VR and Empathy Building in Healthcare
Healthcare professionals must be well-trained and have competence and expertise in their chosen field. Even so, what sets the best healthcare systems apart from the rest are those whose staff show high levels of emotional intelligence. A critical feature of emotional intelligence is empathy.
Empathy encompasses the ability to understand and vicariously experience the feelings and thoughts of another. It requires much more than a cognitive understanding. Empathy is about an emotional, experiential and visceral understanding, as if you have “walked a mile in someone else’s shoes” and have shared their experiences. Empathy is also about behavior. Empathy is something that you can see in another’s action.
In this report, we show that traditional approaches to empathy training that rely on text or PowerPoint are ineffective because they target a cognitive, as opposed to an experiential, emotional and behavioral understanding of empathy. Although role-playing and simulation are better because they do target an experiential, emotional, and behavioral understanding of empathy, we show that this is not time- or cost-effective, and is not scalable. Instead, we argue that interactive storytelling with VR provides an effective empathy building solution that is time- and cost-effective, and is scalable in ways that role-play and simulation are not.
To train empathy in a person, we must understand the psychology and neuroscience of learning so that we can effectively engage the parts of the brain that matter. The human brain is comprised of at least four distinct learning systems.
The experiential learning system has evolved to represent the sensory aspects of an experience, whether visual, auditory, tactile or olfactory. Critical brain regions include the occipital, temporal, and parietal lobes. Every experience is unique, adds rich context to the learning and is immersive. Experience is at the heart of empathy training. The more one can vicariously experience the feelings, thoughts, and experiences of another, the more empathetic they will become.
The cognitive system is our information system. The critical brain region here is the prefrontal cortex. The cognitive system processes and stores knowledge and facts using working memory and attention. Critically, these are limited resources and form a bottleneck that slows learning with more information coming in than can be processed. A cognitive understanding of empathy is important, but not nearly as important as the experiential, emotional or behavioral components.
The behavioral system in the brain has evolved to learn motor skills. The critical structure is the striatum whose processing is optimized when behavior is interactive and is followed in real-time (literally within milliseconds) by corrective feedback. This system builds the “muscle memory” that drives empathetic behaviors. This system links rich experiential contexts (represented by the experiential learning system) and emotions with the appropriate behavioral responses. It is one thing to know the definition of empathy, to know that eye contact is important, and to know that you need to show understanding, but it is completely different (and mediated by different systems in the brain) to know how to show empathy with eye contact and behaviors that demonstrate true understanding.
More than anything, it is the emotional learning system in the brain that builds the interpersonal understanding, awareness, and sensitivity that are at the heart of empathy and an understanding of our and others’ behaviors. If one can “walk a mile in someone else’s shoes” and gain that vicarious understanding, awareness and sensitivity of another, they can build empathy. The critical brain regions are the amygdala and other limbic structures. Emotional learning, when combined with context rich experiences, builds rich repertoires of empathetic understanding and behavior.
Text and Powerpoint are ineffective methods for training empathy because they engage only cognitive systems. Role play and simulation are better because they are interactive, involve emotion-laden situations and behavior, but even here it is often difficult to suspend the reality of who you are and who your role-playing partner might be. In addition, people differ in their willingness and ability to role play. Finally, simulation and role play are time-consuming, costly, and not scalable.
Interactive storytelling with virtual reality, on the other hand, can address the shortcomings of traditional approaches to patient education and empathy building. With interactive storytelling in virtual reality you “learn through experience”. Experiential learning with VR is far superior to information learning with text because VR broadly engages multiple learning and memory systems in the brain in synchrony.
For example, as a nurse-in-training might don a VR headset and “walk a mile in the shoes of a patient”. They can obtain a first-person virtual experience of the stress and anxiety that a patient feels when someone is explaining a procedure to them and they don’t understand all of the jargon and terminology. They can experience what it is like to be a patient interacting and communicating with an empathetic nurse and with a nurse who shows little empathy. These “walk a mile in my shoes” experiences are visceral.
Analogously, a nurse-in-training might be transported into the middle of a busy emergency room and shadow a seasoned nurse explaining a patient’s condition to their distraught spouse. Using voice-over, the seasoned nurse might explain how they are showing empathy to soothe the concerns of the spouse. The nurse-in-training is in the situation and can feel the emotions. They can combine the information provided by the seasoned nurse with the behaviors they are observing, all within an emotion-laden, realistic experience. This engages multiple learning systems in synchrony and will build empathy quickly and effectively.
With emotion-laden, experiential empathy training via interactive storytelling with VR, a healthcare system can differentiate itself from the rest, but providing the top medical, but also emotional support for their patients. With VR training for healthcare professionals you can achieve this goal—one experience at a time.
This is Part 3 of a 4-part series focused on applications of virtual reality (VR) in senior care.
Twenty-five percent of Americans are predicted to be 65 or older by 2030 (U.S. Census). The overwhelming majority of these baby boomers (approximately 90%) aim to age-in-place. Interestingly, these numbers drop significantly when physical and mental deterioration sets in. In a recent LeadingAge survey, 40% of baby boomers said they wanted to live somewhere other than the place they currently call home if they had a physical disability impacting their day-to-day lives, and 70% want to be in a staffed senior care facility if they have dementia and need help with daily activities. These statistics are telling and suggest a growing need for senior care professionals. Between 2016 and 2026, the direct care workforce is expected to grow from 4.4 million to 5.8 million--an increase of 30%. This places a heavy burden on staffed senior care facilities to recruit, onboard and train direct care workers to meet the complex needs of seniors.
Twenty-five percent of Americans are predicted to be 65 or older by 2030 (U.S. Census) and this demographic will outnumber those 18 and younger by 2035. Physical, emotional and cognitive changes associated with normal aging place an enormous emotional and financial burden on the senior, their family and the healthcare system. Studies show that as many as 13% of home care recipients experience an adverse event, may of which are preventable.
The goal of all hospital administrators and medical personnel is to effectively treat every patient’s medical condition. Ensuring that healthcare providers are highly trained in all aspects of a medical procedure will surely increase patient satisfaction, but this is only half of the equation. The other half centers around the patient’s understanding of and familiarization with the upcoming medical procedures.