Manuel Jennifer K, Purcell Natalie, Abadjian Linda, Cardoos Stephanie, Yalch Matthew, Hill Coleen, McCarthy Brittan, Bertenthal Daniel, McGrath Sarah, Seal Karen
San Francisco Veterans Affairs Health Care System, San Francisco, CA, United States.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.
JMIR Med Educ. 2023 Aug 28;9:e42862. doi: 10.2196/42862.
Many individuals with posttraumatic stress disorder (PTSD) first present to primary care rather than specialty mental health care. Primary care providers often lack the training required to assess and treat patients with PTSD. Virtual trainings have emerged as a convenient and effective way of training primary care providers in PTSD assessment and communication methods (ie, motivational interviewing [MI]).
The aim of this study was to conduct a pilot randomized controlled trial of a synchronous Virtual Worlds (VW; a virtual world where learners were immersed as avatars) training versus an asynchronous web-based training on PTSD and MI, comparing the feasibility, acceptability, usability, and preliminary efficacy of 2 different training platforms among primary care providers.
Participating primary care providers were randomized to a VW and a web-based PTSD training. Outcomes were collected at baseline, posttraining, and 90-days follow-up. Standardized patient interviews measured participants' communication skills in assessing and managing patients with PTSD symptoms.
Compared to the web-based training, the VW training platform achieved larger learning gains in MI (ie, partnership and empathy) and in discussing pharmacotherapy and psychotherapy for PTSD. Both VW and web-based trainings led to increases in PTSD knowledge and primary care providers' self-confidence.
The asynchronous web-based PTSD training improved PTSD-related knowledge and self-confidence but was not as effective as the VW immersive experience in teaching MI or clinical management. Because VW training is synchronous and new for many learners, it required more time, facilitation, and technical support. As computer technology improves, VW educational interventions may become more feasible, particularly in teaching clinical skills.
ClinicalTrials.gov NCT03898271; https://tinyurl.com/mu479es5.
许多创伤后应激障碍（PTSD）患者首先就诊于初级保健机构而非专科心理健康机构。初级保健提供者往往缺乏评估和治疗PTSD患者所需的培训。虚拟培训已成为培训初级保健提供者进行PTSD评估和沟通方法（即动机性访谈[MI]）的一种便捷有效的方式。
本研究的目的是对同步虚拟世界（VW；学习者以化身形式沉浸其中的虚拟世界）培训与基于网络的异步PTSD和MI培训进行试点随机对照试验，比较两种不同培训平台在初级保健提供者中的可行性、可接受性、可用性和初步疗效。
参与的初级保健提供者被随机分配到VW和基于网络的PTSD培训中。在基线、培训后和90天随访时收集结果。标准化患者访谈测量参与者在评估和管理有PTSD症状患者时的沟通技巧。
与基于网络的培训相比，VW培训平台在MI（即伙伴关系和同理心）以及讨论PTSD的药物治疗和心理治疗方面取得了更大的学习成果。VW和基于网络的培训都提高了PTSD知识和初级保健提供者的自信心。
基于网络的异步PTSD培训提高了与PTSD相关的知识和自信心，但在教授MI或临床管理方面不如VW沉浸式体验有效。由于VW培训是同步的，且对许多学习者来说是新的，因此需要更多时间、引导和技术支持。随着计算机技术的进步，VW教育干预可能会变得更加可行，尤其是在教授临床技能方面。
ClinicalTrials.gov NCT03898271；https://tinyurl.com/mu479es5 。
