Towards a Reflective Practicum of Embodied Conversational Agent Experiences Diego Rivera-Gutierrez ∗ , Andrea Kleinsmith ∗ , Teresa Johnson † , Rebecca Lyons † , Juan Cendan † , Benjamin Lok ∗ ∗ Department of Computer & Information Science & Engineering, University of Florida, Gainesville, Florida email: {djrg,alk,lok}@cise.ufl.edu † College of Medicine, University of Central Florida, Orlando, Florida email: teresa.johnson@ucf.edu, rlyons@ist.ucf.edu, juan.cendan@ucf.edu Abstract—A reflective practicum is a low-pressure, low-risk learning environment. In a reflective practicum a learner is educated in a professional practice and how to use reflection in the setting of that professional practice. An example of a low-pressure and low-risk learning environment is the use of embodied conversational agents (ECAs) in medicine to provide training for interviewing and diagnostic skills. However, such ECA experiences have not been used to teach how to use reflection in the setting of a professional practice. In this paper we present a framework that supports explicit reflective learning for ECA experiences. Using this framework, ECA experiences become a reflective practicum. This framework was applied to an ECA experience called the Neurological Examination Rehearsal Virtual Environment (NERVE), and created a sample experience called the NERVE Reflective Practicum (NERVE-RP). We conducted a user study in which second-year medical students (n = 76) used NERVE-RP and engaged in reflection based on the experience. The results of the user study show that students engage in valuable reflections during the experience including instances of critical reflection. Keywords-reflective learning; reflective practicum; embodied conversational agents; virtual patients I. I NTRODUCTION Sch¨ on [9] defined a “reflective practicum” as a setting designed for the task of learning a professional practice (e.g. medicine). In a reflective practicum students also learn how to use reflective learning in that professional practice. A reflective practicum is meant to be a low-pressure and low- risk environment for the learner. In a reflective practicum, a facilitator supervises learners as they engage in two kinds of experiences: a) simulated experiences that approximate real world scenarios they might face in their professional practice or b) real-world experiences under close supervision from the facilitator. In a reflective practicum, the facilitator challenges the learners to face situations they might not be familiar with and prompts them with questions that help them reflect on previous knowledge to solve the uncertain situations that arise. An example of such a low-pressure and low-risk environ- ment is the use of embodied conversational agents (ECAs, also known as “virtual humans”) to train learners for interpersonal scenarios. ECAs have been used to provide learning inter- ventions for medical interviews and examinations [4]. These learning interventions share characteristics with the reflective practicum that Sch¨ on described: 1) they are a low-pressure and low-risk environment where learners can make mistakes and 2) they are a simulated experience that approximates the real world. In addition to these characteristics, ECAs provide addi- tional benefits that help create important learning experiences. For example, ECAs can provide hands-on exposures to cases that could not be replicated by a human actor. In a medical setting, ECAs can display pathologies that include physical findings such as facial paralysis [4]. While ECA experiences fit the characteristics of a reflective practicum, these experiences have not yet been used to teach how to use reflection in the setting of a professional practice. Reflection can be critical in learning from these ECA experi- ences. Reflection helps the learner understand the experience and how the lessons learned apply to their professional setting [2]. In this paper, we present a framework that provides an explicit reflective learning component to ECA experiences. This framework allows ECA experiences to fully become a reflective practicum. This framework was applied to the Neurological Examina- tion Rehearsal Virtual Environment (NERVE) to create the NERVE Reflective Practicum (NERVE-RP). NERVE is an ECA experience in which medical students train by interview- ing and examining ECAs suffering from cranial nerve palsies. Cranial nerve palsies present asymmetric eye movement or facial responses and often are an indication of underlying potentially life threatening conditions. We used the presented framework to enhance this training application and prompt medical students to reflect on how this interaction can improve their professional practice. We present a user study in which 76 second-year medical students used NERVE-RP. The results from the study show students engaged in valuable reflections during the interaction, including instances of critical reflection. The results also show a statistically significant negative effect in the reported social presence of the ECA when learners en- gage in reflection during the interaction, these results highlight the need to balance the value provided by reflections with the potential to lose realism of the simulated experience. II. RELATED WORK A. Reflective Learning and Reflective Practicum As described by Sch¨ on [9], a “practicum” is a learning setting where learners are instructed in a professional practice by participating in simulated experiences that approximate the real world under the supervision of a facilitator. This kind of 2014 IEEE 14th International Conference on Advanced Learning Technologies 978-1-4799-4038-7/14 $31.00 © 2014 IEEE DOI 10.1109/ICALT.2014.202 694