VERBATIM LEARNER COMMENTS This selection contains the 100 longest positive comments, 15 longest neutral / mixed comments and 13 longest negative comments from the supplied appendix. These selected counts do not reproduce the sentiment proportions of all feedback. Comments are ordered by recorded word count, longest first, with ties ordered by source row. Comments whose category depends on an unresolved judgment call were left out of the source appendix. Quotations match the original CSV exactly, apart from spacing and line breaks. Spelling, capitalization, punctuation, and wording are unchanged, with no ellipses or inserted corrections. One reviewer assigned these categories, and some may still be wrong. POSITIVE COMMENTS 1. 93 recorded words I am inherently shy and have been out of regular practice for 10 yrs. But having a face to look at that responded with human emotions was actually very reassuring to me!! I take notes into the treatment room so I can ask questions intelligently but in this scenario did not have the advantage of prompts and notes so I wobbled and our interview took a circuitous course! I think eventually I got most of was needed into the interview though your AI did not capture it. as it was out of order! 2. 92 recorded words Completing the CME with the virtual patient forced me to invest more in this training. My plan of care and discussion of treatment was lacking when analyzed by the AI tool. I think I was aware of that when it was happening but was great to get the feedback. It confirmed my weak areas. I have not managed a patient in a primary care setting in this way. I have often referred to other providers. This gave me some practice on how to conduct the visit and how to focus my learning. 3. 82 recorded words The virtual patient simulation was an excellent learning tool to pull all of the information together as in a real life scenario. I really appreciate the feedback at the end of the conversation with suggestions for improvement. I am more of a hands on/direct learner. I work in Palliative Medicine so daily I am seeing patients on opioids for malignant pain. Though I've come across barriers with patients with past history of substance/OUD. I belong to a Substance Abuse Committee. 4. 80 recorded words This is a very effective tool for walking through a patient discussion about OUD. I did consult the SAMHSA guidelines about how to start Burprenophine during our discussion, but the guidlines are not super user friendly in the moment. Perhaps a review of when to start this medication based off what the patient is currently using could be useful. Also, if the idea of buprenorphine is to be eventually weaned off, how do we ensure pain management and not relapse? 5. 80 recorded words Very beneficial tool! It was great to actually have these discussions because they are good preparation for having them with real patients. This is a simulation that I would easily do again to continue to hone and practice this conversation and skill. Areas to improve would be helping frame the discussion prompts with the virtual patient better, just giving the one sentence outline of what to do is helpful but does not fully encompass all that needs to be discussed. 6. 72 recorded words Very effectives. I would have loved to get fedback on the tratment and pt management aproach i chosed, but none on the mgt approach was given for example; I chosed to offer him extended release form of oxy and Naloxone PRN if needed. with Naloxone education. I would have loved to know if he will be better off with starting him on Bupernorpine/naloxone today even though he is still in pain. 7. 69 recorded words I really liked the virtual patient exchange. I would have spoken more, and asked more questions with nods and nonverbal agreement, but I didn't know how much I could say or how many times I could go back and forth. I think I will do much better on my next virtual patient interaction. I also liked the feedback given at the end of the course. That was very useful! 8. 67 recorded words I'm sure this is a great learning tool for providers who have regular exposure to patients with chronic pain, however, for me, in pediatrics, this is a very NEW exposure and HUGE learning curve. So, I don't feel I can accurately evaluate this learning module. I can say though, that this virtual AI concept is a GREAT practice tool for those already familiar with the intervention process!! 9. 67 recorded words I love that it helped me to undertsand a clear and difinitive pathway to sitting down with aptient and dipping i to thearea of possible OUD and desire to help the patient. I found it more engaging than just erdaing and has helped me from adiffrent perspective in that even though an AI, made me feel very confident in trying to narrow down how we could Jeremy 10. 66 recorded words I really enjoyed the opportunity to practice on a "not-real patient." When you are a student and are new and awkward at remembering to ask all of the right questions and say all of the right things, it is extremely nerve-wracking to do so with a real-person. This gave me the chance to practice in a setting that wasn't intimidating. More script prompts would be helpful. 11. 