This document discusses using technology to nurture core human values in healthcare. It suggests that technology can be used to facilitate reflection, promote discussion, and disseminate viewpoints on illness and healthcare through narratives, illustrations, and virtual reality simulations. These tools may help inspire empathy and compassion by allowing students and practitioners to experience illness from a patient's perspective. However, challenges remain in developing effective content and pedagogy for digital empathy training, as well as ensuring proper resources, design, curation and instructor guidance. Overall, the document examines how various technologies could potentially augment efforts to teach empathy and values in medical education.

1. Technology to Humanise Values for Effective Medical Practice
Dr Poh-Sun Goh
Associate Professor and Senior Consultant
Department of Diagnostic Radiology
National University of Singapore and National University Health System

2. Use of Narratives
Stories
Illustrations
Inspire and move us Promote ReflectionViewpoints
Illness
Healthcare
Goh, P.S., Sandars, J. (2019). Using Technology to Nurture Core Human Values in
Healthcare. MededPublish, 8, [3], 74, https://doi.org/10.15694/mep.2019.000223.1
https://medicaleducationelearning.blogspot.com/2019/06/technology-to-nurture-values-for.html

3. Using Technology
Access
Scale
Viewpoints
Facilitate Reflection
Instructor, Guide, for Feedback
Promote Discussion
Disseminate

4. Examples of Technology
Real Abstract
High cost
Low cost
VR
Theatre
Apps/Games
Video IllustrationsAudio Text
Narratives/Stories
https://news.stanford.edu/2018/10/17/virtual-reality-can-help-make-people-empathetic/
https://gumc.georgetown.edu/gumc-stories/virtual-reality-training-helps-medical-students-develop-real-empathy/
(Role Play)

5. Technology, Art, Medical Humanities
https://commons.wikimedia.org/wiki/
File:Apollo_11_astronaut_Buzz_Aldrin_and_Erisa_Hines_speak_to_members_
of_the_news_media_during_a_preview_of_the_new_Destination_Mars_(29712
147171).jpg
https://en.wikipedia.org/wiki/The_Doctor_(painting)#/media/
File:The_Doctor_Luke_Fildes_crop.jpg
“Empathy is seeing with the eyes of another, listening with the ears of another and feeling with the heart of another.” – Alfred Adler
https://theconversation.com/how-theatre-training-can-boost-your-doctors-empathy-102395
Claus Lamm, Jasminka Majdandžić. The role of shared neural activations, mirror neurons, and morality in empathy – A critical
comment, Neuroscience Research, Volume 90, 2015, Pages 15-24, ISSN 0168-0102, https://doi.org/10.1016/
j.neures.2014.10.008. https://www.sciencedirect.com/science/article/pii/S0168010214002314
https://health.clevelandclinic.org/empathy-exploring-human-connection-video/
https://fortune.com/2019/04/02/artificial-intelligence-humanize-healthcare/

6. What is our role in delivering healthcare?
Recognise that health, illness, suffering and pain are part of the human condition.
We will all become ill at some point, become a patient, or a family member of a patient.
Let’s try a simple exercise, and switch role from healthcare practitioner to patient
Close your eyes
Image you are the patient
Imagine you are suffering, in pain, have the disability of the patient
Switch places with the patient - chair, wheelchair, trolley, bed, operating table
Waiting room, clinic, ward, emergency department, ICU
What are your feelings? Fears? Needs? Hopes and Expectations from healthcare practitioners?

7. Examples of Digital Content that can be Shared, and Technology Used to Build Empathy and Compassion
Text (quotes) - Short quotes can be memorable, easily shared, and convey the essence of an idea in brief.
“Empathy is seeing with the eyes of another, listening with the ears of another and feeling with the heart of another.” – Alfred Adler
“seek to "cure sometimes, treat often, comfort always" - Hippocrates
https://rebelem.com/hippocrates-osler-foam/
"“In your career, you’ll have a choice: to be a physician or a healer. Be a healer.”
above quote from https://reflectivemeded.org/2019/07/09/hearts-exposed-a-medical-students-reflection-on-witnessing-their-first-patient-
death/
Narratives - form the essence of storytelling, conveying messages, contexts, and when presented well evoking an intended response
(for example regarding inequality)
https://www.academia.edu/36666934/This_is_What_Inequality_Looks_Like--Step_1_Disrupt_the_Narrative

