A Virtual Counselor for Breast Cancer Genetic Counseling: Adaptive Pedagogy Leads to Greater Knowledge Gain

We describe an automated, multimodal embodied conversational agent that plays the role of a genetic counselor, designed to communicate breast cancer risk and the recommended medical guidelines to women. The counselor's dialogue is driven by intelligent tutoring systems techniques, risk communication principles, and information processing theories. The virtual counselor dynamically tailors its counseling based on user traits, preferred information processing methods, and dynamic comprehension assessments. We conducted a between-subject evaluation study with 30 women, comparing the adaptive counselor to a non-adaptive version of the counselor and a control condition. Women in the adaptive condition demonstrated a significantly greater increase in breast cancer genetics knowledge compared to women in the other conditions. Our results demonstrate the effectiveness of the multidimensional adaptation mechanisms for improving cancer genetic risk communication.