Interactive Pedagogical Drama for Health Interventions

The goal of Interactive Pedagogical Drama (IPD) is to exploit the edifying power of story while promoting active learning. An IPD immerses the learner in an engaging, evocative story where she interacts with realistic characters. The learner makes decisions or takes actions on behalf of a character in the story, and sees the consequences of her decisions. The story’s characters are realized by autonomous agents. We discuss IPD in the context of Carmen’s Bright IDEAS (CBI), a multimedia title designed to teach problem solving skills to mother’s of pediatric cancer patients. CBI was an exploratory arm of a clinical trial and here we discuss key creative and technical aspects of the design and results from that arm. Topics: Pedagogical Drama; Virtual Learning Environments SubTopics: Agent-based virtual characters; Health Interventions The use of drama as a pedagogical tool is a constant across cultures and throughout history. In Poetics, Aristotle argued over two millennia ago that learning and drama are interwoven: that drama is an imitation of life and humans learn through enjoyment of that imitation. More recently, research in psychology has argued that narrative is central to how we understand the world and communicate that understanding [1]. And of course, the engrossing, motivational nature of story is unmistakable; the world now consumes stories in various media with a “ravenous hunger” [10]. Yet stories can also have a drawback from a learning perspective: they typically place the learner in the role of passive audience instead of active learner. The goal of Interactive Pedagogical Drama (IPD) is to exploit the edifying power of story while promoting active learning. An IPD immerses the learner in an engaging, evocative story where she interacts openly with realistic characters. The learner makes decisions or takes actions on behalf of a character in the story, and sees the consequences of her decisions. The learner identifies with and assumes responsibility for the characters in the story, while the control afforded to the learner enhances intrinsic motivation [7]. Since the IPD framework allows for stories with multiple interacting characters, learning can be embedded in a social context [17]. We take a very wide view of the potential applications of interactive story and IPD in particular. We envision interactive story as a means to teach social skills, to teach math and science, to further individual development, to provide health interventions, etc. In creating an IPD, the demands of creating a good story, achieving pedagogical goals and allowing user control, while maintaining high artistic standards, must all be balanced. To ensure a good story, dramatic tension, pacing and the integrity of story and character must be maintained. Pedagogical goals require the design of a pedagogically-appropriate “gaming” space with appropriate consequences for learner choices, scaffolding to help the learner when necessary and a style of play appropriate to the learner’s skill and age. To provide for learner control, an interaction framework must be developed to allow the learner’s interactions to impact story and the pedagogical goals. These various demands can be in conflict, for example, pedagogically appropriate consequences can conflict with dramatic tension and learner control can impact pacing and story integrity. We have developed an agent-based approach to interactive pedagogical drama. Our first IPD was Carmen’s Bright IDEAS (CBI), an interactive, animated health intervention designed to improve the social problem-solving skills of mothers of pediatric cancer patients. Parents of children with chronic diseases are often poorly equipped to handle the multiple demands required by their ill child as well as the needs of their healthy children, spouse and work. Critical decisions must be made that affect family and work. To help train parents in the problem-solving skills required to address such challenges, CBI teaches a method for social problem-solving called Bright IDEAS [16]. Each letter of IDEAS refers to a separate step in the problem solving method: Identify a solvable problem, Develop possible solutions, Evaluate options, Act on plan and See if it worked. Prior to CBI, the Bright IDEAS method was taught in a series of one-on-one sessions with trained counselors, using worksheets that helped a mother detail her problems in terms of IDEAS steps. The purpose of Carmen's Bright IDEAS is to teach mothers how to apply the Bright IDEAS method in concrete situations. Mothers learn more on their own and at times of their own choosing, and rely less on face-to-face counseling sessions. An early version of the CBI system was first described in [12], and was subsequently further developed and tested. Although the design of agent-based interactive drama systems is an increasingly active area of agent research [e.g., 4,9,15,18], it is also an open area of research with few fielded applications. Further, their use in pedagogical applications is far less common and raises additional challenges, especially in such a challenging application area as psychosocial intervention. CBI has been tested as an exploratory arm of a clinical trial of the Bright IDEAS method at seven cancer centres across the U.S. This paper describes design changes made in the course of preparing CBI for clinical trial, as well as results from its evaluation. 