66 recorded words I like that there was a virtual patient to talk to. I do not have enough experience interviewing patients in a simulation and really enjoyed understanding the feedback that is required to give proper guidance regarding opioid use disorder. I see there are some areas where I can work on and hope to practice this more in the future in order to be a proficient provider. 12. 66 recorded words I love the concept but wasn't fully clear how to do it? I mean you left a series of questions and I think instead of selecting "next" after each one, I just did both TAPs and PHQ-9 questions all at once. I think if I had slowed down and followed the lead of each question, I wouldn't have missed some things as noted in my critique. 13. 64 recorded words I was suprised that the patient interactions were very realistic. I believe the feedback you have given is invaluable, and it will take practice to perfect. This simulation was the first step in addressing OUD with a patient. This tool provided an excellent opportunity to initiate interventions for those first few patient interactions, and the feedback given provided excellent recommendations for improvement. Thank you! 14. 64 recorded words It takes a while to complete but the feedback at the end is helpful. If I were to do this again, it might be useful for me to print a guide of some sort to TAPS and DSM5 OUD criteria that I can refer to before the simulation begins although the prompts at bottom of the patient on questions to ask was also helpful. 15. 62 recorded words This is my 1st interaction with a virtual patient. I think that it is helpful. I appreciated the ability to let the conversation flow ; however I think that in terms of using some of the criteria (eg DSM-5), it would be helpful to have a method for the interviewer to have that available during the questioning . Overall thank you for the expereince. 16. 61 recorded words i could tell that Jeremy was frustrated at the beginning of the conversation, so I realized I was not addressing his concerns appropriately. There was definitely a change in demeanor, when I did get to address his concerns and I like how that mimics real life. The post feedback is very helpful. I agree, I could have explained how bupronorphine works 17. 58 recorded words This virtual patient simulation was highly effective and clinically relevant.It improve understanding of SBIRT, DSM-5 criteria for opioid use disorder, motivational interviewing, MOUD, and harm reduction strategies in a practical primary care setting. The interactive format reinforced patient centered communication and evidance-based management. The case scenarious were realistic, engaging, and helpful for applying concepts to clinical practice. 18. 57 recorded words I really liked this virtual simulation. It wasn't completely clear to me form the instructions and in some of the steps how in depth I should go with certain elements of the history and interviewing. I think doing this siumulation multiple times with different patient scenarios would help me develop more skills and comfort with the process. 19. 57 recorded words I felt that the virtual patient was able to asnwer to real life feedback and questions from the patient and was able to follow along to the information that I provided. It did help to understand better how the flow of a conversation with a patient regarding OUD and starting the conversation regarding starting Medications for OUD. 20. 57 recorded words I thought it was very interesting as a learning tool. My only suggestion would be to give more examples of questions and wording that should be used with these patients that is motivational in nature prior to the simulation. This would have been very helpful for me as I have not really worked with patients with OUD 21. 56 recorded words I like this very much and the feedback was very helpful. However, I did touch on the harm and reduction part, with the naloxone, I talked about safe storage since he had a kid in the home, but I do not think the conversation was caught. Overall, I really liked this and it was good practice. 22. 56 recorded words As a learning tool, it was certainly different. I like the fact that you can 'get right in' and treat, even though it is a simulation. I think it was an overall good experience. I don't know however, if I can get Jeremy bact to work, save his marriag & reduce his back pain safely and effectively. 23. 56 recorded words It does make the practice more life like and real. Some hints and assistance along the way would be helpful for the first time. I went through all the education, but did not have it memorized. Some hints on the side would still help with learning as you would still have to practice actually speaking them. 24. 55 recorded words As someone who does not typically have this as part of their practice, this was an excellent tool. It felt like a pretty real opporutnity to have a discussion with a patient. It was also nice to have the prompts to guide me on the botton bc it is not something I'm used to doing. 25. 55 recorded words This made me address my initial hesitancy in talking with a patient about OUD and providing screening. I think it was very effective in helping me make my way through the screen and provide emapthetic conversation with the patient. I was impressed with the realistic feeling of the interaction once I got used to it. 26. 