Member of the faculty of emergency medicine Dr. Gilberto Salazar and UT Design Director Todd Polk show off a VR training tool. [Photo courtesy UTSW]
Doctors sometimes face potentially violent encounters with patients, but an innovative virtual reality (VR) training tool developed by UT Southwestern Medical Center’s Department of Emergency Medicine in partnership with UT Dallas could soon play a role in helping doctors recognize and respond to these cases.
UT Southwestern said the training tool places doctors in a virtual hospital exam room and presents a series of realistic patient encounters that allow them to practice proven de-escalation tactics.
The need to develop the program was prompted by a nationwide increase in threats to healthcare workers, the UTSW said.
“Continued exposure to workplace violence harms the mental and physical health of healthcare workers,” Gilberto Salazar, MD, associate professor of emergency medicine and of the School of Health Professions, said in a statement. “We owe it to ourselves as doctors to find better ways to deal with this problem. Through virtual reality, we can immerse users in real-life situations and teach them how to react in the most effective way.”
Emergency room violence on the rise
Recent data from the Bureau of Labor Statistics shows that healthcare workers are five times more likely than employees in other industries to experience workplace violence, which ranges from verbal abuse to physical violence, the UTSW said.
Physicians and emergency room staff are more likely to experience patient aggression than their counterparts in other healthcare settings due to the stress and pain associated with multiple emergency room visits.
UTSW said a 2022 survey by the American College of Emergency Physicians found that 85 percent of emergency physicians reported an increase in violent activity in the emergency room over the past five years.
Two-thirds of the roughly 3,000 emergency room doctors surveyed said they had been assaulted in the past year.
Partnering with UT Dallas to develop VR training
Three UTSW Emergency Medicine residents — Andrew Stratton, MD, Maria Box, MD, and Philip Jarrett, MD — developed an evidence-based educational curriculum drawn from a wide range of disciplines, including emergency medicine, nursing, psychiatry and pharmacology, UTSW said.
The curriculum included instructions on how to recognize early signs of aggression and how to de-escalate a situation with an aggressive person.
UTSW said that in developing the VR program, the team partnered with UT Dallas’ UTDesign program, which pairs North Texas companies and organizations with UT Dallas senior engineering and computer science students to find solutions to engineering problems.
The goal was to design a tool that not only puts the user in a hospital room, but also allows them to “feel” what’s going on, said Todd Polk, Ph.D., UTDesign Director for Bioengineering. This was realized by including a haptic feedback vest and gloves, mimicking the feeling of touch, along with a VR headset, UTSW said.
“When a VR individual is swinging on your chest, you actually feel like you’re being hit,” Polk said in a statement. “You get physical feedback that matches the virtual reality image.”
Further development
Salazar and Polk began their collaboration in 2020. The project received a $10,000 Simulation Innovation Award from UT Southwestern for further development.
The project has since received Institutional Review Board (IRB) approval to further study violence in healthcare settings and compare the tool’s effectiveness to other training methods.
The next version of the VR training module is being developed by Austin-based Augmented Training Systems, UTSW said. It will be used for an IRB study and potentially become a key element in the training of physicians and staff at UT Southwestern and elsewhere.
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