Abstract:

Background:
DDS Detective is a "serious game" simulation that allows dental students to interact with a virtual patient and make clinical decisions. It could easily be adopted for medical or other health care students. The goal of the game is to mimic real-world patient interviews so the students learn to ask the right questions and make logical clinical decisions. In a previous paper, our group examined an autonomous virtual patient (AVP) system for identifying differences between novices and experts in dentistry with cases of Orofacial Pain and Oral Medicine. The data showed significant group differences when solving the virtual cases in the number of diagnostic tests ordered, and the number of medications selected. Novices reported that they found virtual patients to be a valuable educational experience. 1

Methods:
The use of a virtual patient system (DDS Detective) has been ongoing since 2010. DDS Detective is a single player networked game and case authoring system to teach dental students and postgrad residents interview skills for diagnostic elaboration. We have developed more than 80 orofacial and oral medicine cases using the DDS Detective web authoring front end that allows to create copies of template cases and customize them. The game and associated web services and the web authoring front end are hosted on a webserver.

Game Design Strategies:
For this game, we elected not to create a high resolution moving, speaking avatars or try to develop a interface responsive to verbal or typed user input. Instead we designed the user interface with a pop-up a menu containing a large set of well-organized questions they could select from. We discovered that 99% of the students elected to use the menu question only to query their patient. Challenges included allowing for easy case content generation and designing the graphical elements such as a graphic performance feedback dashboard with interaction and game-play element to support the objectives we set forth. The choice of the Unity 3D platform allowed us to generate standalone, web-based and iPad versions of the game. We found out that the menu of pre-existing questions allows students to rapidly learn these questions that they do not necessarily know or have in mind when first playing the game.

Results:
The use of the game has proven to be a useful learning resource both for novice and experts in the Orofacial Pain and Oral Medicine field. We are using it as our summative competency examination for both DDS and post-graduate students. We see progressive continuous improvement in scores with ongoing game play with both groups of students and remarkably within 10 cases, our DDS students performance is similar to our graduate students. These results suggest we have good face validity and reasonable effectiveness of the game to improve learning outcomes.

Keywords:

Virtual Patient, Orofacial Pain, Oral Medicine, Serious game.