54 recorded words I enjoyed the AI experience. I feel it has given insight to improve in different areas. I look forawrd to more excuses like this one. I apperiate this type of learning skill that allows you to engage with activity. I apperiate the feedback as well for my weak areas to work on. Thank you 27. 54 recorded words This was very effective at making me think about the questions. Realizing the prompts would be there during the conversation would have been helpful because I wrote a lot of notes that I kept referring to that were not really necessary. The conversation could have gone smoother if I just looked at your prompts. 28. 53 recorded words I am very impressed by the VPS. Ita an effective learning tool that allows one to test their opioid management skills and knowledge like with real patients bt at minimal risks. On improvement, i woild siggest that the AI patients be more responsive in inderstanding learner with English not being their first langage. 29. 50 recorded words I فاthink the interaction was very valuable. I learnt a lot and was able to interact and smoothly inquire about the patient's concerns given the hints at the bottom. It helped simulate a real patient encounter and it made me more confident in possibly diagnosting and treating someone with OUD. 30. 50 recorded words It was my first time using a virtual patient and was unfamiliar with how it worked and how the conversation would be analyzed. After experiencing it, I feel like I have a greater understanding of how to use this tool and will benefit from it more in future CME activities. 31. 49 recorded words i really enjoyed the interactive AI simulation for OUD and believe it has a strong potenetial to reduce the uneasiness of discussing these situations. Expanding this tool to include multiple scenarios would be a valuable in helping new providers build there confidence and feel more comfortable managing similar encounters. 32. 49 recorded words I was surprised at how helpful it was. I think that I would benefit from real-time feedback (like when I click next, it says this is what you did well or what you could improve on) although I recognize that could cause it to be less smooth and realistic 33. 49 recorded words The tool is very effective. It helped me to see my strengths and weaknesses in building rapport, information gathering, and elaboration of a solid plan. It also heped me to see areas that were good but needed more elaboration. Thank you for this opportunity. It was a great experience. 34. 48 recorded words I really thought I would not like an AI patient activity, but I found this very closley mirrors true conversations with patients. Discussing OUD is not easy and can at times feel confrontational instead of caring and empathetic. The more we initiate these conversations, the better patient outcomes. 35. 47 recorded words I really enjoyed this activity but I think that it would have been helpful to know that it should have been more inclusive of a conversation like a real patient interaction and not just a checklist which is kind of what I thought I needed to do. 36. 47 recorded words I think it is great that we had the opportunity to actually interact with the patient because it is easy to read off a script but when the patient has different questions and is throwing in more personal situations it changes our thoughts and decisions at times 37. 46 recorded words It was a different way of learning but beneficial because it was like sitting with a patient and I had to think about my questions. Although, I do not prescribe narcotics often in my clinic the feedback of how to improve my visit was very helpful. 38. 45 recorded words The virtual simulation was engaging and realistic. It effectively reinforced opioid use disorder screening, motivational interviewing, and appropriate use of medication for opioid use disorder. One improvement would be to provide immediate feedback after eah interaction and clearear guidance when multiple acceptable responses are possible. 39. 44 recorded words It helped me consider my areas of weakness with the interview especially when reviewing the individual components also it showed me I had not covered it as well as I thought I did and that I did not do any real planning with Jeremy 40. 44 recorded words I thought this was a very effective learning tool and provided the opportunity to have these conversations with a patient that responded before having these conversations for the first time in the clinic setting. The feedback provided at the end was also very useful. 41. 44 recorded words The virtual patient simulation was a valuable learnig experience that reinforced my knowledge in opioid used disorder screening. One are for improvement would be making it clear when learners should press "next" after speaking and provide feedback confirming that spoken questions were recorded successfully. 42. 44 recorded words This is the first time I have done any type of education with AI and feedback. It was very valuable in being to actually practice this scenario and conversation. The feedback is valuable on how I can improve in practice and in future simulations. 