What Counts as 'Real' in Healthcare Interaction? Examining Human/Technology Hybrid Simulation Interactions in Communication Skills Training.
4 affiliations
- 1School of Nursing and Public Health, Manchester Metropolitan University, Manchester, UK.
- 2Communication and Media, School of Social Sciences and Humanities, Loughborough University, Loughborough, UK.
- 3School of Health Sciences, University of Nottingham, Nottingham, UK.
- 4Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
Abstract
Simulated interaction is a common healthcare training tool and is increasingly technologically mediated. Although the need for clinical realism or authenticity of simulated interactions is commonly understood, less attention has been paid to their interactional realism. However, research beyond healthcare suggests that participants interact differently in simulated scenarios. This paper examines simulations conducted through the MetaHuman Live platform, where a human tutor is live-linked to an avatar using the tutor's voice and mapping their gaze and facial expressions. We use conversation analysis (CA) to analyse student nurses' interactions with this platform, identifying key areas where they differ from 'real' interactions. These are openings, closings, establishing shared knowledge, interactional progressivity and orientation to simulation platforms as an assessment tool. We suggest that features of a hybrid platform which aim to increase realism can also make interaction more complicated for learners trying to navigate between 'the person' and 'the system'. We conclude that, although our analysis suggests ways forward for the more effective integration of simulation technologies in training communication skills in healthcare, it also points to our continued need for a better sociological understanding of how interaction itself works in practice, to provide an evidential basis for design and evaluation of such simulations.
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BibTeX
@article{pilnick2026what,
title = {{What Counts as 'Real' in Healthcare Interaction? Examining Human/Technology Hybrid Simulation Interactions in Communication Skills Training.}},
author = {Alison Pilnick and Lauren Bridgstock and Saul Albert and Rebecca O'Brien and Anne-Marie Borneuf},
journal = {Sociology of health \& illness},
year = {2026},
month = oct,
doi = {10.1111/1467-9566.70284},
url = {https://europepmc.org/article/MED/42895126},
note = {CC BY},
}
RIS
TY - JOUR
TI - What Counts as 'Real' in Healthcare Interaction? Examining Human/Technology Hybrid Simulation Interactions in Communication Skills Training.
AU - Alison Pilnick
AU - Lauren Bridgstock
AU - Saul Albert
AU - Rebecca O'Brien
AU - Anne-Marie Borneuf
PY - 2026
DA - 2026/10/30
JO - Sociology of health & illness
DO - 10.1111/1467-9566.70284
UR - https://europepmc.org/article/MED/42895126
AB - Simulated interaction is a common healthcare training tool and is increasingly technologically mediated. Although the need for clinical realism or authenticity of simulated interactions is commonly understood, less attention has been paid to their interactional realism. However, research beyond healthcare suggests that participants interact differently in simulated scenarios. This paper examines simulations conducted through the MetaHuman Live platform, where a human tutor is live-linked to an avatar using the tutor's voice and mapping their gaze and facial expressions. We use conversation analysis (CA) to analyse student nurses' interactions with this platform, identifying key areas where they differ from 'real' interactions. These are openings, closings, establishing shared knowledge, interactional progressivity and orientation to simulation platforms as an assessment tool. We suggest that features of a hybrid platform which aim to increase realism can also make interaction more complicated for learners trying to navigate between 'the person' and 'the system'. We conclude that, although our analysis suggests ways forward for the more effective integration of simulation technologies in training communication skills in healthcare, it also points to our continued need for a better sociological understanding of how interaction itself works in practice, to provide an evidential basis for design and evaluation of such simulations.
SN - 0141-9889
SN - 1467-9566
ER -