1. The Design of Carmen’s Bright IDEAS In our basic design for interactive pedagogical drama, there are five main components: a cast of autonomous character agents, the 2D or 3D puppets which are the physical manifestations of those agents, a director agent, a cinematographer agent, and finally the learner/user who impacts the behavior of the characters. Animated agents in the drama choose their actions autonomously but also follow directions from the learner and/or a director agent. Director and cinematographer agents manage the interactive drama's onscreen action and its presentation, respectively, so as to maintain story structure, achieve pedagogical goals, and present the dynamic story so as to achieve best dramatic effect. The design of all these agents requires both general capabilities as well as knowledge specific to the interactive drama that is being created. The story for Carmen’ Bright IDEAS was developed via collaboration between the authors, clinical colleagues at two of the seven sites where the Carmen was to be tested and a professional scriptwriter (Jonathan Kaplan). The story and design features of the interactive experience went through a sequence of formative evaluations with mothers at one of these sites. The story is organized into three acts. The first act reveals the back story; various problems Carmen is facing, including her son’s cancer, her daughter Diana’s temper tantrums, work problems, etc. The second, main, act takes place in an office, where Carmen discusses her problems with a clinical counselor, Gina, who suggests she pick a solvable problem and use Bright IDEAS to help her find solutions. See Figure 1. With Gina's help, Carmen goes through the initial steps of Bright IDEAS, applying the steps to one of her problems and then completes the remaining steps on her own. The final act reveals the outcomes of Carmen's application of Bright IDEAS. Figure 1: Gina & Carmen (right) The design goal for the overall CBI experience was to mirror, but be distinct from, the kinds of problems the learner faces. The learner was supposed to be transported into the drama away from the stress of their own problems. Whereas the emotions evoked would be strong, the transportation would make them more manageable. To realize this goal, we chose a presentational, third person experience where learners influenced Carmen but were not immersed in the drama. Characters would not directly talk to the learner about their own problems, which might be insulting or too distressing. Presentational drama would allow for psychological distancing and the freedom to explore coping strategies through Carmen. Further, it reduced interactivity demands – stressed mothers did not need to control their character moment-to-moment since it had its own motivations. The interactivity would nevertheless allow active learning, promote identification with Carmen and ideally lead to belief in the efficacy of the skills being taught. To the extent the learner explored unproductive coping strategies with Carmen, we wanted those strategies projected back into the drama where they would be dealt with. 1.1. Interaction Model The interaction model we designed for CBI is what we call a rubber-band model. See Figure 2. Both Gina and the learner exert influence over Carmen. It is Gina's job to keep the social problem solving on track so that the story proceeds to a successful outcome by effectively responding to Carmen's cognitive and emotional state, at times motivating her through dialog to work through the steps of IDEAS on some problem or alternatively calming or reassuring her. The human mother interacts with the drama by making choices for Carmen such as what problem to work on and how she should cope with the stresses she is facing. The learner can choose alternative internal thoughts for Carmen, such as “I hope this helps with Diana.” These were presented as thought balloons (see Figure 3). Both Gina’s dialog moves and the learner’s choices influence the cognitive and emotional state of the agent playing Carmen, which in turn impacts her behavior and dialog, perhaps in conflicting ways. In this interaction model, the Gina agent is both on-screen character and the drama’s director. The Carmen agent has her own cognitive and emotional dynamics (hence rubber-band metaphor) that ensure her behavior is believable, regardless of how Gina and the learner influence her. The combination of Gina's motivation of Carmen through dialog and the learner’s emotional impact on Carmen creates tension, a tug-of-war between Gina’s attempts to motivate Carmen and the initial, possibly less positive, attitudes of the Carmen/learner pair. As the learner plays a role in determining Carmen's attitudes, she assumes a relationship in this tug-ofwar, including, ideally, an empathy for Carmen and her difficulties, a responsibility for the onscreen action and perhaps empathy for Gina. If Gina gets Carmen to actively engage in applying the IDEAS technique with a positive attitude, then she potentially wins over the learner, giving her a positive attitude. Regardless, the learner gets a vivid demonstration of how to apply the technique. Figure 2: Rubber Band Model Figure 3: Thought Balloons