“Virtual Coaches” for Symptom Management

“Pretend that I am your health care practitioner and respond out loud to me… Tell me about your pain, aches, soreness, or discomfort.” Imagine hearing this from a virtual trainer, a computer-generated avatar of a health care practitioner on the screen in front of you, instructing you to practice discussing your symptoms with her so that you become better at doing so with your real-world doctor. Would this help you share more information about your symptoms? Would further prompts from the avatar asking for more information about your discomfort help you recall and present more useful information? A recent pilot study with 30 adults aged 60 and older (McDonald et al 2011) suggests that such virtual coaching may, in fact, help individuals present their symptoms more effectively. Randomly assigned study participants using the virtual coach reported more symptoms than participants using a video coach or no coach at all.

Studies on the methods that practitioners use to elicit symptoms show that practitioners often limit the reporting of symptoms through ineffective listening or interrupting. The coaching effect, a term used by pain researchers, refers to the idea that patients can be trained to more effectively communicate about their pain, which enables them to receive more helpful treatment. The cost of coaching, however, limits the use of person-to-person coaching, so the researchers designed this study to develop an affordable, potentially home-based coaching system.

On average, participants using the virtual coach presented one additional symptom compared to those using the videotaped coach. The sample size was too small to compare the content of the symptoms reported by each group—for example, whether or not the symptoms reported by those using the virtual coach were more clinically useful. However, the study provides further evidence that computers are a viable means to provide health information to older adults and fits with a growing body of data that suggests that interactive technologies may help with health communication. Now that pilot studies such as this one are demonstrating the viability of such technologies, clinical trials will be able to thoroughly explore how effective they can be.


McDonald DD, Gifford T and Walsh S (2011). “Effect of a Virtual Pain Coach on Older Adults’ Pain Communication: A Pilot Study.” Pain Management Nursing 12(1) 50-56.


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