The persuasiveness of humanlike computer interfaces varies more through narrative characterization than through the uncanny valley

Indiana University-Purdue University Indianapolis (IUPUI)Just as physical appearance affects persuasion and compliance in human communication, it may also bias the processing of information from avatars, computer-animated characters, and other computer interfaces with faces. Although the most persuasive of these interfaces are often the most humanlike, they incur the greatest risk of falling into the uncanny valley, the loss of empathy associated with eerily human characters. The uncanny valley could delay the acceptance of humanlike interfaces in everyday roles. To determine the extent to which the uncanny valley affects persuasion, two experiments were conducted online with undergraduates from Indiana University. The first experiment (N = 426) presented an ethical dilemma followed by the advice of an authority figure. The authority was manipulated in three ways: depiction (recorded or animated), motion quality (smooth or jerky), and recommendation (disclose or refrain from disclosing sensitive information). Of these, only the recommendation changed opinion about the dilemma, even though the animated depiction was eerier than the human depiction. These results indicate that compliance with an authority persists even when using a realistic computer-animated double. The second experiment (N = 311) assigned one of two different dilemmas in professional ethics involving the fate of a humanlike character. In addition to the dilemma, there were three manipulations of the character’s human realism: depiction (animated human or humanoid robot), voice (recorded or synthesized), and motion quality (smooth or jerky). In one dilemma, decreasing depiction realism or increasing voice realism increased eeriness. In the other dilemma, increasing depiction realism decreased perceived competence. However, in both dilemmas realism had no significant effect on whether to punish the character. Instead, the willingness to punish was predicted in both dilemmas by narratively characterized trustworthiness. Together, the experiments demonstrate both direct and indirect effects of narratives on responses to humanlike interfaces. The effects of human realism are inconsistent across different interactions, and the effects of the uncanny valley may be suppressed through narrative characterization

Sending an Avatar to Do a Human’s Job: Compliance with Authority Persists Despite the Uncanny Valley

Just as physical appearance affects social influence in human communication, it may also affect the processing of advice conveyed through avatars, computer-animated characters, and other human-like interfaces. Although the most persuasive computer interfaces are often the most human-like, they have been predicted to incur the greatest risk of falling into the uncanny valley, the loss of empathy attributed to characters that appear eerily human. Previous studies compared interfaces on the left side of the uncanny valley, namely, those with low human likeness. To examine interfaces with higher human realism, a between-groups factorial experiment was conducted through the internet with 426 midwestern U.S. undergraduates. This experiment presented a hypothetical ethical dilemma followed by the advice of an authority figure. The authority was manipulated in three ways: depiction (digitally recorded or computer animated), motion quality (smooth or jerky), and advice (disclose or refrain from disclosing sensitive information). Of these, only the advice changed opinion about the ethical dilemma, even though the animated depiction was significantly eerier than the human depiction. These results indicate that compliance with an authority persists even when using an uncannily realistic computer-animated double

Uncanny valley and motor empathy

poster abstractThe uncanny valley phenomenon (Mori, 1970/2012) is the tendency to perceive as eerie human-looking characters with nonhuman features. It has been repeatedly claimed that falling into the uncanny valley can lead to a loss of empathy for a character (Hodgins, Jörg, O’Sullivan, Park, & Mahler, 2010). Empathy is the tendency to orient one’s responses to the situation of another instead of one’s own (de Vignemont & Singer, 2006). Empathy has been shown to be a combination of dissociable neurocognitive processes broadly grouped as cognitive, emotional, and motor empathy (Blair, 2005). It takes on such forms as perspective taking, sympathy, nonconscious mimicry, and the synchronizing of facial expressions, postures, and movements. To determine whether the uncanny valley suppresses motor empathy, operationalized as movement synchronization, a pilot study was undertaken by 25 participants. The study required participants to perform an action while viewing videos of a human character or its silhouette performing the same action. The frequency of actions performed by participants fell within their individual frequency and that of the character regardless of whether the participants were asked to coordinate or not coordinate their movement with the character. No significant difference in performance was noticed between the human character and its silhouette for all the conditions. Participants were observed to adjust their individual frequency in a similar manner for both the human character and its silhouette. Future studies with systematic variation in the human realism of the character’s features (e.g., skin texture or eye size) and its type of movement (biological vs. mechanical) can help ascertain the extent to which the uncanny valley phenomenon suppresses motor empathy

