Purposeful Practice for learning social skills in VR

A few months ago I wrote a post about the VR in Education conference I attended at the University of Swansea. The videos of of the conference are now online so I thought I would post mine and revisit my talk.

The major message of the talk was, something that Sylvia Pan and I have been working on for years, that Virtual Reality can be a really valuable medium for learning professional social skills like the skills needed by doctors to talk empatheticly to patients.

Body Language Works

The first half of my talk went over a lot of examples of social interaction in VR and explained the idea (which I have written about before) that body language works in VR in a way that it doesn’t in other media.

The fact that we share a 3D space with a virtual character means that we can experience things like eye contact in a very real way that we can’t on skype, where looking at some one just means looking out of the screen.

This means that social interactions feel real and that allows us to learn social interactions skills in a realistic way.

Professional Social Skills

Being a professional, like a doctor, involves a lot of knowledge. You need to really understand the biology of the human body as well as the many diseases that can afflict it, not to mention the pharmacology of the many medicines you can prescribe. You learn this through many years of study at medical school.

But as Donald Schön point out, professionals also have a range of skills that you can’t just learn from books. Diagnosis for doctors or making good arguments for lawyers. These skills can only be learned via practice and experience.

Some of the most important skills that professionals need are social. While most of us have plenty of opportunity to practice social skills in our daily lives, in work people often need to deal with social situations that are very different from our ordinary social life, and much more challenging. Doctors need to convince patients to give up smoking, or even tell them they have a terminal disease. Police have to interview suspects, lawyers have to argue cases and business people have to negotiate deals.

These kinds of social skills are normally things we think of people either having or not. Certainly they aren’t things we normally think of teaching together with biology or accounting.

The Power of Practice

While it is easy to think that good social skills are innate, you either have them or you don’t, the latest science is showing that most of the talents we commonly think of as innate are actually learned. Researcher like K Anders Ericsson have studied expertise in many areas of life from sport, to chess and professional work and found that what we normally think of as talent is actually down to practice, a lot of practice. We can even learn things that were thought of as special gifts like perfect pitch. Malcom Gladwell popularised this idea in the 10 000 hour rule: it takes 10 000 hours of practice to make you an expert. Though, in fact Ericsson points out that this isn’t very accurate: we don’t have any scientific evidence for exactly how much practice you need and, as we will see, the quality of practice is as important as the quantity.

So, it is likely that the social skills we need in professional work can be learned through practice. The trouble is they are very hard to practice because the social situations involved are very rare and often very important. Medical students do not, and should not, have opportunities to practice with terminally ill patient and businesses would not entrust trainees with important negotiations.

These skills are often practiced in role plays, where each student plays one part in the conversation. While this is the best we can do at the moment, the situation is obviously not real. It doesn’t have the emotional charge of a real encounter with a patient, client or suspect, so it doesn’t prepare you well for the real situation.

What you need is to be able to have the full experience of a situation as you practice.

Experience on Demand

And that is what VR can give you: the experience.

Jeremy Bailenson uses the term “Experience on Demand”, to express the way that VR allows you to easily have experiences that would be very difficult to have in real life.

Not thinking about an experience, not reading about it, not watching it and not acting it out, but actually having an accurate simulation of the experience.

Because body language works in VR and so a social interaction feels like a real social interaction, we can use VR to experience, and therefore practice, difficult social situations.

This is particularly true of the emotional charge of a situation, which, as I said earlier, is very difficult to reproduce in a role play.

Bailenson talks about using VR to train quarterbacks for American Football. He says that one of the most important thing that VR provides is the complex emotions involved in having several large football players running at you, something you cannot get from books or video.

And the same goes for a doctor facing a terminally ill patient.


This is nicely illustrated by Sylvia Pan’s work on VR for doctors. She had a scenario involving a family doctor being pressured by patients wanting antibiotics inappropriately.

Antibiotics resistance is one of the most import current risks in global healthcare. Because antibiotics are prescribed so much, bacteria are evolving to become resistant to them and so we risk having incurable diseases.

Doctors know this and know that antibiotics are ineffective against viral illnesses like colds and flu, but they still often prescribe them when they should not.

Sylvia and colleagues tried to investigate this in VR. She did an experiment with both trainee and experienced doctors and put them in a VR scenario with patients asking for antibiotics. The antibiotics would not have helped with the condition, but the patients were very demanding.

The result was that most experienced doctors and all trainees prescribed antibiotics.

Think about this for a minute. They knew the people in front of them were not real. They knew that prescribing antibiotics was the wrong thing to do. They new they were being watched by medical professionals who were likely to judge them. But they still prescribed antibiotics.

There is no way they would have said that prescribing antibiotics was the right thing to do in this situation if they were asked in a paper and pencil survey, but they did it in VR.

The VR scenario reproduced the emotional experience of this difficult social encounter. The doctors felt the social pressure from the characters. No other medium could do this so well, not even a role play with real people.

While this scenario hasn’t been used for training yet, it could be an excellent way to practice this sort of difficult social encounter in a safe way, without needing to be in front of real patients. It is a way of applying the sort of practice that makes sports people great to social skills.

Purposeful Practice

Unfortunately, K Anders Ericsson points out that any old practice is not good enough. Most of us will have had the experience of practicing a skill again and again without getting better.

This is part of the problem with professional social skills, it is possible for a working professional to have thousands of social encounters over a career without getting any better at them.

Ericsson says that you need a very particular type of practice.

In my talk I use the term Deliberate Practice, which is by Ericsson, but that was before I had read his book, and I now realise that he uses this to mean something very specific that only applies to fields where there is a very well established understanding of how to teach skills, like music or mathematics. I don’t think this applies to social skills. Instead I will use his slightly weaker form of practice called Purposeful Practice.

Purposeful practice has a number of characteristics, but one of the most important is that it involves a specific goal for improvement. You aren’t just vaguely trying to get better, you are aiming for a specific aspect of a skill. For example, you might want to improve your swing during a tennis serve.

But having a goal is not enough, you also need feedback on how well you are doing against a goal. This is what enables you to see when you are doing better and how to improve.

I think that VR has the potential to support purposeful practice of social skills. The ability to do a VR experience many times makes it possible to practice a lot, but because of that it makes it possible to focus practice in very specific aspects of social skills (maybe one day it is how you speak and another day it is how you listen).

It also makes it possible to provide feedback, either automatically for solo practice or from a teacher. This is primarily by recording and replaying sessions, but it might also be possible in future to measure specific aspects of social skills.

What we need to do

So, VR could be a great way to practice professional social skills: it is relatively cheap and low risk but it also feels very much like the real experience.

But, for the practice to be purposeful, there need to be a few important features.

Firstly, it must be possible to practice many times. That probably means that we need a way of automatically generating many variations of a scenario, rather than a single scenario that a learner would quickly get used to.

Secondly, we need a good way of giving feedback. I think for social skills this is likely to be primarily through replaying a scenario and seeing your performance.

So there is still quite a lot of work to be done, but I think there is enormous potential for using VR for social skills training.