In this section we list the virtual learning environments for communication skills we found in the literature, and describe their main characteristics. Although not our main focus, we also include environments primarily used for assessment.
Vogel et al. (2006) define a game as software that has a goal, is interactive, and is rewarding (gives feedback). Interactive simulation activities must interact with a user by offering options to choose or define parameters of a simulation. A user then plays a newly created simulation rather than simply selecting a pre-recorded simulation.
The top-level characteristic for learning environments for communication skills is whether or not, or to what extent, scenarios are scripted. According to Realdon, Zurloni, Confalonieri, Mortillaro, and Mantovani (2006), scripting different ad hoc perspectives is a fundamental prerequisite for a narrative structure in order to reproduce both the flexibility and regularity of communicative exchanges. In ‘Face-to-Face Interaction with Pedagogical Agents, Twenty Years Later,’ Johnson and Lester (2016) evaluate the evolution of features of pedagogical agents over two decades. They present the possibility of interactive natural language dialogue by combining advances in natural language understanding and dialogue management. They argue that complex technologies can be difficult to understand, control, and author; and that this could stand in the way of acceptance and adoption of these technologies by teachers and other stakeholders.
Although agent based approaches for generating a scenario have made considerable progress in the last decade (Bosch, Brandenburgh, Muller, & Heuvelink, 2012), there are still some problems to solve to achieve realistic simulations in which the degrees of freedom are suitable (Muller, Heuvelink, van den Bosch, & Swartjes, 2012). In the latter paper, Muller et al. mention that an advantage of an agent approach is that the non-deterministic behaviour in an agent approach allows for variability in a game-experience. As a disadvantage, they mention that developing an agent based model requires a greater up-front development effort when compared to scripts. It also requires a stricter collaboration between game designers, domain experts and programmers than with scripting approaches, as agent behaviour is not solely defined by fixed scripts. They mention the need for authoring tools to support game designers in developing content.
Communication skills teachers from our university view non-deterministic behaviour in a communication scenario as a disadvantage rather than an advantage. In teaching a communication protocol like bad news, a consultation, a negotiation, a conflict and the like, communication experts want to precisely control every utterance of a virtual character.
In this paper we restrict ourselves to learning environments in which scenarios are scripted, at least to a large extent. We do not include environments in which scenarios are generated by virtual agents approaches.
Selecting relevant literature
Learning environments for communication skills are used in very different contexts, and collecting the available (descriptions of) environments is non-trivial. We searched for papers on learning environments for communication skills on Scopus by looking at the title, abstract, and keywords using a query and refined the query stepwise.
The first step is a search for use of a scenario in communication skills. This leads to 2000+ results in 27 subject areas ranging from Chemistry to Humanities. The first articles were published in the 1970’s; there are 100+ results each year since 2006, the number of results rising steadily till 2013 to 200+ articles each year and a slight decline in 2016 (176 articles).
In a meta-analysis of the cognitive and motivational effects of serious games, Wouters, Van Nimwegen, Van Oostendorp, and Van Der Spek (2013) find that serious games were found to be more effective in terms of learning and retention, but not more motivating than conventional instruction methods. We refine our search to the area of serious/applied games. This leads to 668 results in 23 subject areas. The first articles date from the 1980’s, and there are already ten articles in 2017.
For this paper we refine the search query to virtual environments and simulations. This leads to 19 results; the first article is from 2008 and there are fewer than 5 articles per year since. The papers are in 9 subject areas: Psychology, Earth sciences, Chemistry, Humanities, Medicine, Mathematics, Engineering, Social sciences and Computer science. Finally, we refine the search further to exclude environments that focus on agent approaches. This search leads to fourteen papers and the trend is the same as in the previous step.
The final search query is:
The use of scripted scenarios in virtual learning environments for communication skills training is a relatively new area used in selected domains.
Besides this query, we asked communication skills teachers from the faculties of Pharmacy, Medicine, Veterinary medicine, and Psychology at our university to provide references to research papers on learning environments for communication skills in their respective fields. After scanning the abstracts returned by our query and the suggestions from the communication skills teachers, we selected nine papers that describe a learning environment with scripted communication skills scenarios (Bosse and Provoost 2015; Bracegirdle and Chapman 2010; Cláudio et al. 2015; Gebhard et al. 2011; Guo et al. 2014; Jeuring et al. 2015; Leuski and Traum 2011; Réty et al. 2008; Wauters et al. 2012).
Analysing the literature
The selected papers use varying terms to describe similar concepts, for example: scenario or dialogue, section or subject, statement or fragment or choice. In this section, we consistently use a single term for such a concept. We describe these terms on an abstract level and go into more detail in the following paragraphs per paper.
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A scenario is a sequence of interleaved subjects in a context.
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A subject is a directed graph of statements within a scenario, usually dealing with a particular theme.
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A statement is a piece of text.
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An authoring tool is software that allows an author (usually a non-programmer) to create a scenario.
Bracegirdle et al. (2010) present a ‘programmable patient’, with a ‘brain’ that is essentially a scenario in our description. Clinical educators can add subjects to a scenario. A student asks or selects questions that correspond to nodes in a tree. If a question is not recognized, a student can choose to store the question together with an answer in this tree. Scenarios are not completely scripted: questions corresponding to nodes can be asked in various ways. A scenario does not affect the emotion of a programmable patient (virtual character) in this game. A programmable patient is standardised in comparison to an actor and this leads to equity in assessment.
