從使用者觀點檢視虛擬實境技術在衡鑑能力評量的可行性

本研究將虛擬實境（virtual reality, VR）技術用於「VR版心理衡鑑初次晤談客觀結構式臨床測驗」（簡稱「VR版初次晤談OSCE」）的開發，並透過使用者觀點檢視VR技術在衡鑑能力評量的可行性。本研究包含測試階段與正式研究。在測試階段，本研究聘任六位諮商／臨床心理碩士生與心理師擔任模擬考生，檢驗「初次晤談OSCE」在諮商與臨床心理的通用性。模擬考生在「初次晤談OSCE」的測驗分數顯示，兩組模擬考生在「病史詢問」和「溝通技巧與專業態度」面向，皆未呈現顯著差異，初步證實其在諮商與臨床心理的通用性。正式研究階段，本研究招募37位研究參與者，分成臨床組學生、諮商組學生與諮商心理師三組，檢驗VR技術在衡鑑能力評量的可行性與VR系統的設計品質。三組參與者在「心理衡鑑能力評量表──簡明版」測量結果顯示，「VR版初次晤談OSCE」用於「鑑別診斷」與「統合推論」的可行性優於「溝通技巧」與「專業態度」。在「虛擬實境使用性量表」測量結果顯示，參與者在VR系統設計方面，對於「使用者介面」與「求助功能」評價最高，認為「語音辨識」與「互動性」設計仍有待改善。從使用者觀點而言，VR技術在衡鑑能力評量的應用具有可行性，待系統開發成熟後，可進一步評估其在OSCE施測成本節約的效果。

