Researchers develop first avatar-based decision support technology for caregivers

One of life's toughest decisions is whether to continue or withdraw life-sustaining therapies for loved ones who are unable to make their own healthcare decisions.

The goal of a two-year, $460,000 National Institute of Nursing Research-supported project at Case Western Reserve University's school of nursing is to develop and test an avatar-based decision technology, called Electronic Surrogate Decision Maker Resources and Tailored Training (eSMARTT).

The vision and goal of Ronald Hickman, assistant professor at the Frances Payne Bolton School of Nursing, is to ease this decision-making process for family members facing these care choices.

Researchers at the nursing school and the Case School of Engineering will collaborate to build one of the first avatar-based decision support technology for caregivers. It is designed to give caregivers resources about medical care and choices for the patient.

"We are taking advantage of serious gaming technology to create an interactive learning experience that is customizable to the caregiver's decisional needs and prior decision-making experience," he explained.

Hickman will develop and test eSMARTT among caregivers of cognitively impaired patients discharged from the hospital to a nursing home. Drawing on their experiences, he plans to incorporate their information about what they needed in the process.

Information includes what families need to do, interactive simulations to clarify patient and family preferences, opportunities to practice communicating the patient's healthcare preferences to virtual providers, and decision coaching that can enhance the quality of the decision making process.

This eSMARTT goes beyond traditional decision aids, such as printed material, websites, and videos, and aims to provide an interactive simulation that promotes experiential learning for caregivers, Hickman said.

He added that it will advance the understanding of how to effectively develop and deliver interactive decision support to a growing population of caregivers faced with making healthcare decisions for their loved ones.

Once built, the researchers will test the eSMARTT's effectiveness with more than 200 caregivers in a clinical trial.