271 - Impact of a Remote Virtual Reality Curriculum on Interprofessional Conflict Management Communication Skills

Poster Number: 271
Publication Number: 271.331

Lisa E. Herrmann, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Laura E. Elliott, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Karen Jerardi, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Matthew W. Zackoff, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Melissa Klein, Cincinnati Children's Hospital Medical Center ; University of Cincinnati, Cincinnati, OH, United States; Francis Real, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Conflict management communication skills are essential for effective interprofessional team functioning. Existing conflict trainings, often using role play or high-fidelity simulation, are time and resource intensive. Virtual reality (VR) may enhance provider communication skills, but its effectiveness for conflict communication training is unknown.

Objective: To determine the impact of a VR-based curriculum delivered via Zoom on clinicians’ interprofessional conflict management skills

Design/Methods: This randomized control pilot study included pediatric hospital medicine attendings, fellows and nurse practitioners. Participants were randomized into intervention (I) or control (C) groups. The I group underwent conflict communication VR training in Winter 2021, while the C group completed a pre-existing VR communication training on influenza vaccine refusal to provide similar exposure to VR-based training. VR sessions were delivered via Zoom due to the COVID-19 pandemic. 2-3 months following their VR training, participants in both groups completed a standardized VR simulation, also via Zoom, requiring management of a new interprofessional conflict. These recorded VR scenarios were independently reviewed by two blinded raters using a 12-item rubric of observable cooperative conflict management behaviors and a 5-point Global Entrustment Scale (GES). The assessment rubric was adapted from existing communication assessment tools with iterative refinement by experts. Raters participated in an initial rater training session, to improve consensus related to rubric scoring. Interrater agreement (IRR) was calculated using Cohen’s kappa. Items with an IRR of kappa < 0.5 or 100% positive percent agreement were excluded from subsequent analysis. Differences on scored behaviors between I and C groups were evaluated using generalized linear models to account for the two raters.

Results: Forty of 51 participants (78%) completed this study. Four participant videos were used in rater training. The I group (n=17) demonstrated significantly better performance on the GES (p=0.003) and specific evidence-based conflict management behaviors, including summarizing team member’s concerns (p=0.02), and explicitly checking for acceptance of the plan (p=0.02). As shown in Table 1, many scores trended higher for the I group.Conclusion(s): In this pilot study, I group participants demonstrated enhanced conflict management skills compared to controls. VR via Zoom may be an effective method of communication training that could enable broad scalability. Next steps include further rubric refinement and larger scale implementation.
Table 1. Conflict Communication Virtual Reality Performance