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Immersive Narrative: Digital Character Development and Narratives for Enhancing Students’ Empathy and Deeper Learning

Lab Contact: Sylvester Arnab


External Team Members:
  • Sheila Leddington Wright (team lead)
  • Sean Graham
  • Michelle Stanley



“Observe, record, tabulate, communicate. Use your five senses. Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become expert”
Sir William Osler (1849–1919)


Assessment of a client is a crucial part of most healthcare professionals. Deep level understanding and being able to accomplish an effective assessment is integral to the success of the management and treatment of a client. Therefore considerable time is devoted in education to enabling this process to occur in an efficient and effective manner. To achieve these ends students need to be able to observe and listen to the client whilst simultaneously considering; what is the next appropriate question to ask that will develop an understanding of the client’s problem. The process is complex and not easily structured as each client has his or her own story. There are guidelines to follow which notate the skeleton of basic information required by the clinician to make a provisional hypothesis. This in turn informs what is required to be examined in the objective part of the assessment.

The traditional approach is to teach the theory and technical skills with case studies to simulate the real life experiences. The next step for the novice is to enter the world of clinical practice, which is accepted as the best way to develop and learn these skills. The aim therefore prior to this is to prepare the student as much as possible by exposing them to as close as possible to real life situations.

Therefore In Sports Therapy, six characters were developed from a variety of diverse backgrounds, ages, and lifestyles. These characters were developed as posters and then subsequently brought to life in Adobe Flash. They have been widely adopted amongst the Sports Therapy team for use in modules, and the students have expressed the usefulness in having these characters support their assignments. The animations however are simple talking heads, and only portray part of the story of direct interaction with clients and clinician.

Interviewing a client is a complex process: the client has an agenda for their problem and the clinician has the task to understand and make sense of the information gathered not just verbally but also through the body language, vocal tone, micro expressions and other such auditory and visual signals which can subconsciously trigger responses in these situations. Gradually a history or story is built up from the information the client has given which is developed through the questioning of the clinician. The overall picture will be influenced by other people’s stories or experiences the clinician has encountered. Assumptions can be made prior to a meeting, but perceptions can quickly change when meeting face-to-face. To enhance this students are encouraged to take subjective histories from their peers and friends. Similarly, theory based models only give a vague insight into how a real-life scenarios unfold, with role-play being time consuming in organising.

To give students more lifelike examples to follow, rather than the traditional written questions, the six characters were developed further to give accurate life-like visual interpretation through 3D animation, with characters, rigs and animations that can be re-purposed, without the need for employing actors or simulated clients. This animation is able to capture the full range of emotion and expression expected in a real life situation. This enables the student to have an experience and deeper understanding of the whole client as a character.


The research question is therefore:

Would fidelity in character representations influence the level of engagement and enhance empathy and deeper understanding of learning scenarios?

Schon D. (1987) Educating the Reflective Practitioner. San Francisco, Calif: Jossey-Bass Inc Publishers
Strohschein, J., Hagler, P. & May, M (2002) Assessing the need for change in clinical education practices Physical Therapy, 82 pp. 160–172



  • Develop 3D character and scenario for proof of concept: Developing a scenario and Unity 3D based on Sports Therapy case studies.


  • Translate into the VR/360 environment: Translating the scenario into a VR environment.

in-game-VR screenshot


  • Randomised Control Trials: An RCT (n>45) consisting of a control group with 4 different interventions (a written script, audio dictation, traditional screen based animation, and an immersive VR animation) to evaluate the significance of a 3D character approach to storytelling. Analysis of findings will indicate any direct impact on the quality and effectiveness of learning resources developed within the University, and for the wider academic community.


Technology Application

The learning technologist and Sports Therapists worked together to develop a narrative that would be considered a realistic scenario based on professional experience. The script was recorded as audio and added to the 3D model through LipSync, which removed the need to animate the speech manually. The body language and movement was then captured using the perception neuron motion capture suit and the animation cleaned in 3D animation software. Although expensive, this saved a large number of hours that would traditionally be allocated to manual animation. To publish the animation as a VR resource, Unity game engine and Google Cardboard SDK (Software Development Kit) were used.

3d-character-design-activity      3d-character-design-screnshot-1


In total, it took around 30 days to research and develop a workflow, create the reusable 3D models, and develop the resource specific assets. For the future development of the 5 remaining characters it is expected to take around 10 days each. All the models created are also reusable for other projects within the university.

Scenario and character development

Jing-Wei Song was chosen out of the 6 original characters to develop into the narrative media that underpinned the random control testing. Jing-Wei is a 14 year-old competitive rhythmic gymnast of Chinese heritage who lives at home with her parents. Her father works nights, and her mother has been diagnosed with multiple sclerosis. Jing-Wei is a bright student who is taking her GCSE’s a year early, but due to her complex home-life and added pressure of GCSE’s, her coach has advised her to visit the Sports Therapist when she noticed a drop in her performance.

In-house development

The development of in-house academic e-resources requires a rapid and cost effective workflow, which in general is contrary to the needs of high quality 3D animation. Through recent advancements in software, the learning technologist was able to create a workflow that met these needs. The development software used were:

  • 3D Character – Adobe Mixamo – Institutional license
  • Environment models – Blender – Free and open source
  • Character Animation – Perception Neuron MoCap – Commercial purchase
  • Speech Animation – Rogo Digital LipSync– Commercial license
  • Audio– Adobe Audition – Institutional license
  • VR engine – Unity / Cardboard SDK – Available free


Milestones & Timeline

  • April 2016
    • RCT
  • March 2016
    • Development completed
  • June 2016
    • Analysis of RCT, reporting and article writing to target SJR: Q1/Q2 journals


Research Finding to Date

  • Ongoing.



  • 18/04/2016 – First update
    • The RCT was conducted at the DMLL, taking over the Grass area and the three project rooms to carry out the four trials (1 control and 3 treatments). The exposure to the four mediums were repeated for all groups to allow learning and understanding patterns to be evaluated. The satisfaction and engagement level will also be analysed. Photos below depict the activities during the RCT.




Project Timeline:

Start date:

January 2016

End date:

June 2016




Associated Faculties:

  • Health and Life Sciences
  • The Centre for Excellence in Learning
    Enhancement (CELE)

Associated Schools:

  • Sports Therapy



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