full range of psychiatric disorders during training, simulations such as “standardized patients” (SPs), that is, actors hired to portray patients, are nearly universal in current medical education (1, 2), and have been used to evaluate trainees’ skills with objective structured clinical examinations (OSCE) (3). Use of computer-generated “virtual human patients” (VPs) is increasingly appealing as technology produces VPs that are consistent and realistic (4–7). A recent randomized trial found that both VPs and SPs produced equivalent improvements in diagnostic ability among nurses, physicians, psychologists, and public health workers (8), and the versatility of VPs makes them well suited to teach clinical reasoning skills (9). VPs can be programmed to reflect a wide variety of clinical symptoms and behaviors useful in teaching trainees critical thinking and diagnostic acuity (9). VPs can also be utilized to evaluate psychiatric residents’ and medical students’ clinicalmanagement strategies. Both SPs and VPs offer a supervised practice for trainees before they encounter a challenging, live patient (e.g., patients with trauma exposure, sexual assault/rape, physical attacks, and physical/sexual abuse); however, VPs, unlike SPs, are not limited by potential financial constraints to train actors (2). At present, there is little published data to guide the design and integration of VPs into psychiatric education; thus, research is needed (9). The potential benefits of VPs in medical education are the unlimited realistic simulations of patients of all ages and diverse ethnic and cultural characteristics to students, in a safe and reproducible manner (10). The objective of this pilot studywas to investigate the feasibility of interviewing a virtual adolescent patient (VP) with posttraumatic stress disorder (PTSD) and to increase trainees’ and educators’ awareness of this technology (5–7).