Bosse et al. (2015) use a scenario in which a student chooses between several statements. In addition to statement choices for a student, a statement of a virtual character may also have choices. The latter choices depend on values of emotional parameters, which in turn may vary for different characters. A statement choice of a student influences the value of these parameters. The main technology in the implementation is a scenario with conditional branches, in which emotional parameters are used. Students find this game an effective learning tool.
Gebhard et al. (2011) present Visual SceneMaker, an authoring tool for creating interactive applications with multiple virtual characters. SceneMaker separates content, such as statements, from logic, such as conditional branching. Content is specified in a scenario in the form of statements and stage directions for controlling gestures, postures, and facial expressions. The logic of an interactive performance and interaction with virtual characters is controlled by a sceneflow. A sceneflow is a hierarchical scenario with nodes that structure content of an interactive presentation and edges that specify how this content is linked together. Visual SceneMaker is evaluated in experiments; the visual programming approach and modelling structures are comprehensible and let non-experts create virtual character applications in a rapid prototype fashion.
Claudio et al. (2015) demonstrate Virtual Humans (VH) in an interactive application, the goal of which is to train and assess self-medication consultation skills. A domain expert develops a scenario using an authoring tool called Dialogue Creator. A scenario is a graph implementation and consists of a sequence of statements between a VH patient and a player, with associated scores per answer. Each node in a graph corresponds to a statement that is articulated by a VH or a statement option for a player and its associated score. Seven pharmacy experts performed an evaluation of the application. These experts consider this application a valuable tool for training and assessing the over-the-counter counselling skills of a player, and recommend to follow such training with real interactions and live evaluation.
Leary’s Rose (2012) focusses on natural language recognition of player sentences. Input sentences are classified on two axes: the vertical axis indicates whether a speaker is dominant or submissive towards a listener, and the horizontal axis indicates a speaker’s willingness to cooperate with a listener. A scenario engine selects an appropriate response to a player’s input on the basis of identified keywords and relative positions of both player and Virtual Agent on the axes. A player’s input is fed to a finite state machine (FSM) and if an input matches a state, the FSM selects a reply from the available follow-up states.
Rety et al. (2008) present a framework for interactive narrative authoring in the domain of virtual storytelling where a user is provided with navigation choices in an interactive narrative. The framework is based on a generalised concept of a section, which is close to a subject in our description. A subject consists of hierarchically structured fragments (a statement in our description). A statement is defined as an atomic content element containing simple text and possibly other media. A statement may also be composed recursively and consist of a set of statements, a behaviour and a termination property. Behaviour can be set by an author as either deterministic to indicate that a user reads in the order of subjects or as non-deterministic to indicate that a user reads with no predefined order. A termination property is a condition that an author sets to determine when a subject terminates. A user then moves on to a following subject. A user reads an interactive narrative created in this framework by successively accessing statements in a subject.
Leuski and Traum (2011) describe a Non Player Character (NPC) editor, which includes natural language understanding and generation, and statement management. This authoring tool is designed primarily to develop question answering characters. The focus is to deliver an appropriate answer for a user’s question. An author creates a response handling strategy by populating a language database with specific answers to sample questions and assigning these answers to an individual character. Different characters may have different knowledge about an event and respond differently to the same question. At run-time, a statement manager matches a user’s question to an answer of an associated non player character. NPCEditor has been evaluated and is an effective and versatile system in applications for virtual question answering characters. As future work, the autors mention dialogue management as a specialized component.
Jeuring et al. (2015) describe Communicate, a serious game for practicing communication skills. An important aspect of Communicate is the de-coupling of scenario development by communication skills experts from the implementation. A communication expert iteratively develops a scenario as a directed acyclic graph of statements in an authoring tool. A statement has an incremental score, emotional effect, and feedback. Statements can be structured under subjects. A scenario parser uses this graph to generate a scenario specific reasoner. During gameplay, a player receives information about statement choices at each step in a series of interactions with a virtual character. At the end of a simulation a player receives a final score on communication skills.
Guo et al. (2014) present a game prototype for practicing communication skills in a medical consultation process. The communication skills module accesses knowledge content and a scenario through a restful web service. Knowledge is modelled as rules, which determine which player actions have a positive or a negative effect during a medical consultation, as well as the influence of each type of action on a patients stress level. A scenario models a virtual patient with some key characteristics, which are chosen from the knowledge content. A scenario also defines possible actions for a player with a virtual patient in each phase of a medical consultation process.
Dialogue authoring assets
In addition to the literature review, we looked at available dialogue authoring tools by searching in the Unity asset store (www.assetstore.unity3d.com) and asking game developers from the RAGE (Realising an Applied Gaming Eco-system: www.rageproject.eu) project for recommendations. From the selection, we looked at:
These authoring tools concentrate mostly on the dialogue aspect of a scenario used in entertainment games. They range in functionality from simple tools offering basic dialogue sequences to advanced tools. We identify three features relevant to a scenario in these tools.
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The tools support the construction of a sequence of statements representing a dialogue flow from a player to a computer and vice-versa.
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They provide the possibility for a player to have multiple choices as a response to a computer question or a situation.
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Many tools use preconditions; a particular dialogue fragment is only reached if a certain condition is fulfilled. For example, a player must have completed a certain task prior to reaching a particular dialogue fragment.
Articy is a visual environment for the creation and organization of game content offering virtual characters, locations and a game development environment. Chatmapper has a basic free version available. Twine is an open-source tool for creating interactive, non-linear stories and resembles Interactive narratives (Réty et al. 2008).