Virtual Reality Intervention to Support Clinicians' Firearm Safety Counseling Behaviors

Study Overview
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Brief Summary
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The goal of this clinical trial is to assess the efficacy of REACH Firearm Safety in a sample of pediatric residents. The main question it aims to answer are: Do residents who have completed REACH Firearm Safety have increased documentation in the electronic medical records for screening and counseling for safe firearm storage? Participants will be asked to engage in a virtual reality curriculum (REACH Firearm Safety). Researchers will compare the REACH Firearm safety group to a group of participants who complete an abbreviated online training.

Detailed Description
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The American Academy of Pediatrics urges pediatricians to counsel parents on the dangers of childhood access to firearms and restrict access through safe storage practices. However, evidence suggests that most pediatricians do not provide firearm-related counseling in real-world clinical practice. This is notable as firearm-related injury is now the leading cause of death in children aged 1-19 years in the United States. Virtual reality (VR) is a type of simulation-based medical education that allows users to interact with virtual environments and characters in a seemingly realistic way. Investigators developed Resident Education And Counseling on Household (REACH) Firearm Safety, a VR curriculum to allow pediatricians to practice screening and counseling on firearm safety. The objective of this proposal is to assess the efficacy of REACH Firearm Safety, along with key implementation metrics, to justify and inform scale and distribution of the training approach. To achieve the objective, Investigators will: (1) Conduct a multi-site two-arm randomized controlled pilot study assessing the efficacy of REACH Firearm Safety and (2) Measure acceptability, appropriateness, fidelity, feasibility, and cost of implementation of REACH Firearm Safety. The proposed research is significant and innovative because it is the first rigorous effort to evaluate the efficacy of VR as a training platform to teach communication skills related to firearm safety counseling.

Official Title
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Implementation of a Novel Virtual Reality Intervention to Support Clinicians' Firearm Safety Counseling Behaviors

Conditions
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Virtual Reality, Simulation Based Medical Education, Firearm Injury

Intervention / Treatment
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* Behavioral: Resident Education And Counseling on Household Firearm Safety
* Behavioral: Modified American Academy of Pediatrics Safer


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Resident with continuity clinic at either Kentucky Clinic South, University of Kentucky (UK) Internal Medicine and Pediatrics group, CCHMC Hopple Street Neighborhood Health Center, or University of Cincinnati (UC) Hoxworth Medicine-Pediatrics Clinic Exclusion Criteria: Resident unable to read or speak English Resident with continuity clinic outside of inclusion criteria clinics

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resident Education And Counseling on Household (REACH) Firearm Safety<br>Resident participants will complete a modified online self-guided American Academy of Pediatrics (AAP) Safer curriculum. Next, residents will complete REACH individually with a trained facilitator. | Behavioral: Resident Education And Counseling on Household Firearm Safety<br>* An intervention that includes a self-directed online curriculum and virtual reality simulations, designed to teach firearm screening and counseling among clinicians.<br>* Other names: REACH Firearm Safety;|
| Active Comparator: Modified AAP Safer<br>Resident participants will complete a modified online self-guided American Academy of Pediatrics (AAP) Safer curriculum. | Behavioral: Modified American Academy of Pediatrics Safer<br>* An intervention that includes a self-directed online curriculum.<br>* Other names: Modified AAP Safer;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent Change From Baseline in the Percentage of Participants with documentation within the medical record of access to firearms. | Documentation of discussion during clinical encounter of access to firearms. | 6 months | 
| Percent Change From Baseline in the Percentage of Participants with documentation within the medical record of counseling on firearm injury prevention. | Documentation of discussion during clinical encounter of firearm injury prevention. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Virtual Reality, Simulation Based Medical Education, Firearm Injury