Why Shared Experiences Matter in Kidney Care

Posted by Todd Maddox & Tim Fitzpatrick on Dec 27, 2019 3:56:41 PM
How VR Enhances Understanding and Communication Through Shared Experience
Meet Aiko

Aiko is a 59-year old mother of three. Aiko was diagnosed with Type 2 diabetes over a decade ago now, but was hospitalized four years ago when her kidneys “crashed”, landing her in the hospital rather unexpectedly. Though she has been on dialysis ever since that first surprise trip to the hospital, recently she was informed that her long wait for a kidney transplant might finally be over. Aiko is excited about the prospect of having a healthy kidney that will free her from the dialysis regiment that has controlled her life for years, but naturally she is anxious and stressed about the upcoming surgery and its implications for returning to normal life.

Like 9 in 10 Americans, Aiko has struggled to understand her medical conditions and treatment. When she talks to her care providers– whether it’s her nephrologist, dialysis RNs or frontline care technicians – she often struggles to comprehend much of what they are describing. Even when she feels that a concept or treatment is beginning to make sense during a conversation with her care team, she quickly realizes she must be missing something when it comes time to perform the procedure or make a decision. The terminology is unfamiliar, communication seems fragmented, and treatments and procedures are frustratingly complex. Truthfully, Aiko often finds herself trusting her care team blindly, because at the end of the day, they are trained professionals and it’s just too difficult to keep up and make sense of the situation. Trusting the care team is just plain easier than figuring out what she needs to know in order to have an informed opinion or understanding of her care.

And like most people, Aiko finds she is unable to generate vivid pictures in her head to help her understand her medical condition and treatment accurately. But beyond the issue of comprehension, her problems are exacerbated by constant questioning from her family members and loved ones. She is embarrassed that she does not understand her situation better, but she is equally frustrated by the lack of effective learning resources provided by her care team.

Now, even though she has been waiting for this opportunity for years, Aiko must prepare for a complex and scary surgery that will require a stay in the hospital, followed by a significant recovery period at home. Aiko is stressed, anxious, and feels helpless due to her overall reliance on being told what to expect next, much of which stems from her lack of knowledge and understanding.

The Problem

Patient literacy is low, and this is due in large part to the lack of effective patient education and training tools. These ineffective informational materials, along with one-on-one conversations with nephrologists, serve as the two primary sources of learning for patients with kidney disease. While written materials lack effectiveness, conversations with providers lack consistency and scale. Together, the two primary sources of learning for kidney disease patients are coming up short where there is tremendous potential to make an impact in their lives and health outcomes.

As Aiko’s situation demonstrates, talking to nephrologists and reading documents filled with challenging medical terminology is only marginally ineffective. This follows because all of this information is processed by the cognitive learning system in the brain. This system uses working memory and attention (both limited capacity resources) in an attempt to generate a mental representation in the patient’s brain of kidney function, the ins and outs of a kidney transplant surgery, and the post-operative recovery.

Screenshot from 2019-12-19 09-15-39

Although the cognitive learning system in the brain is truly remarkable, it is unrealistic to expect that this system can build the accurate mental representations patients like Aiko need. But with the recent Executive Order on Advancing American Kidney Health, which aims to increase patient choice through alternative treatments for end-stage renal disease (ESRD) and increase access to kidney transplants, patients will need effective educational tools to help them make vital decisions about their health.

The Solution

“Learning is an experience. Everything else is just information.” -Albert Einstein

Experience is at the heart of a virtual reality solution for patient education and is at the core of effective communication between healthcare professionals and patients. Imagine a virtual reality experience in which Aiko dons a VR headset and a virtual kidney is displayed in front of her. Her nephrologist can see what Aiko sees using a tablet. The nephrologist describes the function of the kidney within the broader renal system while Aiko views a dynamic virtual display showing the whole system with the kidney highlighted. Suppose a second VR experience begins by outlining the timeline of Aiko’s upcoming kidney transplant. The nephrologist is able to guide Aiko through the whole procedure while using VR assets to help highlight specific time points and surgical techniques. By providing a shared experience that is 3D and dynamic, Aiko is able to easily generate the mental representation that she so desperately needs. This follows because VR engages experiential, emotional, and cognitive learning centers in the brain in synchrony.

These VR experiences enhance Aiko’s understanding of kidney function and the specifics of her kidney transplant surgery, but what about all of her anxiety and stress around the hospital stay and post-operative healing? Again, a VR experience is in order. Imagine a VR experience focused on preoperative and perioperative hospital familiarization. Aiko could be transported into the lobby of her local hospital where she is greeted in VR by Susan, a resident nurse. Susan shows Aiko where she goes to be admitted. Next, Susan takes Aiko on a tour of the hospital where they visit preoperative patient waiting rooms, the operating room and post-operative recovery unit. Susan shows Aiko how the bed works, where the bathroom is located, and how to use the all-important call button. At this point, Linda enters the room. Linda introduces herself as a former kidney transplant patient. She assures Aiko that the surgical team is top-notch and that her hospital stay will be a breeze. Linda talks about some of the critical post-operative procedures and what Aiko needs to pay special attention to when she gets home, and throughout her recovery.

Because all of the hospital staff are well versed in the same VR experiences, if Aiko has a question the hospital staff can refer back to the VR experience when answering the question. Because both Aiko and the staff have a shared experience, communication is more effective and understanding is enhanced. Of course, if at any point Aiko wants to refresh her memory, or share the experience with a family member, she simply pulls out her VR headset and immediately has access to a refresher.

The power of shared experiences is strongest when patients and their families have access to an effective educational resource at every critical juncture and decision point throughout their journey.

Screenshot from 2019-12-29 09-33-21

This experience-based approach to education and training broadly engages multiple learning systems in Aiko’s brain. She now has a strong and meaningful mental representation in her brain that she can convey to friends and family, and most importantly one that enhances her understanding and confidence about her care plan. These experiences are shared by her healthcare providers facilitating understanding and communication. VR enhances patient and provider understanding and communication, reduces stress and anxiety, and enhances confidence and satisfaction – one experience at a time.

 

 

Topics: Training, Communication, Learning, Patient Education, Workforce, Kidney Care

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  • Increases actionable empathy
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