Virtual Patient Sexual History Interview Simulation

DESCRIPTION (provided by applicant): Nearly 65 million people in the United States are currently infected with an incurable sexually transmitted disease (STD). And every year, 15 million more cases are diagnosed. One in four of these new infections occur in teenagers. Nearly 1,700 adolescents have autoimmune deficiency syndrome (AIDS) and 1% of girls aged 10 to 14 have unintentional pregnancies. Physicians widely recognize the need to obtain a comprehensive patient sexual history to prevent, diagnose and decrease the prevalence of STDs, human immunodeficiency virus (HIV), and unintentional| pregnancies. However, physicians often fail to obtain a sexual history in a clinical setting, primarily due to embarrassment, poor training and few patient encounters during medical school in which to learn, practice, and master sexual interviewing techniques. Unpracticed skills can result in a knowledge gap that is carried forward into postgraduate training, and eventually, future patient care. Omitting or taking an incomplete sexual history can result in incorrect diagnosis and improper or delayed treatment. To help meet this need, we propose the development of an innovative interview simulation computer application that can be used by physicians and other healthcare providers to learn the skills required to elicit positive patient responses and take a complete sexual history. The use of computer-assisted simulation programs is changing the methodologies of medical education. Patient simulation is used by anesthesiologists, radiologists, surgeons and others to provide an endless array of possible simulated interactions, in a risk-free environment. Simulation provides the physician with a wide variety of interview situations that are not available in textbooks or videotapes. A typical physician would need several months, or even years to experience the same range of opportunities as those in a simulation program. The product we are proposing has the potential to reach a wide audience, including 800,000 allopathic and 41,000 osteopathic physicians, over 97,000 medical residents, and over 17,000 allopathic and 10,000 osteopathic students, as well as thousands of other healthcare providers who are involved in patient interview situations. Our Phase I objective and primary outcomes assessment for this program is the development of a prototype application to teach physicians to comfortably take a sexual history from five adolescent girls with varying personal characteristics. In our Phase 1 research, we will develop the profiles for five virtual adolescent female patients and appropriate interview questions and answers for incorporation into a prototype application that will randomly select patients to be interviewed. The prototype application will be personally tested by physicians and physicians-in-training as part of our Phase 1 research. This product, when completely developed in Phase II, will be a standardized, comprehensive virtual interview simulation training program that can help healthcare providers, primarily physicians and physicians-in-training, build their skills in communicating effectively with their patients, including being able to take a complete sexual history.