Doctor –patient consultations in C-19: rapid development and deployment of a virtual patient to support providers breaking bad news

Teresa Pawlikowska, Caroline Delaney, Barry Harnedy, Declan Dagger, Connor Gafney

Keywords: C-19 Consultations Virtual patient Breaking Bad News

The C-19 pandemic has affected vast numbers of patients, relatives, carers and health care workers, and added complexity to communication between these groups, many need to adapt fast.
No personal continuity with patients
Loved-one/Carer can be remote from hospital
Verbals & non-verbals affected by PPE
IT - remote connection via phone, tablet, etc.
Often news of transfer to ITU, sudden deterioration
Doctors and front line staff can be stressed by breaking bad news

Research questions:
Can a virtual patient which allows practice and feedback assist doctors in breaking bad news in this context?

The intention was to rapidly upskill staff. This virtual patient was device agnostic, so anytime, anywhere interaction was possible.
It is developed on a game platform, the participant plays the doctor role and is given their own feedback.
It is confidential, with real time feedback and coaching.
It is based on the Cambridge Calgary Guide (Silverman 2013) and the SPIKES protocol for Breaking Bad News (Baile 2000)
So it presents a best practice, Patient centred approach
For the doctor or staff member it presents them with an opportunity for active learning, role play and feedback.

So far it has been used by a wide variety of postgraduate front line staff and evaluation shows that:
94% felt that content was engaging
91% reported that it was realistic.
It was highly recommended and further evaluation is ongoing and will be reported.

A virtual patient developed on a game based platform for breaking bad news remotely in the C-19 pandemic has been evaluated as useful for upskilling frontline staff.

Points for discussion:
Can you feedback on any improvements you would find useful?

Can you see other uses of this?