8. Empathy courses within medical curriculum - can form the backbone of systematic instruction and guidance for medical
students and healthcare practitioners
(example below)
https://www.theatlantic.com/health/archive/2015/03/how-to-teach-doctors-empathy/387784/
Kiosses, V.N., Karathanos, V.T. & Tatsioni, A. Empathy promoting interventions for health professionals: a systematic review of
RCTs. J of Compassionate Health Care 3, 7 (2016) doi:10.1186/s40639-016-0024-9
https://jcompassionatehc.biomedcentral.com/articles/10.1186/s40639-016-0024-9
Patel S, Pelletier-Bui A, Smith S, Roberts MB, Kilgannon H, Trzeciak S, et al. (2019) Curricula for empathy and compassion training
in medical education: A systematic review. PLoS ONE 14(8): e0221412. https://doi.org/10.1371/journal.pone.0221412
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0221412
https://www.pharmaceutical-journal.com/cpd-and-learning/learning-article/how-to-demonstrate-empathy-and-compassion-in-a-
pharmacy-setting/20206124.article?firstPass=false
Vázquez Campo, Miriam & Vidal, Leticia & Torres-Iglesias, Angela & Mateos, Raimundo & Olivares, José & García-Lado, Isabel &
Garcia- Caballero, Alejandro. (2019). Facial Emotional Perception Training for Medical Students. Creative Education. 10. 1792-1801.
10.4236/ce.2019.108128.
https://www.researchgate.net/publication/334990398_Facial_Emotional_Perception_Training_for_Medical_Students
https://www.scirp.org/journal/paperinformation.aspx?paperid=94179

9. Podcasts - take advantage of the qualities of the human voice and sounds to convey emotion and feeling, to move the listener
(multiple examples within blog below)
https://blogs.bmj.com/medical-humanities/2018/05/01/how-podcasts-make-me-an-empathetic-physician/
and
https://www.cancer.net/blog/2018-03/your-stories-podcasts-how-cancer-impacts-families
Illustrations and Art - the traditions of art, illustrations and photography to capture scenes of illness and healthcare can broaden the
exposure and experience of healthcare practitioners to situations and points of view
http://www.bbk.ac.uk/art-history/research/visualising-illness
and
https://www.folio.ca/psychiatry-student-uses-art-to-shed-light-on-the-darkest-shades-of-illness/
Video - is a powerful visual and auditory medium that can be used to depict health and illness, and be easily shared on multiple mobile
and online platforms
(for example facing depression in the elderly)
https://www.channelnewsasia.com/news/video-on-demand/facing-depression/an-elderly-s-perspective-10036596
Blasco, Pablo & Moreto, Graziela. (2012). Teaching Empathy through Movies: Reaching Learners' Affective Domain in Medical Education.
Journal of Education and Learning. 1. 10.5539/jel.v1n1p22.
https://www.researchgate.net/publication/
265878964_Teaching_Empathy_through_Movies_Reaching_Learners'_Affective_Domain_in_Medical_Education/citation/download

10. Theatre and Drama - being an audience member of live theatre and drama, viewing dramatisations of healthcare offer the
opportunity to experience settings of healthcare and illness.
Matthiessen, Christian & Law, Locky. (2019). Dramatised Medical Consultations: What Are They Like and How Can We Use Them.
10.13140/RG.2.2.11929.88161.
https://www.researchgate.net/publication/
333866273_Dramatised_Medical_Consultations_What_Are_They_Like_and_How_Can_We_Use_Them
http://hub.hku.hk/handle/10722/278880
Dow, A. W., Leong, D., Anderson, A., Wenzel, R. P., & VCU Theater-Medicine Team (2007). Using theater to teach clinical empathy:
a pilot study. Journal of general internal medicine, 22(8), 1114–1118. doi:10.1007/s11606-007-0224-2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2305755/
Reilly, J., Trial, J., Piver, D. E, & Schaff, P. B. (2012). Using Theater to Increase Empathy Training in Medical Students. Journal for
Learning through the Arts, 8(1). http://dx.doi.org/10.21977/D9812646 Retrieved from https://escholarship.org/uc/item/68x7949t
https://escholarship.org/uc/item/68x7949t
Bee Teng Lim, Helen Moriarty & Mark Huthwaite (2011) “Being-in-role”: A teaching innovation to enhance empathic communication
skills in medical students, Medical Teacher, 33:12, e663-e669, DOI: 10.3109/0142159X.2011.611193
https://www.tandfonline.com/doi/full/10.3109/0142159X.2011.611193
https://www.medicaleconomics.com/med-ec-blog/can-acting-classes-help-physicians-learn-show-empathy
http://www.critical-stages.org/17/teaching-empathy-implementing-theatre-pedagogy-in-the-medical-school-curriculum/
http://theconversation.com/how-theatre-training-can-boost-your-doctors-empathy-102395

