Abstract: A system and method are disclosed for generating a report for an internal state of a patient. The system includes a computer configured to generate a virtual environment comprising a base layer and provide one or more object models to be placed in the virtual environment. The computer is further configured to provide one or more tools to manipulate the virtual environment and the one or more object models and automatically determine an internal state of a patient based, at least in part, on the selection and manipulation of the one or more object models and the manipulation of the virtual environment.