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What do speech pathology students gain from virtual patient interviewing? A WHO International Classification of Functioning Disability and Health (ICF) analysis
  1. Anna Miles1,
  2. Sarah Hayden1,
  3. Stephanie Carnell2,
  4. Shivashankar Halan2,
  5. Ben Lok2
  1. 1 Speech Science, University of Auckland, Auckland, New Zealand
  2. 2 Virtual Experiences Research Group, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Anna Miles, Speech Science, School of Psychology, Tamaki Campus, the University of Auckland, Auckland 92019, New Zealand; a.miles{at}


Background Virtual patients have an established place in medical education but do virtual patient interviews train holistic clinicians or just diagnosticians? This study explored speech pathology students’ virtual patient interviews using WHO International Classification of Functioning Disability and Health (ICF).

Methods Eighteen speech pathology students in their final year of training participated. Students interviewed virtual patients with dysphagia (swallowing difficulties) as part of their curriculum. Student questions and patient responses were coded using established ICF coding. Codes were tallied and compared under categories of body structures, body functions, activities/participation and environmental factors. Flesch Reading Ease was calculated as a measure of health literacy.

Results Conversational turns primarily focused on the ICF component—activity and participation in both student questions and virtual patient responses: 0.03% body structures, 30% body functions—swallowing, 7% body functions—associated, 43% activities/participation and 19% environmental factors. Personal factors such as gender, ethnicity, age or socio-economic situation were not mentioned by student or patient. Patients commented on social impact on self and/or family, sometimes in the absence of targeted student questions. Student and virtual patient Flesch Reading Ease scores were congruent.

Conclusion Speech pathology students naturally matched their virtual patient’s health-literacy level and asked a range of medical and daily living questions. Virtual patients readily offered social impact information to student questions. Computer science: healthcare teams should consider creating virtual patients who challenge students to practise asking sensitive questions and in doing so develop holistic thinkers with competent communication skills.

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  • Twitter Anna Miles @annacmiles.

  • Contributors AM, SH, SC, SH, and BL planned, conducted and reported the work. All these contributors gave their final approval of the version to be published and agree to be accountable for the accuracy and integrity of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval This study was approved by an appropriate national ethics committee (UAHPEC/016700) and all respondents provided written informed consent. All procedures were in accordance with the ethical standards of the institutional ethics committee and with the 1964 Helsinki declaration.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplemental information.

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