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The Journal of the American Board of Family Medicine 22 (4): 387-398 (2009)
DOI: 10.3122/jabfm.2009.04.080208
© 2009 American Board of Family Medicine
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Original Research

Virtual Reality Skills Training for Health Care Professionals in Alcohol Screening and Brief Intervention

Michael Fleming, MD, MPH, Dale Olsen, PhD, Hilary Stathes, MEd, Laura Boteler, BS, Paul Grossberg, MD, Judie Pfeifer, MEd, Stephanie Schiro, BA, Jane Banning, MSSW and Susan Skochelak, MD, MPH

Department of Family Medicine (MF, JP, SS), University of Wisconsin, Madison
Department of Pediatrics (PG), University of Wisconsin, Madison
Clinical Teaching and Assessment Center (JB), University of Wisconsin, Madison
School of Medicine and Public Health (SS), University of Wisconsin, Madison
SIMmersion, LLC, Columbia, MD (DO, HS, LB); Department of Pediatrics

Correspondence: Corresponding author: Michael Fleming, MD, MPH, Professor of Family Medicine, University of Wisconsin Madison, School of Medicine and Public Health, 1100 Delaplaine Court, Madison WI, 53715 (E-mail: mike.fleming{at}fammed.wisc.edu)

Background: Educating physicians and other health care professionals about the identification and treatment of patients who drink more than recommended limits is an ongoing challenge.

Methods: An educational randomized controlled trial was conducted to test the ability of a stand-alone training simulation to improve the clinical skills of health care professionals in alcohol screening and intervention. The "virtual reality simulation" combined video, voice recognition, and nonbranching logic to create an interactive environment that allowed trainees to encounter complex social cues and realistic interpersonal exchanges. The simulation included 707 questions and statements and 1207 simulated patient responses.

Results: A sample of 102 health care professionals (10 physicians; 30 physician assistants or nurse practitioners; 36 medical students; 26 pharmacy, physican assistant, or nurse practitioner students) were randomly assigned to a no training group (n = 51) or a computer-based virtual reality intervention (n = 51). Professionals in both groups had similar pretest standardized patient alcohol screening skill scores: 53.2 (experimental) vs 54.4 (controls), 52.2 vs 53.7 alcohol brief intervention skills, and 42.9 vs 43.5 alcohol referral skills. After repeated practice with the simulation there were significant increases in the scores of the experimental group at 6 months after randomization compared with the control group for the screening (67.7 vs 58.1; P < .001) and brief intervention (58.3 vs 51.6; P < .04) scenarios.

Conclusions: The technology tested in this trial is the first virtual reality simulation to demonstrate an increase in the alcohol screening and brief intervention skills of health care professionals.



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A. V. Neale and M. A. Bowman
Fourth Journal of the American Board of Family Medicine Practice-based Research Theme Issue
J Am Board Fam Med, July 1, 2009; 22(4): 343 - 345.
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