A virtual human interaction using scaffolded ping-pong feedback for healthcare learners to practice empathy skills

Virtual human interactions are increasingly used for empathy skills training in healthcare by providing feedback during or after the interaction. The post-interview feedback consists of evaluation results of users' empathic responses and can be provided once without interfering with the interaction. However, this type of feedback is insufficient to engage trainees in obtaining a deeper understanding and insights into their learning. The scaffolded ping-pong feedback consists of a multi-round of descriptions explaining how to formulate desired empathic responses to induce users to explore an understanding of how to respond empathically. To increase the training effectiveness to enhance users' expressed empathy, we studied how to apply scaffolded ping-pong feedback in virtual human interactions to train users' empathy skills. In this paper, we studied how different forms of feedback impact users learning how to express empathy to screen-based virtual humans. To evaluate the training effectiveness, we collected 638 empathic responses from 27 clinician participants in the interaction with two virtual patients integrated with scaffolded ping-pong feedback. We compared them with 809 empathic responses from 25 clinician participants in the post-interview condition. The result shows that the scaffolded ping-pong feedback helped clinician participants to provide a higher percentage of medium-empathy level and a lower percentage of low-empathy level empathic responses than the post-interview feedback. The scaffolded ping-pong feedback was perceived as more difficult to use but did not affect the overall interaction experience with virtual patients. This work demonstrates the applicability of integrating ping-pong feedback to strengthen the training effectiveness of virtual human education interventions.