Ohio University

CHSP leads interdisciplinary team in creating virtual world that addresses implicit bias in healthcare

CHSP leads interdisciplinary team in creating virtual world that addresses implicit bias in healthcare
In this capture from a virtual reality presentation, the patient, Destiny, converses with her nurses. (Cinematography by Matt Love)

Destiny is a female in her early 20s. She’s from Appalachia; she’s pregnant, not married, and her parents aren’t really in the picture.

She’s also addicted to opioids.

Did you make any personal assumptions about this person?

If you were a practicing healthcare professional, could your personal bias impact the level and/or type of medical care that you would ultimately provide to this individual?

With the help of virtual reality and funding provided by Ohio’s Medicaid Technical Assistance and Policy Program (MEDTAPP), these questions and more are being examined and addressed by an interdisciplinary team at Ohio University as part of an innovative new project entitled “Virtual Reality Simulations to Address Provider Bias and Cultural Competency.”

The VR project aligns with one of OHIO President M. Duane Nellis’ strategic pathways for increasing interdisciplinary collaboration, public service and being a positive catalyst of economic and quality of life change in Appalachia.

Dr. John McCarthy, MS, BM, CHSP associate professor of communication sciences and disorders and interim associate dean for research and graduate studies, serves as the co-primary investigator for the virtual reality simulations with Dr. Deborah Henderson, MSN, BSN, CNE, professor and director of the School of Nursing.

Destiny was developed by OHIO’s College of Health Sciences and Professions (CHSP). She is joined in the program by Lula Mate Tate, a similar VR character developed by the Heritage College of Osteopathic Medicine.

“We tried to think about what kind of issues people are confronting and what do we want them to know from a cultural competency perspective,” McCarthy said. “We want our providers to really think about what they’re bringing to interactions with people who live in this region.”

While the Heritage College opted to create an elderly diabetes patient, CHSP created a younger person who embodied a number of different issues.

“We wanted to bring up some strong feelings in people so they would have to confront that provider bias,” McCarthy said.

The Scripps College of Communication and School of Dance, Film and Theater have joined CHSP and the Heritage College to create 360-degree, virtual reality worlds for both Destiny and Lula Mae. Participants will be able to enter these worlds and view 10 unique scenes involving each character. The scenes were shot at Grover Center and other locations around the Athens Campus. Destiny’s scenes involve scenarios most relevant to nursing and social work fields.

“With this project, students can be placed in a virtual reality world that provides them with an opportunity to practice and correct and provide more culturally sensitive care,” Henderson said.

Henderson described one of the VR scenes in which a perfectly capable nurse handled Destiny with great care, and no red flags were seen with her approach. However, when the nurse handed Destiny’s file to another nurse, some of her implicit bias was revealed, potentially influencing the second nurse’s bias as well.

“We didn’t want to have nurses view somebody who’s just not very good at their job. That’s not going to get them to confront anything. We’re not saying anything about their skill level,” McCarthy said. “What we’re saying is that there’s an area outside of that and it creeps in. What does that do and did you think about that? Can you maybe catch yourself doing that and maybe you can handle it but are you affecting somebody who is maybe new to the job?”

McCarthy and Henderson also thanked Kerri Shaw, MSW, LISW-S, field director for the social work program, for her team's work in incorporating social work scenarios into Destiny's case, including a scenario in which Destiny is initially provided with too many resource options and becomes overwhelmed. 

Shaw hopes that such a scenario will ultimately help social workers and other healthcare professionals to avoid making assumptions about their clients. She stressed that providing quality care requires social workers to first meet clients where they are by establishing a trusting and therapeutic relationship before sharing resources and information. 

McCarthy said a motivational interviewing component is also included for Destiny’s simulation experience.

A final rendering of Destiny’s simulation is expected to be completed by the end of May and be presented during an Ohio University conference on June 29. In addition to the virtual reality component, a website is being developed that will feature the presentation in 2D and include talking points for before and after the viewing.