A Virtual Reality Resident Training Curriculum on Behavioral Health Anticipatory Guidance: Development and Usability Study

Abstract

Background Behavioral health disorders have steadily increased and been exacerbated by the COVID-19 pandemic. Though behavioral health disorders can be successfully mitigated with early implementation of evidence-based parent management strategies, education for pediatric residents on behavioral health anticipatory guidance has been limited to date, with training challenges compounded by the physical distancing requirements of the COVID-19 pandemic. Virtual reality (VR) simulations provide an opportunity to train residents on this complex competency by allowing deliberate practice of necessary skills while adhering to current social distancing guidelines. Objective This study explored the usability of a VR-based behavioral health anticipatory guidance curriculum for pediatric residents. Methods This mixed methods study included 14 postgraduate third-year pediatric residents who completed the behavioral health anticipatory guidance VR curriculum. Residents completed the MEC Spatial Presence Questionnaire to assess immersion in the virtual environment. Semistructured interviews were used to elucidate residents’ perspectives on the curriculum’s content and format. The interviews were analyzed using conventional content analysis. Results Quantitatively, residents reported a high degree of immersion, spatial presence, and cognitive involvement. Most residents (11/14, 79%) agreed or strongly agreed that it seemed as though they took part in the action of the simulation. Qualitatively, two themes emerged from the data: (1) the curriculum expands behavioral health anticipatory guidance and motivational interviewing knowledge and skills and (2) VR technology is uniquely positioned to develop competence. These themes revealed that the curriculum expanded their current level of knowledge and skill, addressed training gaps, and was applicable to all residents. Additionally, residents experienced VR as immersive, feasible, realistic to the clinic setting, and a safe space to practice and learn new skills. Conclusions Pilot data indicates that VR may be an effective tool to teach pediatric residents behavioral health anticipatory guidance, meeting a current gap in medical education training. This VR curriculum is particularly relevant in the context of the COVID-19 pandemic given the increased behavioral health concerns of families.

Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review

“…Second, immersive VR showed relatively better outcomes regarding skills acquired, learning speed, and information retention rates than classroom training in a sample of frontline health workers [ 100 ]. Third, pediatric residents experienced a desktop VR-based training program as immersive, feasible, and realistic in terms of the clinic setting, and as a safe space to practice and learn new skills [ 101 ]. Fourth, VR-based pregraduation medical training was considered realistic with regard to the initial clinical assessment and diagnostic activity by medical students [ 48 ], even if a nonnegligible proportion of the students experienced difficulties in online access to the VR platform [ 48 ].…”

“…The most adopted VR content was 360° videos or photos, used in 11 studies. Eight studies used virtual environments, 2 studies adopted VR video games [ 79 , 90 ], 5 studies used embodied agents [ 48 , 78 , 99 , 101 , 104 ], 4 studies used hybrid content (ie, a mix of 360° videos or photo and virtual environments or VR video games) [ 49 , 70 , 93 , 100 ], and 1 study did not specify the content [ 85 ] ( Table 4 ).…”

Effectiveness of a Curriculum for Pediatric Residents to Address Adolescent Nonsuicidal Self-Injury

“…An Objective Structured Clinical Examination may also allow for more objective assessment of competence that can be compared to self-assessed competence. Virtual reality simulations for training pediatric residents in behavioral health anticipatory guidance have shown promise [ 30 ]. One innovative strategy utilizes a virtual learning environment (VLE) designed to augment the existing NSSI curriculum outlined in the present study [ 31 ].…”

Methodologies and Use Cases on Extended Reality for Training and Education

“…VR based learning environment is a virtual setting that is developed with educational models. The entire system involves using one or more didactic objectives to demonstrate students' learning experiences, experiences they may not have in the physical world (Herbst et al, 2021). VR-assisted SCL is a pedagogical approach to practice SCL through a VR system.…”

“…It aims to achieve SCL learning outcomes based on the design the VR learning system. Because VR simulations enhance SCL for students, the technology enables the learning of complex competencies by allowing the deliberate practice of necessary skills while adhering to current social occasions and social norms (Herbst et al, 2021). The design helps learners to react to social instruction that builds upon their interactions with VR avatars.…”