IDI Press Release – February 24, 1999

FOR IMMEDIATE RELEASE

Study of Race/Gender Influence on Physician Decisions 
Conducted With Unique Multimedia Technology

February 24, 1999 —A new study suggesting that the race and sex of a patient influence how physicians manage chest pain was conducted using distinctive multimedia technology developed by Interactive Drama Inc. (IDI) of Bethesda, MD.

The study, reported in the February 25 issue of The New England Journal of Medicine, was led by Kevin Schulman, M.D., of Georgetown University Medical Center and conducted by a team of researchers from Georgetown, the RAND Corporation, and the University of Pennsylvania. Funding was provided by the U.S. Agency for Health Care Policy and Research.

In the study, researchers found that women and blacks with chest pain were almost two times as likely as white men not to be referred for cardiac catheterization. The disparity was most dramatic for black women, who were two-and-a-half times as likely as white men not to be referred for the x-ray based diagnostic procedure.

Cardiac catheterization allows physicians to determine whether there are blockages in the coronary arteries, the vessels that feed blood to the heart muscle. The test is commonly administered to patients suspected of having coronary artery disease. Results are used to confirm a diagnosis and identify the best course of treatment.

The study was conducted with a unique multimedia survey tool developed by IDI with medical content provided by the researchers. The survey tool allowed for simulated interaction between doctors and video patients. Physicians were randomly assigned to interact with a video of one of a group of eight patient actors. The group consisted of two black men, two black women, two white men and two white women. The actors learned and performed three identical scripts describing chest discomfort. The multimedia tool also provided physicians with the same medical history and personal information regardless of the specific actor. A total of 720 physicians participated in the survey.

William Harless, Ph.D., one of the study investigators and CEO of IDI, stated: "We carefully directed the acting performance of these virtual patients so that they provided no emotional stimulus. No one was angry or demanding or confrontational or aggressive or aloof or threatening. No one exhibited any behavior to set a physician off. The physicians were dealing with passive, compliant, agreeable, concerned patients, some black some female, some white. By neutralizing all the personalities, the physicians were left with only their race and gender stereotypes of these people, which, as the data show, they freely projected upon the virtual patients."

The multimedia simulated patient approach can also be used to design educational programs to address this problem. "Stereotypes are broken by direct contact and dialogue with people, " said Harless. "Our methodology is capable of changing attitudes and breaking stereotypes because it allows the user to have a direct conversation with a virtual character. We think this method, this technology, if introduced in the proper educational setting in the proper way, can have a positive impact on the race/gender problems that the study has identified."

The multimedia simulated patient method has been proven in other scientific studies, including breaking the stereotypes that medical students have about alcoholic patients and obese patients.

The interactive programs were developed with the use of Conversim™, software designed by IDI to create voice-activated simulations—called Virtual Conversations® programs. To create the dialogues, IDI brings together interactive computer technology (speech recognition, digital video and microprocessor), psychology, techniques of drama, and educational theory. "This study is consistent with our mission to address this technology to the social and educational problems of our time," said Harless.

IDI has been developing voice-activated simulation programs to promote experiential learning since 1984. Early research and development of the method was supported by the National Library of Medicine.

For More Information Contact:

Marcia A. Zier
Interactive Drama Inc.
7900 Wisconsin Avenue Suite 200, Bethesda, MD 20814
Tel: 301.654.0676
FAX: 301.657.9174
Email: mzier@idrama.com