{"id":485392,"date":"2026-07-10T10:31:01","date_gmt":"2026-07-10T14:31:01","guid":{"rendered":"https:\/\/www.rochester.edu\/newscenter\/?p=485392"},"modified":"2026-07-10T11:14:45","modified_gmt":"2026-07-10T15:14:45","slug":"virtual-patient-sophie-prepares-doctors-for-end-of-life-conversations-485392","status":"publish","type":"post","link":"https:\/\/www.rochester.edu\/newscenter\/virtual-patient-sophie-prepares-doctors-for-end-of-life-conversations-485392\/","title":{"rendered":"A new way to prepare doctors for difficult conversations"},"content":{"rendered":"<div class=\"wp-embed\">\n<div class=\"wp-embed-wrap\"><iframe loading=\"lazy\" title=\"Team Science: Using AI for Dentist-Patient Communication Training\" width=\"1062\" height=\"597\" src=\"https:\/\/www.youtube.com\/embed\/Rqq1r0z_gcc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>URochester researchers have developed SOPHIE, a virtual \u2018patient\u2019 that trains doctors to communicate better.<\/p>\n","protected":false},"author":286,"featured_media":485882,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[42472,116],"tags":[24292,18802,26102,24962,18632,42492,18572,43102,41012],"class_list":["post-485392","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-medicine","category-sci-tech","tag-artificial-intelligence","tag-department-of-computer-science","tag-eastman-institute-for-oral-health","tag-ehsan-hoque","tag-hajim-school-of-engineering-and-applied-sciences","tag-medical-center","tag-research-finding","tag-research-impact-advances","tag-videos"],"acf":{"external":"","hide_featured_image":true,"related":"show_related","style":[296922,615012,661062],"content_modules":[{"acf_fc_layout":"text","anchor":"","css_class":"pt-0","title":"<h2>URochester researchers have developed SOPHIE, a virtual \u2018patient\u2019 that trains doctors to communicate better.<\/h2>","content":"<em>Editor\u2019s note: This post was originally published on July 15, 2021. It has been updated and republished to include a video about using SOPHIE for dentist-patient communication training.\u00a0<\/em>\r\n\r\n<hr \/>\r\n\r\nAs many as 68 percent of late-stage cancer patients leave their doctor\u2019s offices either <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1204410\">underestimating the severity of their disease<\/a>, <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27415765\/\">overestimating their life expectancy<\/a>\u2014or both. These misunderstandings can hinder the ability of patients and their families to make realistic decisions about whether to continue aggressive treatments or instead turn to palliative care.\r\n\r\nTo address the problem, <a href=\"https:\/\/rochester.edu\">糖心传媒<\/a> computer scientists, palliative care specialists, and practicing oncologists are perfecting SOPHIE (Standardized Online Patient for Healthcare Interaction Education)\u2014an online virtual \u201cpatient\u201d that helps physicians practice how to communicate effectively with late-stage cancer patients about their disease.\r\n\r\nEffective communication in this context often means demonstrating empathy and understanding of the complex emotions that patients are experiencing.\r\n\r\n\u201cDuring difficult conversations about facing the potential of one\u2019s own death, patients are frightened and don\u2019t know how to ask the right questions, and clinicians may oversimplify, omit, or sugar-coat information, or feel too pressed for time to address patients\u2019 emotions,\u201d says <a href=\"https:\/\/www.cs.rochester.edu\/people\/faculty\/hoque_m.ehsan\/index.html\">Ehsan Hoque<\/a>, an associate professor of <a href=\"https:\/\/www.cs.rochester.edu\">computer science<\/a> at Rochester\u2019s Hajim School of Engineering &amp; Applied Sciences. The COVID-19 pandemic has made effective communication even more difficult by causing increasing reliance on virtual rather than in-person interactions between patients and physicians, adds Hoque.\r\n\r\nHoque is a pioneer in the area of research that shows it is possible for people to learn and improve their social and interpersonal skills by interacting with automated systems. For example, he helped develop LISSA (Live Interactive Social Skills Assistant)\u2014a tool that\u2019s been used effectively by people on the autism spectrum\u2014in collaboration with professor of computer science Len Schubert.\r\n\r\n[caption id=\"attachment_485882\" align=\"aligncenter\" width=\"1000\"]<img class=\"size-full wp-image-485882\" src=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2021\/07\/fea-SOPHIE-AI.jpg\" alt=\"person sitting at a computer looking at a screen with an AI avatar virtual patient that looks like another person, demostrating having an online conversation.