The human likeness of computer-generated characters predicts altercentric intrusion during a counting task (Alternative title: An uncanny valley of visual perspective taking: A study of the effects of character human likeness and eeriness on altercentric intrusion during a counting task)

poster abstractAbstract: Perceivers lose empathy for synthetic human characters when the characters' nonhuman features elicit an eerie feeling. This phenomenon, termed the uncanny valley, may specifically diminish the likelihood of understanding these characters' perspective. Such perspective taking should rely on a more fundamental ability to infer a character's visual perspective merely by looking at the character. Based on this assumption, a dot-counting task was undertaken by 268 undergraduate students in which they either took or ignored the apparent field of vision of computer-drawn characters with varying human likeness. It was predicted that for characters that appear more humanlike, task trials with a similar visual perspective between participant and character would predict shorter response times and higher accuracy, whereas task trials with dissimilar visual perspectives would predict longer response times and lower accuracy. Although these predictions were supported, trials with dissimilar visual perspectives also yielded longer response times when they included certain photorealistic inanimate objects (e.g., a chair). Future studies will ascertain whether such perspective taking ability is similarly affected when the synthetic human characters are more photorealistic

Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians’ and Human Factors Engineers’ Perspectives

We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians’ statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers’ information needs (10%). Severe violations were attributed mostly to meet referrers’ information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants’ requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates’ inability to support referring clinicians’ information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts

Utilizing a user-centered approach to develop and assess pharmacogenomic clinical decision support for thiopurine methyltransferase

BACKGROUND: A pharmacogenomic clinical decision support tool (PGx-CDS) for thiopurine medications can help physicians incorporate pharmacogenomic results into prescribing decisions by providing up-to-date, real-time decision support. However, the PGx-CDS user interface may introduce errors and promote alert fatigue. The objective of this study was to develop and evaluate a prototype of a PGx-CDS user interface for thiopurine medications with user-centered design methods. METHODS: This study had two phases: In phase I, we conducted qualitative interviews to assess providers' information needs. Interview transcripts were analyzed through a combination of inductive and deductive qualitative analysis to develop design requirements for a PGx-CDS user interface. Using these requirements, we developed a user interface prototype and evaluated its usability (phase II). RESULTS: In total, 14 providers participated: 10 were interviewed in phase I, and seven providers completed usability testing in phase II (3 providers participated in both phases). Most (90%) participants were interested in PGx-CDS systems to help improve medication efficacy and patient safety. Interviews yielded 11 themes sorted into two main categories: 1) health care providers' views on PGx-CDS and 2) important design features for PGx-CDS. We organized these findings into guidance for PGx-CDS content and display. Usability testing of the PGx-CDS prototype showed high provider satisfaction. CONCLUSION: This is one of the first studies to utilize a user-centered design approach to develop and assess a PGx-CDS interface prototype for Thiopurine Methyltransferase (TPMT). This study provides guidance for the development of a PGx-CDS, and particularly for biomarkers such as TPMT

Clinician Perspectives on Unmet Needs for Mobile Technology Among Hospitalists:Workflow Analysis Based on Semistructured Interviews

