You may think spending your time in front of a computer screen playing Second Life is a waste of time. You might want to think again. The virtual world, with its virtual citizens, or avatars, is starting to have some applications that could help real-world people.

Scientists and researchers are adapting Second Life to train medical students to practise their interviewing, diagnostic and treatment skills by interacting with virtual patients presenting particular diseases or illnesses which the students go on to diagnose and treat.

A similar computer program being developed by medical educators at the Florida State and Ohio State universities is making computerized case development easier and less expensive. Dr. Bob Heller and Dr. Mike Procter with the Centre for Psychology at Athabasca University are working with this new programmable web interface tool that enables experts to enter information needed to create the case directly into a database without having to work with a computer programmer.

Traditionally, medical students practice conversational diagnostic skills with standardized patients, actors who have been given a script and are playing a role. These actors are programmable to some extent, Heller said, but they rely on the script and they can't go outside that information. Students often have limited access to these standardized patients and the cost can often be prohibitive.

"The sense of immersion of a virtual world provides the feeling of being in an actual office talking to actual patients, who can be programmed with different personalities," Procter said. "Access to a virtual patient is unlimited and on demand. It will not necessarily replace other simulation tools, but it is the best suited of all the models in terms of diagnostic skills development. It is easily programmable and provides an inexpensive and changeable training option to learn how to handle a wide variety of situations and patients."

Procter, an electrical engineer with 30 years of experience with information technology, is working on creating the script of patterns and appropriate responses that enables the behaviour of the virtual patients to be tied to events and to the environment in which the interaction takes place.

"An important part of this work is being able to have the virtual patient deal with a situation when it doesn't know how to respond. It may show ignorance but behave intelligently," Procter said. "If the medical student were to ask about last night's hockey game, the virtual patient might respond by being surprised and asking why that is relevant."

Heller is an experimental psychologist usually working in the field of aging and cognition. His interest in the virtual patient came from a conversation with a colleague about populating a virtual world with famous psychologists such as Freud, Piaget and Skinner. His work on this project concerns the level of engagement and the learning outcome.

While the research into virtual patient simulation is being done around the world, Procter cautions that the programs are not yet ready for prime time. "My impression is that it's a growing field. Different people are interested in investigating the technology. But it still remains to be proven."

Heller agrees: "The research question is, do we see that patient as a real person and will we interact with them as such? The hypothesis is if the student believes they are real, the student will be more deeply engaged and will have a better learning outcome. The assumption is that when people feel immersed in a physical space, it leads to better learning. But some researchers feel that immersion is a distraction. So the research is equivocal at this point."