The Physical-Virtual Patient Simulator: A Physical Human Form With Virtual Appearance and Behavior.

INTRODUCTION:We introduce a new type of patient simulator referred to as the Physical-Virtual Patient Simulator (PVPS). The PVPS combines the tangible characteristics of a human-shaped physical form with the flexibility and richness of a virtual patient. The PVPS can exhibit a range of multisensory cues, including visual cues (eg, capillary refill, facial expressions, appearance changes), auditory cues (eg, verbal responses, heart sounds), and tactile cues (eg, localized temperature, pulse). METHODS:We describe the implementation of the technology, technical testing with healthcare experts, and an institutional review board-approved pilot experiment involving 22 nurse practitioner students interacting with a simulated child in 2 scenarios: sepsis and child abuse. The nurse practitioners were asked qualitative questions about ease of use and the cues they noticed. RESULTS:Participants found it easy to interact with the PVPS and had mixed but encouraging responses regarding realism. In the sepsis scenario, participants reported the following cues leading to their diagnoses: temperature, voice, mottled skin, attitude and facial expressions, breathing and cough, vitals and oxygen saturation, and appearance of the mouth and tongue. For the child abuse scenario, they reported the skin appearance on the arms and abdomen, perceived attitude, facial expressions, and inconsistent stories. CONCLUSIONS:We are encouraged by the initial results and user feedback regarding the perceived realism of visual (eg, mottling), audio (eg, breathing sounds), and tactile (eg, temperature) cues displayed by the PVPS, and ease of interaction with the simulator.