43. 44 recorded words It would have been helpful to have more information on buprenorphine included prior to the interaction as the finer points of buprenorphine and naloxone use in this context were not previously introduced to me. This course was very beneficial for filling that knowledge gap. 44. 43 recorded words WOW!!! This was both really intimidating at first in an area that I dont have expertise in but what a super cool tool. Simulates a real patient encounter. Lets a clinician practice motivational interviewing. I would love to see more CME like this! 45. 43 recorded words This is a wonderful learning tool better then any thenI have seen and prepares you alittle bit more for the real life situation. But what about the patient that is not a calm as Jeremy. Appreciate Jeremy taking it easier on us though. 46. 43 recorded words Good example of a patient expressing there concerns of medication use of opiates for chronic pain.However I miss the personal aspect the body language and eye contact during the interview. It is my first time interacting with AI in a CME avtivity. 47. 42 recorded words This was a fascinating learning session. As I am a veterinarian rather than a human doctor, I am out of my element in screening a human patient and all the elements required for a full functional exam. But it was educational nonetheless. 48. 42 recorded words I thought the use of an AI patient was super cool! I do wish I had a stronger background with some information, such as side effects of the medications so that I could have explained them in better detail to the patient. 49. 42 recorded words Interesting. Was a bit nervous because wasn't sure what to say at the end. But even though I did not say what I should have, I did mention some things, it was not punitive. And the feedback at the end was informative. 50. 41 recorded words This was a great learning experience. I really appreciate that there tips to help guide me with the conversation. I work in oncology and not in primary care, so although I prescribe opioids, the situations are different. This was greast practise 51. 41 recorded words I love that I was able to interact with a patient and that there was a thorough report on areas I could improve! This is the best one yet! I hope to see more of options like this in the future. 52. 41 recorded words This has been very effective. I have been so unsure of the prescribing buprenorphine in place of opiods. This has been a very eye opening experience with the virtual patient and has shown me now how to approach patients with OUD. 53. 41 recorded words This has by far been the best OUD CEU that I have completed since becoming an FNP. This activity was extremely engaging and taught me far more than I would have learned had I simply listened to a lecture about OUD. 54. 41 recorded words Different experience-I lacked the realization that I didn't have to try and ask every question at once. Beneficial to see the flow after simulation. May help to give a brief encounter to see how the simulation flows prior to starting it. 55. 40 recorded words Seems very realistic and helpful to my learning for how to interview a patient with possible OUD. It also challenged me to improve on my motivational interviewing skills which I may not perform on a regular basis in my practice. 56. 40 recorded words My microphone stopped working toward the end of the AI interview--probably the internet connection. The AI interview process is effective. I appreciated the helpful guidance for asking the correct questions. I forgot to set up a follow-up appointment though. 57. 40 recorded words I loved using a virtual AI patient. I would love more activities like this in the future. I believe this is so much better to interact with a patient than to read off a slide or listen to a lecture. 58. 40 recorded words I thoroughly enjoyed the patient simulation. It helped simulate a real like scenario about a difficult conversation that was easy to navigate and it was beneficial to walk through all the steps of the TAPS1/2 and the DSM5 criteria. 59. 40 recorded words Not a bad idea at all. It takes some time to adapt to this format. But with more use personally in the future, I like the format and it appers to be an effective and useful learning tool for providers. 60. 40 recorded words I enjoyed this virtual patient because it allowed me to have real dialog as if I was with a patient. This allowed me to focus my questions while ensuring that I am not presenting the information in a judgemental way. 61. 37 recorded words It was really helpful to practice administering the TAPS-1 and motivational interviewing. I feel like I learned more by actually going through it with the AI patient than I would have listening to a lecture about it. 62. 37 recorded words The simulation was useful for practicing SBIRT creening and motivationa interviewing in opidio used disorder. It helped reinforce practical communication strategies. I think adding more interactive scenarios and immediate feedback after responses could furhter improve learning experiene 63. 37 recorded words I believe it is a valuable tool for those who do not feel comfortable asking questions related to opioid misuse. I feel that a patient chart that is visible will make it easier to perform the examination. 