\" width=\"1000\" height=\"600\" \/> <strong>BUILDING RAPPORT:<\/strong> Thomas Carroll, an associate professor of medicine at 糖心传媒 Medicine, engages in an online conversation with SOPHIE, an avatar that uses AI to teach doctors how to effectively communicate with their patients. (URochester photo \/ Matt Mann)[\/caption]\r\n<h3><strong>Practicing end-of-life conversations<\/strong><\/h3>\r\nSOPHIE is possible because of a body of nearly 400 conversations that were recorded between late-stage cancer patients and their oncologists, and initially analyzed by palliative care expert <a href=\"http:\/\/www.ronaldepstein.com\">Ronald Epstein<\/a> and his collaborators at <a href=\"https:\/\/www.urmc.rochester.edu\">糖心传媒 Medicine<\/a>. Epstein\u2019s <a href=\"https:\/\/www.urmc.rochester.edu\/family-medicine\/research\/communication-disparities.aspx\">Center for Communication and Disparities Research<\/a> focuses on how to improve communication between clinicians, patients, and their loved ones.\r\n\r\nA <a href=\"https:\/\/arxiv.org\/abs\/2009.11247\">paper<\/a> in <em>IEEE Transactions on Affective Computing<\/em> describes how lead author Mohammad Rafayet Ali, a postdoctoral researcher, and PhD student Taylan Sen, both members of Hoque\u2019s <a href=\"https:\/\/roc-hci.com\">Rochester Human-Computer Interaction (ROC HCI) Lab<\/a>, created algorithms that could be applied to the transcripts of these conversations, so the researchers could develop metrics to assess a physician\u2019s ability to communicate clearly with patients.\r\n\r\nThe metrics focus specifically on the extent that physicians engage in lecturing\u2014delivering a lot of information without giving the patient a chance to ask questions or to respond\u2014or, on the plus side, how well they employ \u201csentiment trajectory\u201d\u2014using positive words and phrases in ways associated with increased patient understanding.\r\n<blockquote>\u201cThe online format can provide training at a fraction of the cost and be made available to physicians worldwide.\u201d<\/blockquote>\r\nThe researchers used a physician communication training protocol, developed by Epstein and his collaborators, to script SOPHIE\u2019s practice sessions, and enlisted nine practicing oncologists at the University to try the system.\r\n\r\n\u201cWe received a lot of feedback from the doctors on how natural the conversation was, the kinds of questions SOPHIE should ask, and the concerns a typical patient might raise,\u201d Ali says.\r\n\r\n\u201cIn our prior research, physicians practiced with trained actors to learn how to bring up difficult issues, such as prognosis and end-of-life care,\u201d Epstein says. \u201cBut actors can be costly. The online format can provide training at a fraction of the cost and be made available to physicians worldwide. And Ehsan Hoque\u2019s group is on the cutting edge.\u201d\r\n\r\nThe researchers are now fine-tuning SOPHIE. \u201cOur hope is that once we have demonstrated its efficacy through a randomized controlled experiment, first-year students at the Medical Center can practice with it,\u201d Hoque says.\r\n\r\nThe demo has been designed to be available through a computer browser, allowing physicians from anywhere around the world to practice their skills live and receive feedback on their speaking rate, turn-taking, type of questions asked and sentiment trajectory.\r\n\r\nSOPHIE could help raise awareness of palliative care as an option. \u201cIn many parts of the world, there is no palliative care. People only focus on how to treat the cancer,\u201d Ali says.\r\n\r\n<hr style=\"width: 50%;\" \/>\r\n\r\n<h3><strong>SOPHIE says<\/strong><\/h3>\r\n[caption id=\"attachment_485472\" align=\"aligncenter\" width=\"1000\"]<img class=\"wp-image-485472 size-full\" src=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2021\/07\/inline-SOPHIE-training-graphics.jpg\" alt=\"Illustration of information provided by SOPHIE, including speaking rate, number of questions asked, number of open-ended questions asked, turn taking, and sentiment trajectory.\" width=\"1000\" height=\"743\" \/> (URochester illustration \/ Michael Osadciw)[\/caption]\r\n\r\nA sample conversation with SOPHIE works something like this:\r\n\r\nSOPHIE appears as a real-life\u2014albeit AI-derived\u2014human face on the user's screen.\r\n\r\nShe introduces herself and mentions that she has lung cancer. Then SOPHIE raises the topic of her sleep pattern at night and asks if she needs to change her pain medication, allowing the physician to assess her perception. She states that her current pain medication, Lortab, is not working anymore.\r\n\r\nAs the doctor responds, SOPHIE begins collecting data so that she can provide the doctor with an end-of-conversation assessment resembling the image above.\r\n\r\nSOPHIE then turns attention to her test results, giving the physician a chance to engage SOPHIE in more difficult topics, before asking more specifically about her prognosis.