Fleming Michael, Olsen Dale, Stathes Hilary, Boteler Laura, Grossberg Paul, Pfeifer Judie, Schiro Stephanie, Banning Jane, Skochelak Susan
Department of Family Medicine, University of Wisconsin, Madison, WI 53715, USA.
J Am Board Fam Med. 2009 Jul-Aug;22(4):387-98. doi: 10.3122/jabfm.2009.04.080208.
Educating physicians and other health care professionals about the identification and treatment of patients who drink more than recommended limits is an ongoing challenge.
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.
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.
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.
让医生和其他医疗保健专业人员了解如何识别和治疗饮酒超过推荐限量的患者,是一项持续存在的挑战。
进行了一项教育性随机对照试验,以测试一个独立的培训模拟能否提高医疗保健专业人员在酒精筛查和干预方面的临床技能。“虚拟现实模拟”结合了视频、语音识别和非分支逻辑,创建了一个互动环境,使学员能够遇到复杂的社会线索和现实的人际交流。该模拟包括707个问题和陈述以及1207个模拟患者的回答。
102名医疗保健专业人员(10名医生;30名医师助理或执业护士;36名医学生;26名药学、医师助理或执业护士专业学生)被随机分配到无培训组(n = 51)或基于计算机的虚拟现实干预组(n = 51)。两组专业人员的预测试标准化患者酒精筛查技能得分相似:53.2(实验组)对54.4(对照组),酒精简短干预技能得分52.2对53.7,酒精转诊技能得分42.9对43.5。在使用模拟进行反复练习后,与对照组相比,实验组在随机分组后6个月时的筛查(67.7对58.1;P < .001)和简短干预(58.3对51.6;P < .04)场景得分有显著提高。
本试验中测试的技术是首个证明能提高医疗保健专业人员酒精筛查和简短干预技能的虚拟现实模拟。