Through virtual reality, medical students embody patient experiences
For about 10 minutes, KU School of Medicine-Wichita students in Tiffany Schwasinger-Schmidt’s third-year neurology clerkship class get to see what it’s like to have Alzheimer’s, dementia or Parkinson’s disease.
For about 10 minutes, KU School of Medicine-Wichita students in Tiffany Schwasinger-Schmidt's third-year neurology clerkship class get to see what it's like to have Alzheimer's, dementia or Parkinson's disease.
By slipping on a virtual reality headset, a student becomes Beatriz, a middle-aged Latina woman, and experiences her 10-year journey with Alzheimer's, from her early-onset diagnosis to the late stages of her disease and need for residential care.
Students also can experience what life is like for Dima, a Lebanese American immigrant who has a form of dementia and Parkinson's disease, as she moves from in-home care with her family to a residential community as her health declines.
Hands tremble, shadows are mistaken as threatening figures, objects become hard to grasp, anxiety and aggression set in as the world around them becomes more confusing.
"It's a very authentic experience and incredibly immersive," said Schwasinger-Schmidt, M.D., Ph.D., FACP, assistant professor of medicine and neurology clerkship director.
Simulations like these, called immersive virtual reality, are changing the way health care professionals, as well as caregivers, are trained.
In May 2020, Dr. Schwasinger-Schmidt became the first KU School of Medicine-Wichita faculty member to start using iVR in her class. With a grant from the Medical Alumni Innovative Teaching Fund, a fund supported by KU Medical Alumni Association, Dr. Schwasinger-Schmidt purchased Embodied Labs' iVR technology and two of the simulations that focus on neurological conditions.
California-based Embodied Labs, one of the leading inventors of iVR medical simulations, was started when its CEO became frustrated at trying to get her mother's caregivers to understand how Alzheimer's disease was affecting her mom's life. The Embodied Labs' simulations have grown beyond Alzheimer's disease to include other conditions, like macular degeneration, hearing loss, transgender aging care, social isolation and end-of-life conversations.
Not only does iVR give KUSM-Wichita students an opportunity to "walk a day in the patient's shoes and truly experience what they are experiencing," but it also can help the students develop empathy for patients and their family members, Dr. Schwasinger-Schmidt said.
Studies indicate physicians showing empathy helps decrease patient anxiety and improve outcomes.
"I really wanted to get at helping students develop empathy in medicine because one of the things that we see historically in medicine is that it's easy for students over time to feel burnout with the pressures that come with practicing medicine. Sometimes their empathy takes a little bit of a hit," Dr. Schwasinger-Schmidt said.
The iVR simulations "give them a very unique perspective of what it's like to be a patient living with disease and to be a family member in a way that we can't teach in the curriculum. We can teach the mechanics of the disease but it's very different when you get to experience them."
After the iVR simulation, KUSM-Wichita third-year medical student Katelyn Dugan said she better understands the confusion and frustration patients feel.
"Participating in the virtual reality experience allowed me to experience some of the same physical, mental and emotional struggles people with neurological diseases face every day. As I was transported into the life of a woman with Alzheimer's disease, I encountered confusion about who my family members were and felt lost in my own life. Similarly, when stepping into the shoes of a woman with Lewy body dementia, I experienced frustration when I lacked the ability to move my hands or write. The virtual reality simulation gave me a deeper understanding of the lives of our patients and was a great reminder of the importance of placing yourself in another's shoes."
Dr. Schwasinger-Schmidt has heard similar feedback from other students.
"A lot of them are surprised about what they experience. The noise levels changing, words getting garbled up, seeing what it's like to hallucinate. It's really innovative, and our students are loving this opportunity because it's the closest thing they can get to really understanding what it's like to have a chronic medical condition."
Dr. Schwasinger-Schmidt, who is also director of KU Wichita Center for Clinical Research, eventually will conduct studies to measure if the iVR experiences move the empathy needle among students.
She's already formed a partnership with ComfortCare Homes, a Wichita-based company that provides long-term memory care. Its facilities are ranch-style homes in established neighborhoods where six to eight residents live with caregivers, with many home-like amenities such as gardens and even resident cats and dogs.
The studies were supposed to start last year but were delayed by the pandemic.
Using what's known as the Jefferson Scale of Empathy, developed by the Thomas Jefferson University in Philadelphia and used in more than 85 countries, students will be tested at the beginning of the one-month neurology clerkship to gauge empathy. Students also will be observed by staff on visits with ComfortCare residents before and after they do the IVR simulations to compare if their interactions changed because of the simulations.
The studies will begin once it's safe for KU School of Medicine-Wichita students to visit the ComfortCare residences.