Strategy

The Simulated RN project will utilize a virtual healthcare agent that is designed to deliver face-to-face consultation with patients while upholding a natural appeal. The main design goal was to improve the discharge process by providing an interactive learning environment that enriches user tasks through communicative commonality (e.g., reduced communication barriers). It is predicted that reducing barriers in communication during the discharge instruction process will subsequently improve the acquisition of knowledge, patient comprehension and satisfaction. Corresponding to the Threshold Model of Social Influence human beings initially only respond socially to other human beings (Blascovich, 2002; Blascovich et al., 2002). According to the Ethopoeia concept, if the design space includes social cues, such as interactivity, natural speech, or the filling of social roles, natural feelings are triggered and intrinsic social behaviors are performed (Putten, Kramer, Gratch, & Kang, 2010).

The interface is designed to automate and initiate conversation with the patient (user) and the testing of this process had to be modeled in a representative prototype in order to realistically evaluate the user's social reactions to the virtual social cues. It was believed that a low fidelity prototype would not be valid since many of the design characteristics are based on the virtual agent's communication abilities (verbal and nonverbal).

In addition, concerns with literacy levels for some patients, and addressing the needs of the hearing-impaired, the interface had to support audio narration with written subtitles to accommodate some users (Johnson, Sandford, & Tyndall, 2003). Furthermore, multisensory functions were needed to accommodate various user learning styles (Johnson, Sandford, & Tyndall, 2003), including subject matter content supported by visual aids (Koonce, Giuse, & Storrow, 2011). The presence of these elements in the prototype maximizes the usability and emphasizes the reliability and validity of the testing environment.

Two major driving forces behind the prototype strategy centered on the psychological aspects related to high agency and high behavioral realism. A high fidelity approach to prototyping was adopted to support both aspects in the prototype design. The Threshold Model of Social Influence suggests that a user will intuitively respond socially to another human or in a virtual reality environment to a high agency character (Putten, Kramer, Gratch, & Kang, 2010; Blascovich, 2002; Blascovich et al., 2002). Therefore, efforts were concentrated on the breadth of functionality by developing a prototype that represented characteristics that would model features in a potential target design.

1. A high degree of functionality
2. Consistency with interaction

Description of Prototype

The system features a limited 3D animated virtual healthcare agent that provides audio narration, capable of supporting multiple languages, in a touch based interface. The system begins with an introductory sequence, followed by instructions on how to use the prototype, including an evaluation of the user’s readiness or ability to understanding the navigation process. The prototype of the system was designed with these main features:

• 3D animated virtual healthcare agent
• Computer generated speech, including a demonstration in Spanish (SIDS section)
• Subtitles
• Scripted conversation intended to communicated workflow, including instructions
• Touch based user responses, using modal dialogue boxes
• Ability to pause workflow at anytime
• Educational content related to post-partum discharge instructions:
• proper feeding of the infant,
• urination patterns, bowel movements,
• umbilical cord care, skin care,
• genital care,
• signs of illness,
• prevention of sudden infant death syndrome,
• car seat selection
• vaccine information
• Optional instructional video (only a placeholder)

 

Independent user navigation is allowed to explore the various educational content tabs, but the virtual healthcare agent will not respond to these user inputs. Therefore, the user may review any topic of interest and periodically, the virtual agent will initiate a re-alignment of the educational content to verbal subject matter.