Dr Alex Young is a trained orthopaedic and trauma surgeon who founded Virti and set out to use emerging technologies to provide immersive training for both new healthcare professionals and experienced ones looking to hone their skills.

COVID-19 has put most in-person training on hold to minimise transmission risks. Hospitals and universities across the UK and US are now using the virtual patient as a replacement—including our fantastic local medics and surgeons at the Bristol NHS Foundation Trust.

The virtual patient uses Natural Language Processing (NLP) and ‘narrative branching’ to allow medics to roleplay lifelike clinical scenarios. Medics and trainees can interact with the virtual patient using their tablet, desktop, or even VR/AR headsets for a more immersive experience.

Dr Alex Young comments:

“We’ve been working with healthcare organisations for several years, but the pandemic has created really specific challenges that technology is helping to solve. It’s no longer safe or practicable to have 30 medics in a room with an actor, honing their clinical soft-skills. With our virtual patient technology, we’ve created an extremely realistic and repeatable experience that can provide feedback in real time. This means clinicians and students can continue to learn valuable skills.

Right now, communication with patients can be very difficult. There’s a lot of PPE involved and patients are often on their own. Having healthcare staff who are skilled in handling these situations can therefore make a huge difference to that patient’s experience.”

Some of the supported scenarios include: breaking bad news, comforting a patient in distress, and communicating effectively whilst their faces are obscured by PPE. Virti’s technology was also used at the peak of the pandemic to train NHS staff in key skills required on the front line, such as how to safely use PPE, how to navigate an unfamiliar intensive care ward, how to engage with patients and their families, and how to use a ventilator.

Tom Woollard, West Suffolk Hospital Clinical Skills and Simulation Tutor, who used the Virti platform at the peak of the COVID pandemic, comments:

“We’ve been using Virti’s technology in our intensive care unit to help train staff who have been drafted in to deal with COVID-19 demand.

The videos which we have created and uploaded are being accessed on the Virti platform by nursing staff, physiotherapists and Operational Department Practitioners (ODPs) to orient them in the new environment and reduce their anxiety.

The tech has helped us to reach a large audience and deliver formerly labour-intensive training and teaching which is now impossible with social distancing.

In the future, West Suffolk will consider applying Virti tech to other areas of hospital practice.”

The use of speech recognition, NLP, and ‘narrative branching’ provides a realistic simulation of how a patient would likely respond—providing lifelike responses in speech, body language, and mannerisms.

The AI delivers real-time feedback to the user so they can learn and improve. With upwards of 70 percent of complaints against health professionals and care providers attributable to poor communication, the virtual patient could help to deliver better care while reducing time spent handling complaints.

Virti’s groundbreaking technology has – quite rightly – been named one of TIME’s best inventions of 2020.

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A research team at MIT developed software, called TextFooler, which looked for words which were most crucial to an NLP classifier and replaced them. The team offered an example:

“The characters, cast in impossibly contrived situations, are totally estranged from reality”, and
“The characters, cast in impossibly engineered circumstances, are fully estranged from reality”

No problem for a human to decipher. Yet the results on the AIs were startling. For instance BERT, Google’s neural net, was worse by a factor of up to seven at identifying whether reviews on Yelp were positive or negative.

Douglas Heaven, writing a roundup of the study for MIT Technology Review, explained why the research was important. “We have seen many examples of adversarial attacks, most often with image recognition systems, where tiny alterations to the input can flummox an AI and make it misclassify what it sees,” Heaven wrote. “TextFooler shows that this style of attack also breaks NLP, the AI behind virtual assistants – such as Siri, Alexa and Google Home – as well as other language classifiers like spam filters and hate-speech detectors.”

This publication has explored various methods where AI technologies are outstripping human efforts, such as detecting breast cancer, playing StarCraft, and public debating. In other fields, resistance – however futile – remains. In December it was reported that human drivers were still overall beating AIs at drone racing, although the chief technology officer of the Drone Race League predicted that 2023 would be the year where AI took over.

The end goal for software such as TextFooler, the researchers hope, is to make NLP systems more robust.

Postscript: For those reading from outside the British Isles, China, and certain Commonwealth countries – to ‘snooker’ someone, deriving from the sport of the same name, is to ‘leave one in a difficult position.’ The US equivalent is ‘behind the eight-ball’, although that would have of course thrown the headline out.

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The consortium includes Google DeepMind, Facebook AI, New York University, and the University of Washington. Each of the consortium’s members believe a more comprehensive benchmark is needed for NLP than current solutions.

The result is a benchmarking platform called SuperGLUE which replaces an older platform called GLUE with a “much harder benchmark with comprehensive human baselines,” according to Facebook AI. 

SuperGLUE helps to put NLP abilities to the test where previous benchmarks were beginning to pose too simple for the latest systems.

“Within one year of release, several NLP models have already surpassed human baseline performance on the GLUE benchmark. Current models have advanced a surprisingly effective recipe that combines language model pretraining on huge text data sets with simple multitask and transfer learning techniques,” Facebook said.

In 2018, Google released BERT (Bidirectional Encoder Representations from Transformers) which Facebook calls one of the biggest breakthroughs in NLP. Facebook took Google’s open-source work and identified changes to improve its effectiveness which led to RoBERTa (Robustly Optimized BERT Pretraining Approach).

RoBERTa basically “smashed it,” as the kids would say, in commonly-used benchmarks:

“Within one year of release, several NLP models (including RoBERTa) have already surpassed human baseline performance on the GLUE benchmark. Current models have advanced a surprisingly effective recipe that combines language model pretraining on huge text data sets with simple multitask and transfer learning techniques,” Facebook explains.

For the SuperGLUE benchmark, the consortium decided on tasks which meet four criteria:

1. Have varied formats.
2. Use more nuanced questions.
3. Are yet-to-be-solved using state-of-the-art methods.
4. Can be easily solved by people.

The new benchmark includes eight diverse and challenging tasks, including a Choice of Plausible Alternatives (COPA) causal reasoning task. The aforementioned task provides the system with the premise of a sentence and it must determine either the cause or effect of the premise from two possible choices. Humans have managed to achieve 100 percent accuracy on COPA while BERT achieves just 74 percent.

Across SuperGLUE’s tasks, RoBERTa is currently the leading NLP system and isn’t far behind the human baseline:

You can find a full breakdown of SuperGLUE and its various benchmarking tasks in a Facebook AI blog post here.

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