關鍵字

客觀結構式臨床測驗；心理衡鑑；虛擬實境技術

並列摘要

Psychological assessment has been regarded an essential competency domain in professional psychology. Influenced by the competency-based movement, researchers and educators start to redesign new measurement tools for assessing psychological assessment competencies (PACs) of psychologists from entry to practice. Compared with physicians and nurses, license examinations of professional psychologists still heavily rely on the paper-pencil tests to measure professional competencies of psychologists. In the past five decades, an objective structured clinical examination (OSCE) has become one of the most commonly used measurement tools to assess professional knowledge, clinical skills and professional attitudes of healthcare professionals at the same time. Several meta-analysis studies have confirmed that an OSCE is not only a reliable and valid measurement tool for assessing clinical competencies of healthcare professionals, but also a good teaching aid to facilitate a wide range of clinical skill training courses. In Taiwan, OSCEs have been widely used to assess professional competencies of physicians and nursing practitioners, however, its application in professional psychologists is still very limited. Lan et al. (2011) proposed four possible factors affecting the OSCE application in professional psychology. First of all, competencies in professional psychology (e.g., rapport building skills, expressions of empathy) are more abstract and difficult to measure than those in medicine and nursing. Second, it requires longer time and more effort to develop and administer a psychology OSCE than a medical OSCE or a nursing OSCE. Third, faculty members and practicing psychologists need to receive further training (e.g., taking an OSCE rater training workshop) to ensure that they reach inter-rater agreement before scoring student or participant performance on a psychology OSCE. Last but not least, the major obstacle to adopting OSCEs in professional psychology is high cost of running an OSCE on a regular basis. Compared with the resource input of a medical OSCE, the resource input of a psychology OSCE is relatively insufficient. If the cost of running a psychology OSCE could be effectively reduced, it would help to promote the OSCE application in professional psychology. To overcome the aforementioned problem, the virtual reality (VR) technology was applied in this study to develop a VR version of the Intake OSCE (VR-intake OSCE) to serve this need. The purpose of the present study was to examine the feasibility of the VR technology in assess competencies in psychological assessment through the viewpoints of students and psychologists. The present study comprises three phases: the testing phase 1, the testing phase 2 and the formal study phase. In the testing phase 1, six psychologists from master education to practice were hired as mock test takers to examine the versatility of the intake OSCE in assessing PACs of psychologists from counseling and clinical psychology. The intake OSCE was developed by Lan et al. (2015) to examine psychologists' PACs when conducting an intake interview. This test consists of a standardized patient test (SP test), a follow-up short answer test (S test) and a multiple-choice test. In the testing phase 1, only the SP test and the S test were selected to examine the versatility of the intake OSCE in assessing PACs of psychologists from counseling and clinical psychology. No significant score differences were found between clinical psychologists and counseling psychologists. This result confirmed that the intake OSCE could be used to assess psychologists in both fields. In the testing phase 2, the same mock test takers (from the testing phase 1) were hired to evaluate the initial version of the VR-intake OSCE, which consists of a virtual standardized patient test (VSP test) and a follow-up S test. To administer a VSP test on the VR equipment, a new VSP system (called VR psychological assessment room) was developed in the present study to serve this need. By adopting the automatic speech recognition technology, the design of the VSP system allows participants to conduct an intake interview with the VSP through a free questioning format, and collect assessment related information (e.g., personal medical history, stressors, and social support) in order to generate a differential diagnosis of the VSP and also provide an initial treatment plan. All mock test takers first took the VR-intake OSCE, and then filled out the post-test questionnaire. This post-test questionnaire was designed to evaluate the quality of the initial version of the VR-intake OSCE and its test administration procedure. Responses provided by mock test takers were summarized as the followings. First of all, mock test takers considered the VR-intake OSCE did not only measure their PACs, but also their abilities to use the VR equipment and the VSP system. For psychologists with little or no VR experience, their test scores might be affected by unfamiliar use of the VR equipment and the VSP system. Second, a mock test taker reported that she felt dizzy and discomfort similar to motion sickness after taking the VSP test, and then affected her performance on the follow-up S test. Third, most of the mock test takers agreed that the VR-intake OSCE could be used to replace some assessment functions of the intake OSCE when its VSP system has been fully developed. Based on responses provided by mock test takers, the test administration procedure of the VR-intake OSCE in the formal study phase was revised as the followings. First, an additional practice VSP test would be provided to allow participants to familiarize the VR equipment and the VSP system before taking the VR-intake OSCE. Second, an intermission session between the VSP test and the follow-up S test would be extended from 5 minutes to 10 minutes to help participants to relieve possible dizziness and discomfort before taking the S test. In the formal study phase, a sample of 37 participants was recruited on a voluntary basis. All participants were divided into three groups (i.e., clinical student group, counseling student group, and counseling psychologist group) to examine the feasibility of the VR technology in assessing PACs of psychologists and the design of the VSP system. All participants first took the VR-intake OSCE, and then filled out a post-test questionnaire, which was designed to examine the feasibility of the VR technology in assessing PACs and the design of the VSP system. Results of the formal study revealed that the VR-intake OSCE was more feasible in assessing cognitive aspects of PACs (e.g., differential diagnosis and integrated inference) than behavioral aspects of PACs (e.g., communication skills and professional attitudes). In terms of the design of the VSP system, participants gave the ＂user interface＂ design and the ＂help function＂ design the highest evaluations. They also suggested that the designs of ＂voice recognition＂ and ＂interactivity＂ needed further improvement. From the viewpoints of students and psychologists, the application of VR technology in assessing PACs of psychologists from entry to practice is feasible. The cost-effective effect of using the VR-intake OSCE to replace the intake OSCE can be further investigated after its VSP system has reached a mature state. In the near future, researchers and educators who are willing to devote themselves to the VR application in psychology OSCEs can develop different types of VSP systems in order to assess a wide range of professional competencies (e.g., intervention, consultation, and supervision/teaching). They can also apply the VR technology to different types of clinical training courses to enhance the training effects and enrich in-class activities.

並列關鍵字

objective structured clinical examination ； psychological assessment ； virtual reality

參考文獻

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被引用紀錄

張宥沁、熊師瑤、程淑華（2023）。虛擬實境應用於諮商與心理治療研究之文獻計量分析。應用心理研究，(78)，63-110。https://doi.org/10.53106/15609251202306002

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從使用者觀點檢視虛擬實境技術在衡鑑能力評量的可行性

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