11. Video games - interactive video, online and mobile games can be designed as guided reflective exercises, to build empathy
(for example to build empathy in children)
https://psychcentral.com/news/2018/08/11/can-a-video-game-boost-empathy-in-teens/137794.html
Kral, T.R.A., Stodola, D.E., Birn, R.M. et al. Neural correlates of video game empathy training in adolescents: a randomized trial. npj
Science Learn 3, 13 (2018) doi:10.1038/s41539-018-0029-6
https://www.nature.com/articles/s41539-018-0029-6
Virtual Reality - has the ability to place the viewer in the healthcare and illness scenario, and has the unique ability to give the
viewer an appreciation of the setting from the point of view of the participants
https://www.edsurge.com/news/2019-08-05-can-virtual-simulations-teach-a-human-skill-like-empathy
https://medicalfuturist.com/virtual-medical-simulations/
https://www.studyinternational.com/news/vr-medicine-student/
Dyer E, Swartzlander BJ, Gugliucci MR. Using virtual reality in medical
education to teach empathy. J Med Libr Assoc. 2018 Oct;106(4):498-500. doi:
10.5195/jmla.2018.518. Epub 2018 Oct 1.
https://www.ncbi.nlm.nih.gov/pubmed/30271295
Schoeller, F., Bertrand, P., Gerry, L. J., Jain, A., Horowitz, A. H., & Zenasni, F. (2019). Combining Virtual Reality and Biofeedback to
Foster Empathic Abilities in Humans. Frontiers in psychology, 9, 2741. doi:10.3389/fpsyg.2018.02741

12. Artificial Intelligence - will have an increasing role in augmenting the impact of educators by scaling up our efforts to provide
customised, personalised guidance and instruction
https://www.forbes.com/sites/nicolemartin1/2019/08/27/robots-are-actually-teaching-humans-to-be-more-compassionate/
#430507d65a80
Touch - "Our sense of touch provides the most profound, deepest, emotional connection between people," Mr Rogers said in a
statement.
https://www.businesstimes.com.sg/technology/new-tech-puts-virtual-sense-of-touch-at-our-fingertips?
cx_testId=46&cx_testVariant=cx_2&cx_artPos=3#cxrecs_s

13. “Virtual reality (VR) and immersive reality experiences can bring an online
audience remotely into a practice setting and simulate the experience of
illness for students and healthcare practitioners (Dyer et al., 2018). These
newer technologies increasingly simulate real life settings and are more
immersive, deepening our insights into a patient’s point of view (Herrera
et al., 2018). Artificial Intelligence (AI), can adapt and personalise the
content to provide a personalised interactive digital experience, with the
potential to increase empathy and compassion (Lakhani, 2019).”
Goh, P.S., Sandars, J. (2019). Using Technology to Nurture Core Human Values in Healthcare. MededPublish.

14. Dyer, E., Swartzlander, B.J. and Gugliucci, M.R. (2018) Using virtual reality in medical education to teach empathy.
Journal of the Medical Library Association. 106, pp.498-500. https://doi.org/10.5195/jmla.2018.518

15. Herrera, F., Bailenson, J., Weisz, E., Ogle, E. and Zaki, J. (2018) Building long-term empathy: A large-scale comparison of
traditional and virtual reality perspective-taking. PLoS ONE. 13: e0204494. https://doi.org/10.1371/journal.pone.0204494

16. Challenges of Using Technology
Pedagogy
Empathic design
Resources
Instructor/Guide
Content
Technology
Digital Empathy
Awareness
TrainingCuration
Development

17. Thank you