64. 37 recorded words I am impressed that you were able to encapsulate what I said and respond with the virtual patient like Jeremy. I appreciate the feedback I was given about room for improvement in conjunction with the positive feedback. 65. 36 recorded words I enjoyed having to think about what to say to a patient and saying it out loud. Valuable to learn what concepts I have difficult articulating before I get to a visit with a real patient. 66. 36 recorded words It was helpful. I have not been in clinical practice for some time and I have not used a AI simulation like this so it will take a bit of practice to be smooth in question. 67. 35 recorded words its a great new tool to have a dialogue even with AI. It does help to you think through what needs to be said & done, as well as practice how to dialogue with patients appropriately. 68. 35 recorded words I appreciate the interactiveness, however, as someone who has yet to start residency it feels a bit daunting to just start talking to a patient. I do appreciate the script to follow along the exercise. 69. 35 recorded words This was very interesting and I honestly never spoke to an AI generated patinet like this before, it was certainly something that I would like to continue to do for my learnings in the future! 70. 34 recorded words Simulation helps me to provide a real based scenario before I deal with patient. It also help me to build confident in communication, asssement and step by step diagnosis, screening, treatment and education skills. 71. 34 recorded words great learning tool and I plan to develop a tool that will remind me of the important questions to use in the motivational interviewing as well as talking points of the use of medication 72. 34 recorded words Excellent learning tool. I would like to have been able to redo a portion of the simulation, becuase I did not word some things very well, and there is no option to redo that. 73. 34 recorded words Interseting learning tool. Found to be helpful, but with very litle knowledge that I had about the drug itself made the end of the interview more challanging, so more education on the drug itself 74. 34 recorded words It was a great experience! It gave a feel of real life situations and expectations. It is a great tool for learning and very effective in preparing providers to bulid confidence in patient management. 75. 33 recorded words I liked it because it was just like seeing patients in clinic, I haven't been prescribing suboxone for years so I need to relearn more about this medication before starting pts on this. 76. 33 recorded words A new type of teaching and interactive tool for my leanring. I think it helped me learn better with its interactive format and its ability to help prod me with the next questions. 77. 33 recorded words thanks- I think more of these CMEs' should have this interactive component ( though I found it somewhat stressful, not being in primary type care. Currently retired with previous outpatient PM&R type practice! 78. 33 recorded words I thought the virtual patient simulation was very helpful. It allowed me to practice skills and address Jeremy's concerns, which were likely concerns that all patients would have. Overall very helpful AI tool! 79. 33 recorded words This was very helpful. I liked that I had the ability to practice clinic conversations with a 'patient' like Jeremy. This interactiong made me feel more comfortable about my SBIRT/motivational interviewing skills. 80. 33 recorded words Great learning tool, reality-like interactions that validate patient-provider encounter. Perhaps deeper guidance and more than one activity would be beneficial. Some of us are not used to have discussions on a regular basis. 81. 33 recorded words This was really neat! I liked the feedback given at the end of the session to see what I could improve on. It is always different when you are talking to a patient! 82. 33 recorded words The virtual patient simulation was engaging. However, given my novice experience as a nurse practitioner student, it would've been helpful to witness a successful conversation regarding OUD before being thrust into the situation. 83. 32 recorded words This is the first encounter I have had with platform. I did enjoy the interactive ability. I wish there was more feedback about what I did right or what could be improved. 84. 32 recorded words I thought this was a unigue presentation. It forced me to think about how to interview a patient over this sensitive topic. I definitely gained valuable information and insight during this module. 85. 32 recorded words I was hesitant at first but actually simulating a patient interview was extremely helpful. I do not practice in adult medicine so I do not get many opportunities to practice these skills. 86. 32 recorded words First time ever experience such as this. Believe I was talking without capturing my conversation at first, but bbelieve I caught on. Great case presentation and development of new learning for me 87. 31 recorded words I just had trouble thinking of questions to ask Jeremy during the program but I think it is a great tool to help learn and improve the overall stiuation. Thank you 88. 