Title:Building in-person empathy with Virtual Reality

In the lower level of Dahlgren Memorial Library, Beatriz is chopping a potato. No matter how many times she lifts the knife, she can’t seem to wield it properly. She looks up in her kitchen, and sees her family singing happy birthday to her. Then the kitchen fades away and she is in a field of flowers. When the kitchen returns, her family stares at her with worried faces. The simulation ends, and the Georgetown medical student takes off his virtual reality (VR) headset.

This frustrating and confusing experience is a learning tool designed to help medical professionals understand the perspective of a patient with Alzheimer’s disease. Georgetown University School of Medicine has partnered with Embodied Labs to bring immersive VR experiences to students in the geriatrics clerkship, and to incoming students in the new Master of Science in Aging & Health program.

CEO and founder Carrie Shaw created Embodied Labs after becoming a caregiver at age 19 to her mother, who had early-onset Alzheimer’s disease. Now, the modules she developed are being used to help Georgetown students step into the perspective of patients experiencing her mother’s condition, as well as macular degeneration, Lewy body dementia, Parkinson’s disease, and end of life. VR users can move the animated hands of the patient persona and also see, hear, and speak with actors who were filmed for the simulations.

“These virtual reality experiences put you in the body of the patient,” says Linda Van Keuren, assistant dean for access and resource manage- ment at the Medical Center’s Dahlgren Memorial Library. “Each patient has a name and people will talk directly to you.”

VR is not new to medical education, and Georgetown is making investments to expand offerings, says Jett McCann, director of Dahlgren Memorial Library and senior associate dean for knowledge management. A growing movement for more empathy training also matches the Jesuit values that attract medical students to Georgetown. “We have a responsibility here to explore things,” says McCann. “Teaching empathy underscores cura personalis.”

Third-year student Lorrane Kabert (M’21) experienced simulated vision and hearing loss through the macular degeneration module during her geriatrics clerkship. “It was so difficult to hear what people were saying to me, which was very upsetting,” she notes. “I felt ignored. I was even more upset with the physician’s interaction with me. He wanted me to take an exam, but the instructions were not clear and even though it was obvious that I did not understand, he proceeded with the exam without making sure I understood what to do.”

New simulation software offers medical students the virtual experience of a person with conditions such as Alzheimer’s disease or macular degeneration.

The VR lesson also reminded Kabert how important it is to check in with patients when delivering instructions, to make sure they understand everything. She’s determined to be a better physician as a result. “I was left with some feelings of guilt, appreciation, and desire to become an even more considerate and empathetic doctor,” she adds.

VR-based empathy training is one strategy to address systemic challenges facing caregivers who serve a rapidly aging patient population. Longer hours, more compressed time with patients, and higher stress are all taxing on doctors’ empathy in modern medicine. Research shows that empathy in medical students declines from first-year to third-year, says Associate Professor Pam Saunders, co-director of the geriatrics clerkship, and director of the Master of Science in Aging & Health program.

In addition, medical education about aging populations poses an access issue. “Geriatrics is one of the poorest paid specialties,” says McCann, leaving medical students with heavy debt loads to choose other, more lucrative paths.

When presented with these concerns, the School of Medicine Parents Council made a $27,000 gift to convert an old staff lounge in the library into a VR lab with enough space for safe movement while wearing headsets. The new lab space will open in the fall, equipped with Oculus Rift equipment, six individual computer stations, and one group experience screen.

Saunders is hopeful that the lab will offer more educational opportunities for students. “VR allows us to expand the number of experiences a student can have,” says Saunders. “Not everyone who rotates in geriatrics will work with a patient suffering from Alzheimer’s in those two weeks. This could be a great way of introducing geriatric medicine to the entire student population. If we could give every third-year student a chance to do those modules, that would be really powerful.”

The modules expose students to a diversity of patients, demonstrate how doctors work in teams with nurses and social workers, and teach more techniques. With increased funding, the library could purchase modules related to orthopedics, assessments of gait and functional ability, treating a patient after a fall, and many surgical applications. All such applications would maximize students’ in-person learning opportunities with real mentors and patients.

“In all medical fields, we’re really trying to teach empathy, compassion, and understanding of other perspectives,” says Saunders. “VR would never replace working with patients one-on-one, but it is a nice supplemental strategy. It’s one tool in our toolkit to help support those goals of caring for the whole person.”