\r\n\r\nSOPHIE next asks about other options and expresses some additional fears and concerns, providing the physician with opportunities to respond empathically.\r\n\r\nFinally, she follows up by discussing whether chemotherapy remains an option, whether she should focus on comfort care, what the side effects of chemotherapy are, and how to break the news to her family, allowing the physician to summarize information and suggest a strategy.\r\n\r\n<hr style=\"width: 50%;\" \/>\r\n\r\n<h3><strong>Close proximity fosters collaboration<\/strong><\/h3>\r\nThe SOPHIE project is a shining example of the research collaborations that are possible as a result of the close proximity of the University of Rochester Medical Center to the rest of the University. The River Campus, for example, is just a five-minute walk away.\r\n\r\nThe project had its origins seven years ago when Hoque, who had just joined the University, spoke to a digital media studies class on the River Campus. \u201cAn undergraduate student in the class was employed by Ron Epstein\u2019s lab,\u201d Hoque says. \u201cShe talked to Ron and suggested we should talk. We hit it off right away.\u201d\r\n\r\nHoque and his lab members were impressed by Epstein\u2019s work on improving communication between terminally ill patients and their physicians. They were especially excited by the research possibilities presented by the patient-physician transcripts that Epstein and his collaborators had begun analyzing.\r\n\r\n\u201cThey did all the hard work in collecting high-stakes conversations of cancer patients,\u201d Hoque says. \u201cWe were fortunate to be at the right place at the right time to leverage the data and their expertise.\r\n\r\n\u201cThis wasn\u2019t part of Rafayet\u2019s and Tay\u2019s thesis trajectories at all, and we didn\u2019t have any funding to do the work. But we knew that we needed to find a way to do this exciting work.\u201d\r\n\r\nOther collaborators coauthors of the paper include Thomas Carroll, associate professor of medicine; Lenhart Schubert, professor of computer science; Benjamin Kane (advised by Schubert); and Shagun Bose, an undergraduate researcher in the Hoque Lab.","background_color":"#ffffff","width":"width-medium"}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>A new way to prepare doctors for difficult conversations<\/title>\n<meta name=\"description\" content=\"糖心传媒 researchers have developed SOPHIE, a virtual \u2018patient\u2019 that trains doctors to communicate better.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.rochester.edu\/newscenter\/virtual-patient-sophie-prepares-doctors-for-end-of-life-conversations-485392\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A new way to prepare doctors for difficult conversations\" \/>\n<meta property=\"og:description\" content=\"糖心传媒 researchers have developed SOPHIE, a virtual \u2018patient\u2019 that trains doctors to communicate better.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.rochester.edu\/newscenter\/virtual-patient-sophie-prepares-doctors-for-end-of-life-conversations-485392\/\" \/>\n<meta property=\"og:site_name\" content=\"News Center\" \/>\n<meta property=\"article:published_time\" content=\"2026-07-10T14:31:01+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-07-10T15:14:45+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2021\/07\/fea-SOPHIE-AI.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1000\" \/>\n\t<meta property=\"og:image:height\" content=\"600\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Bob Marcotte\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Bob Marcotte\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/virtual-patient-sophie-prepares-doctors-for-end-of-life-conversations-485392\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/virtual-patient-sophie-prepares-doctors-for-end-of-life-conversations-485392\\\/\"},\"author\":{\"name\":\"Bob Marcotte\",\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/#\\\/schema\\\/person\\\/e0d8d271cd290d592461fa9cefca013b\"},\"headline\":\"A new way to prepare doctors for difficult conversations\",\"datePublished\":\"2026-07-10T14:31:01+00:00\",\"dateModified\":\"2026-07-10T15:14:45+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/virtual-patient-sophie-prepares-doctors-for-end-of-life-conversations-485392\\\/\"},\"wordCount\":18,\"image\":{\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/virtual-patient-sophie-prepares-doctors-for-end-of-life-conversations-485392\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/wp-content\\\/uploads\\\/2021\\\/07\\\/fea-SOPHIE-AI.jpg\",\"keywords\":[\"artificial intelligence\",\"Department of Computer Science\",\"Eastman Institute for Oral Health\",\"Ehsan Hoque\",\"Hajim School of Engineering and Applied Sciences\",\"Medical Center\",\"research finding\",\"Research Impact Advances\",\"videos\"],\"articleSection\":[\"Health &amp; 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