Background: The hospitalist workday is cognitively demanding and dominated by activities away from patients’ bedsides. Although mobile technologies are offered as solutions, clinicians report lower expectations of mobile technology after actual use. Objective: The purpose of this study is to better understand opportunities for integrating mobile technology and apps into hospitalists’ workflows. We aim to identify difficult tasks and contextual factors that introduce inefficiencies and characterize hospitalists’ perspectives on mobile technology and apps. Methods: We conducted a workflow analysis based on semistructured interviews. At a Midwestern US medical center, we recruited physicians and nurse practitioners from hospitalist and inpatient teaching teams and internal medicine residents. Interviews focused on tasks perceived as frequent, redundant, and difficult. Additionally, participants were asked to describe opportunities for mobile technology interventions. We analyzed contributing factors, impacted workflows, and mobile app ideas. Results: Over 3 months, we interviewed 12 hospitalists. Participants collectively identified chart reviews, orders, and documentation as the most frequent, redundant, and difficult tasks. Based on those tasks, the intake, discharge, and rounding workflows were characterized as difficult and inefficient. The difficulty was associated with a lack of access to electronic health records at the bedside. Contributing factors for inefficiencies were poor usability and inconsistent availability of health information technology combined with organizational policies. Participants thought mobile apps designed to improve team communications would be most beneficial. Based on our analysis, mobile apps focused on data entry and presentation supporting specific tasks should also be prioritized. Conclusions: Based on our results, there are prioritized opportunities for mobile technology to decrease difficulty and increase the efficiency of hospitalists’workflows. Mobile technology and task-specific mobile apps with enhanced usability could decrease overreliance on hospitalists’ memory and fragmentation of clinical tasks across locations. This study informs the design and implementation processes of future health information technologies to improve continuity in hospital-based medicine.This work was supported by a pilot grant (PPO 15-401; AS) and a Center of Innovation grant (CIN 13-416, M Weiner), both from the United States Department of Veterans Affairs Health Services Research and Development. AS is supported in part by the following grants: KL2TR002530 (A Carroll, PI), and UL1TR002529 (A Shekhar, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award

Building Cohesion in Distributed Telemedicine Teams Findings from the Department of Veterans Affairs National Telestroke Program

Background: As telemedicine adoption increases, so does the importance of building cohesion among physicians in telemedicine teams. For example, in acute telestroke services, stroke specialists provide rapid virtual stroke assessment and treatment to patients at hospitals without stroke specialty care. In the National Telestroke Program (NTSP) of the U.S. Department of Veterans Affairs, a virtual (distributed) hub of stroke specialists throughout the country provides 24/7 consultations nationwide. We examined how these specialists adapted to distributed teamwork, and we identied cohesion-related factors inprogram development and support. Methods: We conducted a case study of the stroke specialists employed by the NTSP. Semi-structured, condential interviews with stroke specialists in the virtual hub were recorded and transcribed. We explored the extent to which these specialists had developed a sense of shared identity and teamcohesion, and we identied factors in this development. Using a qualitative approach with constant comparison methods, two researchers coded each interview transcript independently using a shared codebook. We used matrix displays to identify themes, with special attention to team cohesion, communication, trust, and satisfaction. Results: Of 13 specialists with at least 8 months of NTSP practice, 12 completed interviews; 7 had previously practiced in telestroke programs in other healthcare systems. Interviewees reported high levels of trust and team cohesion, sometimes even more with their virtual colleagues than with local colleagues. Factors facilitating perceived team cohesion included a weekly case conference call, a sense of transparency in discussing challenges, engagement in NTSP development tasks, and support from the NTSP leadership. Although lack of in-person contact was associated with lower cohesion, annual in-person NTSP meetings helped mitigate this issue. Despite technical challenges in establishing a new telehealth system within existing national infrastructure, providers reported high levels of satisfaction with the NTSP.Conclusion: A virtual telestroke hub can provide a sense of team cohesion among stroke specialists at a level comparable with a standard co-located practice. Engaging in transparent discussion of challenging cases, reviewing new clinical evidence, and contributing to program improvements may promotecohesion in distributed telemedicine teamsThis work was funded by the Veterans Health Administration (VHA) Office of Rural Health (016ORH), VHA Office of Specialty Care, VA Health Services Research and Development (HSR&D) Precision Monitoring Quality Enhancement Research Initiative (QUE 15-280). Funding sources had no role in study design, data collection, data analysis, data interpretation, or manuscript writing. The views expressed herein are those of the authors and do not necessarily reflect the views of the U.S. Department of Veterans Affairs