31 recorded words This was the first time I have used a tool like this. I was instructive and revealing. I would appreciate immediate feedback and an opportunity to redo segments that needed improvement. 89. 31 recorded words I enjoyed the interaction as it makes the provider get involved as if we were really interviewing a patient with a opiiod addiction. The iteraction makes you think and sets in. 90. 31 recorded words It was very helpful and somewhat close to real-life events in clinical practice. However, not every patient is as open-ended with their answers as AI-patient was, which could be further explored 91. 31 recorded words This was this first time I have ever used a virtual ai patient learning tool. I feel tit was very similar to what I would expect from a patient in clinic. 92. 31 recorded words The questions were long, so I wish that the patient could have just answered it by clicking on the question instead of reading it out. Otherwise, it was engaging and helpful. 93. 31 recorded words Felt like I needed to go over each question for the screening over again at the end even so the questions were addressed in the earlier conversation. But, Overall, very good 94. 31 recorded words good with helping as a learning tool. It would be nice to be able to have the chart on screen so that i could review information while speaking with the patient. 95. 31 recorded words It is as close to an actual patient encounter as possible in building communication skills in getting more comfortable to cover all topics empathetically and effectively before performing live in clinic. 96. 30 recorded words Jeremey did repeat a lot of the questions with the answer I was looking for which was nice but real life pateint encounters are not always as upfront with answering. 97. 30 recorded words It was moderately helpful. I should have clicked next several times before launching into my questions as I believe I got ahaead of the conversation on the first introductory encounter. 98. 30 recorded words It is an effective method of learning as it provids an interactive way to apply clinical knowledge and keep you think about your learnings and skills in an educational environment. 99. 30 recorded words The virtual patint was a goos way to test my knowledge and practice the screening process for identifyng OUD. The evaluation of my performance at the end was very helpful. 100. 30 recorded words The patient simulation was much more human than I expected; he answered in a way that made me take into account his potential relationship and job concerns over opioid use. NEUTRAL COMMENTS 1. 97 recorded words In real life I would have the TAPS and DSM V in front of me looking at it while talking to him until memorized. It would have been nice if full view of such was provided and I could then go through like I would in real life. I really did not realize I was being provided the questions until near end and by that time I had already gotten the responses to all the DSMV questions to see issue existed. But good feedback I should have asked more open ended ?s for openings where admitted issues. 2. 93 recorded words It was interesting but I did find it a little ackward at first. Jeremy wasn't as good an Avatar as could be meaning that it wasn't that easy to overlook that he was ai generated. For example, the "listening" was long an so it was difficult to be as naturally conversational and empathetic as I usually am with a live person. For example, I would be much more likely to say something like, "wow it really sounds like you have a good relationship with Ema, it must be really tough for you when... 3. 92 recorded words i liked the siulation but how to do it was confusing and there should be a warning or a numerical count down to the screens. i did not do the last part because i pressed next before i could speak on it. the quality of the AI simulation was great and helpful. another comment is that the previous slides stated that OUD was the leading cause of death 18-44 yrs old but that is not true. unintentional deaths are the leading cause for ages 18-44, like MVA's and overdoses. please be accurate 4. 90 recorded words For the first several interactions with Jeremy I could not hear and did not realize I could use the drop down to read his responses. For most of those times I indicated this by saying I am sorry my computter is not working... and/or I assume you ..... I think my interactions would have been more applicable if I had heard or been abe to read his responses. Thank you. Despite the technical issues I liked this format and learned quite a bit. a bit difficut to read the slides 5. 88 recorded words I wasted, at a minimum, an hour trying to get the microphone to work on my iMac. I was never able to get it to work and had to switch to a different computer. Once I did, I had to go through the pretesting and the course again to get to the interview. This module does not appear to remember how far one has progressed. This actually happened several time. Other than this short-coming, the virtual patient simulation was actually valuable and solidified the process needed to communicate. 6. 