A virtual patient, named Denise, may help future physicians feel more comfortable and capable assessing suicide risk.
Suicide is occurring earlier and more often in the United States than ever before. Rates are up 25 percent in the last decade to 12.4 per 100,000 individuals annually. It’s the second-leading cause of death for college students and third for all 15-24 year olds, according to the American Foundation for Suicide Prevention. Twenty percent of high school students report having seriously considered suicide during the previous 12 months.
The Medical College of Georgia study of second-year medical students is helping determine if the opportunity to ask tough questions about suicide risk to a virtual (computer-simulated) patient can help real families avoid this tragedy.
Mood disorders, such as depression, are the most common mental health disorders coming to physician attention that carry a high risk of disability and suicide.
In the American Foundation for Suicide Prevention-funded study, 40 sophomore medical students watch a video of a physician interviewing a patient with a mood disorder. The interview includes a suicide risk assessment. Another 40 students will electronically interview Denise, who was designed by the University of Florida Department of Computer and Information Science and Engineering.
Later, all the students go to MCG’s Clinical Skills Center to interview an actor portraying a patient with a mood disorder. A subgroup will also interact with a second actor with a different mental health problem. These actors, called standardized patients, are trained to portray and report symptoms associated with a certain condition.
Before all MCG students enter their clinically intensive third and fourth years of medical school, they spend time with these patients, honing communication and patient-examination skills.
The researchers hypothesize that students who interact with Denise will be better able to assess suicide risk in the standardized patients.
If they are right, researchers want to share Denise with other medical students. They also want to study Denise’s long-term impact on students as they take clinical rotations in psychiatry and graduate from medical school.
While students type their questions and mostly get a typed response from Denise, the virtual interaction helps them think through what to ask and the best way to ask it. In fact, Denise tells them when she doesn’t understand. To enhance Denise’s inter-actability, MCG is sharing unanswered questions with collaborators at the University of Florida, to see if maybe she should respond. As in life, sometimes the problem is just a matter of phrasing.
Studies show that front-line providers, such as family medicine physicians, don’t feel comfortable assessing suicide risk. In countries with some of the highest suicide rate, such as Japan and Hungary, targeted provider education has helped decrease rates.
Warning signs of suicide include unrelenting low mood, hopelessness, desperation, anxiety, withdrawal, sleep problems, increased alcohol and/or other drug use, impulsiveness, taking unnecessary risks and threatening suicide or expressing a strong wish to die, according to the American Foundation for Suicide Prevention.
Urvaksh Karkaria covers Technology.