Online Program

NYC use of virtual patient avatars to train PCPs on managing treatments of patients with trauma-related mental health disorders

Wednesday, November 6, 2013 : 11:15 a.m. - 11:30 a.m.

Monika Eros-Sarnyai, MD MA, Office of Mental Health Disaster Preparedness and Response, New York City Department of Health & Mental Hygiene, Queens, New York, NY
Glenn Albright, PhD, Department of Psychology, Baruch College of the City University of New York, New York, NY
Every year, more than 57 million American adults suffer from a diagnosable mental disorder, yet 62% of them go untreated, creating a significant public health challenge. This challenge is exacerbated following large-scale traumatic events, such as 9/11 or, most recently, Hurricane Sandy that can lead to a surge in the number of patients seeking help for physical ailments, which, in fact, may be masking underlying mental health disorders. Primary care providers (PCP), acting as the first point-of-care for nearly half of the U.S. patient population, are in a unique position to change this paradigm by identifying patients with mental health disorders and developing treatment plans that integrates mental health treatment.

To address the need for better detection and referral, the New York City Department of Health and Mental Hygiene developed in collaboration with a simulation company, an online role-playing training simulation to train PCPs in identifying and managing the treatment of patients with the four most common trauma-related mental health disorders: Post-Traumatic Stress Disorder, depression, substance and alcohol abuse disorders, and Generalized Anxiety Disorder. In addition to learning to identify warning signs and discuss treatment options, PCPs are taught how to engage in collaborative decision-making, conduct follow-up care, and apply effective conversation tactics to increase patient engagement, trust, and adherence to treatment plans. This is accomplished by the providers interacting and role-playing in conversations with emotionally responsive, fully animated patient avatars that act and respond like real patients in distress.

The simulation was launched in 01/13 and is currently disseminated in NYC through partnerships with hospital and healthcare networks. Data is being collected on the effectiveness of the training. On a small matched sample (n = 8 pairs) all measures are trending towards significance. A power analysis was conducted with the criterion for significance of alpha=0.05. The analysis revealed that with a sample size of 30 pairs, the study will have power of 89.5% to yield statistically significant results. Thus, in comparing pre/post training differences we expect significant increases in the PCP's ability to 1) identify risk factors and warning signs of trauma-related mental health disorders, 2) screen patients for trauma-related mental health disorders, 3) discuss treatment options, 4) engage in collaborative decision-making about treatment plans, and 5) build intrinsic motivation in patients to adhere to a suggested treatment plan.

Learning Areas:

Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe how NYC Dept. of Health and Mental Hygiene is using an innovative online simulation with emotionally responsive patient avatars to train primary care providers to identify and manage the care of patients with trauma-related mental health disorders Demonstrate a virtual reality simulation used by NYC to train PCPs how to integrate mental health into their practice List 5 beneficial aspects of the program

Keyword(s): Mental Health, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Albright is the former Chair of the Department of Psychology at Baruch College and has received distinguished teaching awards at both Baruch and New York University. He is actively involved in publishing and presenting at numerous conferences addressing how game-based role-play training simulations can cost-effectively support public health initiatives designed to impact large numbers of people to bring about permanent changes in behavior in the areas of health, and behavioral health.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Kognito Interactive Director of Applied Research Co-founder

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.