Using VR to experience how it feels when a patient throws a shoe at you

Psychology students usually only get to meet patients very late in their studies. Therefore, neuroscientists Ineke van der Ham and Judith Schomaker want to research whether students learn more effectively from a virtual experience with a patient with dementia than from a text. “We have plans to develop more VR experiences like ‘Dementia Up & Close’ in education,” says Schomaker.

How did you get to research this?

Many psychology students would like to become clinical (neuro)psychologists, but do not come into contact with patients until very late in their studies. Often that first patient contact does not occur until an internship or thesis project in the final year.

One reason for this is that we have hundreds of first-year students every year—again this year ~650—and so this kind of the patient contact earlier in the study is complicated. With innovative extended reality (XR) technologies, we have the unique opportunity to create an immersive, realistic experience, allowing students to experience the (sometimes violent) behavior of patients up close, but within the walls of the university or even at home.

The question is: Is such a virtual experience effective?

Can you describe the research design?

In this Dementia Up & Close project, we want to investigate how learning from a text and learning from a virtual experience relate to each other. In one condition of the experiment, students will experience several 360-degree videos in virtual reality. In these videos, students will see patients with dementia demonstrating behaviors that fit this syndrome.

These are sometimes quite intense scenarios with transgressive behavior that a student would not otherwise easily experience. In a second condition, students will learn about dementia in a more classical way. Then we will test what students learned from the experiences. Do they remember more from such an immersive experience, or is a classical form of presentation just as effective or even better?

Why is it important that participating students have no previous experience with someone with dementia?

The idea is that in our experiment, students can experience a patient with dementia up close for the first time. If you already have a lot of experience with an individual with dementia, chances are that many of the behaviors we show will be recognizable to you. We may then have a harder time exploring how much you learned from the videos.

In addition, it is possible that background knowledge could color the experience, for example, because you already have specific expectations about the behavior of patients with dementia.

Do the students in the study communicate with the virtual patient?

Students look around during the experience of the scenarios, which really gives the feeling of “being there.” It is not currently an interactive experience. For our research on the effectiveness of learning from such an experience, this is actually good, because it allows us to have control over the material.

Dynamic-interactive experiences with patients can be very powerful. We are now working with a company that makes these kinds of dynamically interactive scenarios in VR to see how we shape that, but that’s so for the future.

The step from learning from a book to clinical practice seems quite large. What difficulties do beginning clinicians face who are new to working with ‘real patients?’

Our training is academic and we train students primarily to learn to think academically. When students first encounter patients late in training, they often feel completely unprepared for that experience.

Although understanding the neurobiological mechanisms is crucial, this knowledge does not help you immediately the moment a patient demonstrates transgressive behavior. Reading about a patient throwing a shoe, for example, is a lot less intense than actually experiencing a patient throwing a shoe at your head. Experiencing a patient group and learning how best to deal with them is difficult from paper.

The type of immersive experience we are using in this study could allow students to experience at an earlier stage of their studies how certain disease states manifest themselves in behavior and how that can affect the environment.