Prof. Linda Sprague Martinez & Colleagues Use Virtual Reality to Teach Medical & Social Work Students About Social Health Determinants
Social Determinants of Health (SDoH), a group of factors that includes housing, income, employment, and education, are often the reason for variations in health outcomes and rates of hospitalization. Although SDoH screening during medical visits has been adopted by many health systems, medical education has continued to focus on the identification and treatment of disease at the individual level. A pilot project led by Boston University School of Social Work (BUSSW) Associate Professor Linda Sprague Martinez and colleagues at BU School of Medicine (BUMed) hopes to change that.
The teams explored whether a virtual reality (VR) learning environment can increase medical, physician assistant, and social work students’ confidence in their ability to refer, advocate and, ultimately, mitigate patients’ health-related social needs. In partnership with Dr. Pablo Buitron de la Vega at BUMed, Prof. Linda Sprague Martinez, along with BUSSW Ph.D. students Noelle Dimitri (PhD’21) and Cristina Araujo Brinkerhoff (PhD’23), brought social work and medical students together to learn how to address SDoH through virtual reality (VR). Findings from their study, “Virtual Reality Simulated Learning Environments: A Strategy to Teach Interprofessional Students about Social Determinants of Health” were recently published in Academic Medicine.
Practicing Collaboration through Multidisciplinary Medicine
Medical students often struggle to address SDoH when they begin their careers. “Generally, trainees are ill-equipped to address SDoH and are led to believe they are beyond the scope of clinical practice,” say the authors. By integrating social work into medical education, students will be better prepared for practicing medicine in the real world.
In this pilot study, fifteen medical, physician assistant and social work students from Boston University participated in Zoom-based seminars covering topics including health equity and SDoH, screening for SDoH, and barriers to accessing healthcare. In addition, they discussed team-based care and interprofessional practice. Next, students applied their learning through interactions with patients using virtual reality simulations. Working together across disciplines, students evaluated the patient together and provided appropriate resources and care. The exercise allowed medical students to think about the far-reaching impacts of SDoH, and how to best address their patient’s needs. Meanwhile, social work students took on a leadership role during the patient encounter and modeled patient engagement strategies while assessing social needs and identifying local assets.
Reviewing Feedback from Participants
The study participants noted that medical students were able to effectively address SDoH with their patients and valued the contributions of their social work colleagues. “A history taken by a social worker is automatically so much more in-depth than any social history I have been taught to take in medical school,” said one participant. Another medical student highlighted that collaborating with social work students helped them better understand patient needs before making a care plan. “I need to know more about what resources are available to patients in all aspects that are commonly a barrier to care, including housing, employment, food, insurance, medicine, and job training or searches.” Social work students, meanwhile, reported feeling empowered and saw themselves as leaders on the team.
The VR technology played a key role in aiding collaboration and participants mentioned the rich potential for this technology to be applied in more educational settings. “I thought the VR session itself was a really cool way to get some real-life practice, considering I’d never done a case with a social worker,” said a participant. “I thought that was a really valuable experience and I was surprised at how well the VR stimulation represented what a real-life scenario would be like.”
Future Research
This study provided medical educators with a new opportunity to incorporate SDoH into their curriculums. Exploring the potential of virtual reality may be the best way to prepare medical students for their patients’ complex lives and needs. Through this pilot, it was clear students from medical and social work disciplines could gain knowledge from each other, collaborate, and find viable solutions to the problems presented to them. While a larger sample size is needed if this research is to be generalizable, more research into the acceptability, feasibility, and learning outcomes provided by VR technology could open even more avenues for exploration.
Learn More About Prof. Sprague Martinez’s Research