87 recorded words interesting skill building. The AI character seemed spot on. It was too much information to deal with in a 15 minute encounter, although the prompts helped alot. Without the prompts I would have been lost. It felt a little stunted and did not flow like a real person. The objectives are not realistic for primary care. Too many issues to deal with that are new for the time alotted for that reason it was a tad overwhelming. For the time alotted, the learning needs to be simplified. 7. 87 recorded words I think this was a useful tool to use but it was frustrating because my connection apparently was going out and I had to repeat myself a number of times so my questioning got shorter each time because I was afraid I would run out of time. It was also somewhat overwhelming as I do not prescribe opioids in my practice - as a provider who has dealt with it on a regular basis and is refining their skills, I would imagine it would be much less intimidating. 8. 86 recorded words This type of activity is positive and helpful - it took me several minutes to "feel comfortable" with the technology. I was focused on covering the "list" a little more than I was focused on "Jeremy," which made it a little more difficult to have a "natural" conversation. this is my first time using this method of learning. I do appreciate the scenario and interaction. The critique was helpful and reflects some of my nervousness during the activity. I generally "talk with my hands" and could not 9. 84 recorded words Not real pt. Often can get significant information with pt infront of you. Mannerisms, hygeine, rapidity of speach. Often make connections with pts on visual ques such as if they like cars/recreat on T shirts and such. I think in future could be good tool. Unfortunately this would take a lot of time. Probably use multiple hand outs, frequent visits. If you have a busy practice the time would be unrealistic for the reimbursement you get. definetly understand the need but limited time 10. 82 recorded words I was actually surprised about how well the AI was programmed and how it would give appropriate answers to my questions. Of course this is a bit weird , and i believe that had I talked to a real person I would be much more compfrtable to ask the questions and to connect. The fact that is just a program takes away a lot of the trying to connect because at the back of your mind you know it is just a machine 11. 82 recorded words Virtual Patient simulation is a novel concept and I feel is definitely helpful, as they say "practice makes perfect". However the intructions on virtual simulation need to improve as it was somewhat vague and there is an initial element of surprise with any new format and a s aresult of which we loos our normal clinical approach when we use a different platform, My session was disconnected perhaps due to recording or connectivity issue and thus teh comment that I was lacking. 12. 81 recorded words Connectivity problems were a barrier because I had to repeat my answers repeatedly due to Internet connection. I also initially had a problem with my microphone. I thought i had more steps to go so I only mentioned naloxone as prompted by the last step. I did not talk about same-day treatment as was brought forth in the learning objectives. His score was high so referal may have been warranted, but it would have been nice to practice discussion about buprenorphine. 13. 79 recorded words This is the first time I used AI and when I interview residents or patients I always look for thier positioning and whther they look at me and seem attentive to what I am saying. This is difficult with a robotic like figure, although I was impressed with his answering of questions. The answers were formidable and patient was gracious in answering which is not always the same with in person interviews who are sometimes more upset and angry. 14. 77 recorded words It was very helpful to be able to practice with an AI patient. I had an issue when he asked about drug testing disqualying him for work while using buprenorphine as there was not much information provided throughout all 4 modules I worked through on how buprenorphine works, dosing, impact in drug testing or impact on pain. It would be helpful to provide more information on this drug that I have never used in family practice before. 15. 66 recorded words I think having an example to copy first before being asked to perform it would be good. I've never had any of these types of converstaions before and all of this is new to me. I don't even really understand bupernorphine works or hwo it will help with pain and also with OUD. More education and even a sample coversation before doing it would be helpful. NEGATIVE COMMENTS 1. 93 recorded words Its not that effective. To tell me that my microphone doesnt work right over and over is not ok. I have 6-8 hour days on zoom with patients and do not have microphone issues. Overall, i think its ineffective to have a back and forth with me. It would be better to watch a patient like jeremy have a conversation with the primary care doc. We, the viewers, could watch the dialogue. and at the bottom of the screen you could have notes when the doc is discussing TAPS, SUD, PHQ9, buprenorphine, etc. 2. 