Game-based Skills Development in Alcohol Assessment and Intervention

 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，我们将建立在我们的平台独立的临床遇到3D患者培训环境。该项目通过增加现实主义和重新构建培训作为一个具有挑战性的游戏来扩展临床遇到3D患者培训环境。分支路径学习、暴露于临床后果和时间压力增加了挑战。在游戏中取得成功，从而获得必要的酒精评估和干预技能，需要参与的经验，优化和完善的技能，并选择获胜[基于最佳实践，以病人为中心]的方法。该游戏复制了现实世界的病人护理挑战，但有效地提供了各种各样的临床经验。在有意识的实践中，他们评估，干预和体验可能在我们支离破碎的医疗保健系统中错过的后果。作为一个例子，我们的模拟病人没有“失去后续行动。“这个项目独特地增加了时间压力的挑战。在今天的治疗环境中，时间不是无限的;玩家必须有效地与患者互动，并迅速采取适当的行动。学生进行面试，并进行标准化的评估与虚拟（例如，计算机生成的）患者。它们接收不同的模拟患者响应（例如，接受，困惑，拒绝，可疑的行为）和导师反馈，以回应他们所做的选择和决定。为了对酒精使用进行分类，并根据指示建立酒精使用诊断，他们继续选择体检组件，并选择和解释诊断屏幕和测试。作为适当的卫生专业学生在他们的临床培训的早期阶段，学生制定一个循证治疗计划，最大限度地减少在使用饮酒的风险，并提供适当的后续行动。游戏积分和视觉奖励强化了最佳实践选择，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）目标受众学生和教师的需求分析和偏好测试; 2）培训框架和游戏设计文档; 3）计划培训的半功能交互式原型，具有逼真的3D角色; 4）用于产品第二阶段评估研究的评估;和5）与医学生一起进行原型的alpha/可用性测试。第二阶段将完成这项工作，为教师和培训主任制作临床挑战：酒精实施指南，以实施游戏，并评估其与医学生群体的有效性。一个强大的游戏评估将评估学习者对这种新方法的接受程度，热情，以及通过随机，交叉，等待列表控制，前测/后测设计对技能，信心和态度的影响。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。《临床挑战：酒精》的强大评估为我们自己的环境提供了信息，并为其他研究人员和教育工作者提供了关于基于游戏的3D环境培训向学生灌输临床技能和行为的能力的指导。

 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.