Game-based Skills Development in Alcohol Assessment and Intervention

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 D Patient Training Environment This project expands the Clinical Encounters D 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 andquot lost to follow up andquot This project uniquely adds the challenge of time pressure As in todayandapos 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 needs analyses and preference testing with target audience students and faculty a training framework and game design document a semi functional interactive prototype of the planned training with realistic D characters assessments to be used in the Phase II evaluative study of the product and 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 D environment training to instill clinical skills an behaviors in students PUBLIC HEALTH RELEVANCE The personal financial and other costs of at risk drinking and alcohol use disorders to society are well known yet tomorrowandapos s medical students are still unprepared to time efficiently assess and intervene regarding their patients alcohol use The Clinical Challenge Alcohol project builds upon our existing Clinical Encounters D Patient Training Environment to create a challenging game to be mastered Medical students experience the real world challenges of patient care including time pressure the need to make assessment and intervention decisions and exposure to the effect of those decisions on their patients By engaging and challenging medical students to improve their alcohol assessment and intervention skills future physicians may be better prepared to assist patients with at unhealthy alcohol use and improve the health outcomes of those patients