JMIR Medical Education (08/28/23) Vol. 9 Manuel, Jennifer K.; Purcell, Natalie; Abadjian, Linda; et al.
Researchers conducted a randomized control trial of synchronous Virtual Worlds (VW) training for primary care providers (PCPs) on posttraumatic stress disorder (PTSD) management and motivational interviewing (MI) to evaluate its feasibility, acceptability, usability and preliminary effectiveness compared with asynchronous web-based training. The VW program simulated trauma and PTSD symptoms and allowed participants to engage with instructors and each other. Learners included doctors, nurse practitioners and other trainees from the Department of Veterans Affairs, other community healthcare systems and university affiliates. The researchers randomized 99 eligible PCPs to VW training and 101 to web-based training. VW training taught skills in interviewing and screening PTSD patients and navigating impediments to mental health care, while web-based training comprised an introductory module and four narrated video training modules teaching MI-enabled interaction with patients. Fifty-one participants in each arm ultimately completed the training. Post-training PTSD knowledge and self-confidence in PTSD clinical skills significantly increased among learners in both cohorts, which were maintained at the 90-day follow-up. VW training participants reported gaining more MI knowledge in terms of empathy and partnership and in discussing pharmacotherapy and psychotherapy for PTSD, although in-group differences were not significant. Participants in that group particularly valued the VW platform's ability to accommodate different learning styles, but learners reported greater usability levels in the web-based training program. "This gap between the efficacy of the VW platform and its ease of use highlights the need for greater efforts in improving usability," according to the authors.