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Grant used to create VR of patient's perspective

University of Cincinnati project uses virtual reality to raise awareness on where patients live, work and play

Published Friday, November 8, 2019

For the very first time, a virtual reality simulation depicting patients challenged by social determinants of health will be used as a clinical tool to train providers caring for these special populations.

The project using VR to raise awareness and empathy in local health care providers is the result of a collaboration between the UC College of Nursing, Department of Family and Community Medicine at the UC College of Medicine and Center for Simulations and Virtual Environments Research (UCSIM). The VR simulations introduce the providers to the conditions where patients live, learn, work and play and affect a wide range of health risks and outcomes, called social determinants of health.

The project is funded by a $1 million grant from the Medicaid Technical Assistance and Policy Program (MEDTAPP), which is a university research partnership combining nonfederal and federal funds to support the efficient and effective administration of the Medicaid program. It is exemplary of the urban impact agenda highlighted in UC's Next Lives Here strategic direction. 

“For the project, Medicaid put out a call for potentially funded institutions to create virtual reality simulations to take to Medicaid providers with the theme of social determinants of health,” says Sue Brammer of the UC College of Nursing. “Those are things like the neighborhood you live in and whether or not there’s poverty or food insecurity; things that impact your health that aren’t internal.”

Brammer and co-principal investigator Gordon Gillespie, also of the College of Nursing, worked with Saundra Regan, Chris White and their team from the UC Department of Family and Community Medicine to create two scripts for the VR simulations. One features a man with schizophrenia who has a variety of factors that made him late to his appointment, including a lack of money for transportation. He winds up getting kicked out of his apartment and can’t afford to pay for the prescription medicine ordered by the physician. Brammer says the character is based on an amalgamation of clients she has encountered over the years.

The second simulation shows a woman from Puerto Rico who has a variety of chronic health conditions and speaks English with a heavy accent. Due to communication difficulties, she misses the cab she called from her apartment to get to her appointment. She calls for another ride but is blocked from getting outside because of some threatening people in her apartment building. She finally gets outside, but has missed her second ride and faints because of her health problems and is taken to the hospital. That leads to a third missed appointment, preventing her from getting the health care she needs.

The VR user puts on a headset and two hand controllers and views each simulation from the patient’s point of view to experience the variety of challenges they face.

“The simulations are about 20 minutes each and at the end there is a narrative of the different social determinants of health,” says Brammer. “The simulation refers back to the different scenes to show which determinants the patients faced, providing a teaching element.”

Brammer says the scripts were brought to VR by Chris Collins, founder of the UC Center for Simulations & Virtual Environments,  and her team. The project was evaluated by content experts from UC’s Department of Family and Community Medicine and College of Nursing, as well as  community providers to provide feedback on the validity of the simulations during the development process.

"The grant is groundbreaking,” says Dr. Barbara Tobias, interim chair of the Department of Family and Community Medicine. “Our department’s expertise in vulnerable populations helped create, pilot and evaluate these vignettes. It’s been an exciting interprofessional partnership with the UC College of Nursing and truly a model for future endeavors.”