91 recorded words As an older physician not trained with virtual patient simulations, it felt awkward and stiff. I assume younger physicians would be more well versed in this modality as a learning tool and might not feel the same way about it. The format of the entire course was difficult to read on a laptop given the small fonts. If the font was enlarged for the bottom panel, the size of the upper panel actually decreased which led me to have to keep changing the font size up and down for each section. 3. 86 recorded words It seemed as though I was simply parrotting a script... maybe that's what was intended... in which case there are far more efficient ways to do so. Also, towards the end of the AI, a "low internet bandwidth" warning occurred. I chose the 1st option, & I was thrown back to the very start of the activity. Very frustrating. I think the AI example needs a lot of work, or simply a reversion back to older technology: multiple choice responses, which would have been more directed & meaningful. 4. 84 recorded words The simulation was very artificial and conversation unnatural. There were too many questions across the bottom of the screen. I would prefer a list of questions on one screen so I could ask them as they fit into the flow of conversation. The simulation ended too early and before I had the chance to discuss starting treatment and scheduling follow-up. I tapped on next and suddenly it ended without warning. If it is timed, perhaps a countdown timer in the corner would be helpful. 5. 84 recorded words Saying i didn't ask TAPS questions or assess DSM-V criteria isnt really accurate if you realize that I knw the answer to the TAPS question already based on brief review of Jeremy's chart. Some of the deficiencies you noted in my treatment plan, harm reduction and detailed assessment of all of the aspects of Jeremy's are not well covered in the material presented to me. Saying that this activity should take 30 minutes is not realistic, especially for someone like me as a Radiologist. 6. 80 recorded words it was not helpful as he said he did not understand me and that I should speak in English. My repeated questioning went unanswered, so then I skipped the rest of the interview as I was not able to get him to answer anything at all > I said I am here to help you. He did not answer how often he was using his medicine currently and whether he had used any other medications. I did not find it useful. 7. 79 recorded words I had difficulty with wifi connection and my microphone, and it kept kicking me out in the middle of the simulation which means starting over at the beginning of the whole module. I understand restarting the simulation, but it got extremely frustrating. Also, I accidentally clicked through one of the steps on accident (I was trying to hit the mic button but hit next instead) so it would be better if you had to use the mic before proceeding 8. 78 recorded words I was not provided with a privacy disclaimer or information. Will my responses be used to further build AI models? I would like any sort of disclosure or disclaimer of this nature to be presented. The AI patient was a bit repetative and did not quite mirror normal, clinical patient interactions. I feel like the patient was almost too understanding of the situation and provided little pushback or questioning, which doesn't really prepare a clinician for real-world interactions. 9. 75 recorded words The encounter is artificial and difficult for me (an older physician) to accommodate. Trying to read the information at the bottom of the screen and translate it into some sort of language for the exercise was particularly difficult. The small window at the bottom of the screen was difficult to read and required scrolling during the exercise, which was difficult given the testing environment. I don't think I took much away from the exercise. Sorry. 10. 71 recorded words There needs to be a refresh option. The first time the simulation was stuck on Jeremy thinking and I ended up having to start all over. The second time through I got to the last two parts and he was still thinking and I couldn't complete the last two tasks I ended up just clicking the next button so I didn't have to go through the whole training a 3rd time. 11. 71 recorded words I did not like it as I am not as good with computers as others. I am also older. I am an MRO and work in a Drug rehab as medical director and the criteria are already performed before the patient arrives. I have always felt AI is phony and the patients responses prevented me from asking or saying what I wanted. I think your patient needs to be more real 12. 67 recorded words I did not like that this course did not have an option to go back or forward, and there was no way to tell how much time was left in the lecture. The speaker was very monotoned. I thought the AI patient experince was ok. I would have liked to watch a video of an expert talking to the AI patient, before talking to the patient myself. 13. 66 recorded words This made me feel as if I was playing some computer game. I felt like I was asking the same questions over aand over just to score the points I needed to get through the game. This did not feel anything like an actual patient encounter. I have been practicing for more than 40 years, and this was unlike any real patient encounter I've ever had.