Game-based Skills Development in Alcohol Assessment and Intervention

 描述(由申请者提供)：临床挑战：酒精项目旨在通过改善医学生的酒精评估和干预技能来改善有酒精使用风险或酒精使用障碍的患者的结果。为了实现这一目标，我们将在我们的平台独立临床遭遇3D患者培训环境的基础上进行构建。这个项目通过增加真实感和将训练重新组织为一个需要掌握的具有挑战性的游戏来扩展临床遭遇3D-患者训练环境。分支路径学习、暴露于临床后果和时间压力增加了挑战。要想在游戏中取得成功，从而获得必要的酒精评估和干预技能，需要投入到体验中，优化和完善技能，并选择获胜的方法[以最佳实践为基础，以患者为中心]。这款游戏复制了现实世界中病人护理的挑战，但有效地提供了各种临床体验。在刻意的实践中，他们评估、干预并经历我们支离破碎的医疗保健系统可能遗漏的后果。举个例子，我们的模拟病人并不是“失访”。这个项目独一无二地增加了时间压力的挑战。就像在今天的治疗环境中一样，时间并不是无限的；玩家必须有效地与患者互动，并迅速采取适当的行动。学生与虚拟(例如，计算机生成的)患者进行面谈并执行标准化评估。他们会收到不同的模拟患者反应(例如，接受、困惑、拒绝、可疑行为)和教师对他们做出的选择和决定的反馈。为了对酒精使用进行分类，并按照指示建立酒精使用诊断，他们继续选择体检成分，并选择和解释诊断屏幕和测试。对于处于临床培训早期阶段的健康专业学生，学生应制定循证治疗计划，将饮酒风险降至最低，并提供适当的后续治疗。游戏点数和视觉奖励加强了最佳实践选择，并提高了学生的参与度。第一阶段通过完成以下工作证明了产品的可行性和可接受性：1)对目标受众、学生和教职员工进行需求分析和偏好测试；2)培训框架和游戏设计文档；3)具有逼真3D角色的计划培训的半功能、交互原型；4)将用于产品第二阶段评估研究的评估；以及5)针对医科学生对原型的阿尔法/可用性测试。第二阶段将完成这项工作，为教员导师和培训主管制作《临床挑战：酒精实施指南》，以实施该游戏，并在一群医学生中评估其有效性。对游戏的稳健评估将通过随机、交叉、等待名单控制、测试前/测试后设计，从接受度、积极性以及对技能、信心和态度的影响方面评估学习者对这一新方法的反应。它将比较与酒精评估和干预相关的目标临床技能和核心能力的变化。对临床挑战的稳健评估：酒精告知我们自己的环境，并就基于游戏的3D环境培训向学生灌输临床技能和行为的能力向其他研究人员和教育工作者提供指导。

 DESCRIPTION (provided by applicant): The Clinical Challenge: Alcohol project seeks to improve outcomes of patients with at risk alcohol use or an alcohol use disorder by improving the alcohol assessment and intervention skills of medical students. To accomplish this goal we will build upon our platform independent Clinical Encounters 3D-Patient Training Environment. This project expands the Clinical Encounters 3D-Patient Training Environment by increasing realism and reframing the training as a challenging game to be mastered. Branched path learning, exposure to clinical consequences, and time-pressure heighten the challenge. Succeeding in the game and thus acquiring requisite alcohol assessment and intervention skills requires engaging in an experience, optimizing and refining skills, and choosing winning [best-practice-based, patient-centered] approaches. The game duplicates the real-world challenges of patient care, but efficiently provides a wide variety of clinical experiences. In the deliberate practice, they assess, intervene, and experience consequences that might be missed in our fragmented health care system. As an example, our simulated patients are not "lost to follow up." This project uniquely adds the challenge of time- pressure. As in today's treatment environment, time is not unlimited; players must efficiently interact with patients and rapidly commit to the proper course of action. Students conduct interviews and perform standardized assessments with virtual (e.g., computer generated) patients. They receive differing simulated patient responses (e.g., acceptance, confusion, refusal, suspicious behavior) and preceptor feedback in response to the choices and decisions they make. To categorize alcohol use and, as indicated, establish an alcohol use diagnosis, they proceed to select physical exam components and select and interpret diagnostic screens and tests. As appropriate for health professional students in the early stage of their clinical training, students develop an evidence-based treatment plan that minimizes risk of at use drinking and provides appropriate follow-up. Game points and visual rewards reinforce best practice choices and enhance student engagement. Phase I demonstrated product feasibility and acceptability by completing: 1) needs analyses and preference testing with target audience students and faculty; 2) a training framework and game design document; 3) a semi-functional, interactive prototype of the planned training with realistic 3D characters; 4) assessments to be used in the Phase II evaluative study of the product; and 5) alpha/usability testing of the prototype with medical students. Phase II will complete the work, produce the Clinical Challenge: Alcohol Implementation Guide for faculty preceptors and training directors to implement the game, and evaluate its effectiveness with a population of medical students. A robust evaluation of the game will assess learner response to this novel approach in terms of acceptance, enthusiasm, and impact on skills, confidence and attitude via a randomized, cross-over, wait list control, pre-test/post-test design. It will compare change in target clinical skills and core competencies related to alcohol assessment and intervention. The robust assessment of Clinical Challenge: Alcohol informs our own environment and provides guidance to other researchers and educators regarding the ability of game-based 3D environment training to instill clinical skills an behaviors in students.