Health Education in a Virtual World: Experience with Patient and Professional Education in Second Life

Virtual worlds are rapidly becoming part of the educational technology landscape. Second Life (SL) is one of the best known of these environments. This presentation will describe two of our recent educational projects using SL, one for physicians, and one for patients. Physician education The aims of the project were to explore the feasibility, acceptability and limited efficacy of a virtual world platform for delivering motivational interviewing (MI) training. MI is an evidence-based counseling strategy proven beneficial to support patients seeking health behavior change. Yet, the 2-3 day and travel commitment for face-to-face MI training often presents a barrier to the adoption of MI by healthcare professionals. Virtual worlds offer the potential to improve access and deepen the MI training experience through the use of immersive online environments. Little work is published on the use of SL for this purpose, and minimal evidence exists on educational outcomes for physician training in patient-centered counseling strategies such as MI using a virtual world platform. We trained 13 primary care physicians in a two-session, interactive program in SL on using MI for counseling patients on colorectal cancer (CRC) screening. We measured acceptability of the virtual world learning environment. Efficacy of the MI training was assessed through a tape recorded, blinded rating of a mock patient interview pre- and post-training. Acceptability ratings for the MI training ranged from 4.1-4.7 on a 5 point scale. The SL learning environment was highly rated, with 77% (n=10) of the doctors reporting SL to be an effective educational medium. Learners’ confidence and clinical practice patterns for CRC screening improved following the SL training. Significant increases in global MI skills scores were achieved (p=.001). Component scores for the MI micro-skills also increased, with improvements in four of the five component skills (empathy (p=.001), autonomy (p<.001), collaboration (p=.01), and evocative response (p=.008). The results of this pilot suggest that virtual worlds offer the potential for a new medical education pedagogy to enhance learning outcomes for patient-centered communication skill training. Patient education The lessons learned in the above project are being applied to an NIH-funded comparative effectiveness study of health education delivered in SL vs. face to face for inner-city African-American women with Type 2 diabetes. Patients are being recruited from community-health centers and an urban safety-net hospital, trained in the use of computers, wireless modems, and Second Life, and provided with a laptop computer and wireless 4-G modem to connect to SL while at home. Using principles of social cognitive theory, participants will engage in 8 health education sessions in small groups, and 4 times individually, with a health educator in Second Life, or face-to-face at the hospital if randomized to the comparison group. The sessions are designed to promote lifestyle change (diet and physical activity) to improve glycemic control. Participants in this clinical trial will have baseline and end-point measurements of hemoglobin a1c, physical activity, diet, and other measures to provide data on comparative effectiveness and patient acceptance of, and adherence to, the two methods. []