Evaluation of a novel virtual reality training intervention to address implicit bias among healthcare workers, using an implementation science framework
There is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system. CULTIVATE (Combat...
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| Veröffentlicht in: | PloS one Jg. 20; H. 10; S. e0331324 |
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| Sprache: | Englisch |
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Public Library of Science
17.10.2025
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| Abstract | There is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system.
CULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers' empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality's utility in future healthcare practice.
Reach: 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness: There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption: Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance: Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses.
In this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy. |
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| AbstractList | Background There is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system. Methods CULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers' empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality's utility in future healthcare practice. Results Reach: 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness: There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption: Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance: Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses. Conclusions In this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy. BackgroundThere is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system.MethodsCULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers' empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality's utility in future healthcare practice.ResultsReach: 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness: There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption: Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance: Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses.ConclusionsIn this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy. There is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system. CULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers' empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality's utility in future healthcare practice. Reach: 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness: There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption: Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance: Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses. In this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy. There is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system. CULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers' empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality's utility in future healthcare practice. Reach: 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness: There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption: Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance: Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses. In this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy. Background There is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system. Methods CULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers’ empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality’s utility in future healthcare practice. Results Reach : 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness : There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption : Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance : Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses. Conclusions In this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy. There is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system.BACKGROUNDThere is a link between racial bias and poor health outcomes among Black, Indigenous, and People of Color (BIPOC). We aimed to design and evaluate a novel pilot virtual reality (VR) training program to reduce racial bias among healthcare providers in a university healthcare system.CULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers' empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality's utility in future healthcare practice.METHODSCULTIVATE (Combatting Unequal Treatment in Healthcare Through Virtual Awareness in Empathy) is a mixed-methods study utilizing virtual reality (VR) training to enhance healthcare providers' empathy towards racially and linguistically discordant patients. Participants included White-identifying clinical providers and graduate-level healthcare students, excluding those not engaged in direct patient care, BIPOC providers, and individuals unable to participate in VR training. Empathy was measured using a situational empathy scale and the Jefferson Empathy Scale (JSE) before and after the intervention, which comprised two VR modules, empathy assessments, and a qualitative interview. Quantitative and qualitative analyses were performed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. The RE-AIM model will structure a framework for understanding virtual reality's utility in future healthcare practice.Reach: 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness: There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption: Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance: Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses.RESULTSReach: 30 adults participated, mostly women (n = 21), 47% were physicians, and 8% had no prior implicit bias training. Eighteen participants completed pre- and post-VR empathy assessments and interviews. Effectiveness: There was no significant difference in mean JSE scores pre- (120.7) and post-intervention (122.2), but qualitative data indicated increased emotional responses. Adoption: Participants endorsed the intervention with a mean score of 8 (SD = 2) on a 10-point Likert scale for recommending it to others. Implementation: The program followed the pre-designed protocol. Maintenance: Participants reported improved clinical empathy towards BIPOC patients in qualitative analyses.In this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy.CONCLUSIONSIn this pilot study, participants found VR training to be acceptable and feasible. A larger sample needs to participate in the intervention to determine effectiveness. Qualitative results demonstrated that VR training enhanced empathy. |
| Audience | Academic |
| Author | Reid, Michael J. A. Wilson, Nova Mirzazadeh, Ali Taylor, Kelly D. Olmos-Rodriguez, Madelyn Dandu, Madhavi Gutierrez-Mock, Luis Harris, Savanna Welty, Suzanne Anicete, Lynhea M. Fernandez, Alicia Rojo, Elizabeth M. Harris, Orlando O. Bailenson, Jeremy N. |
| Author_xml | – sequence: 1 givenname: Madelyn surname: Olmos-Rodriguez fullname: Olmos-Rodriguez, Madelyn – sequence: 2 givenname: Lynhea M. orcidid: 0000-0003-3374-7613 surname: Anicete fullname: Anicete, Lynhea M. – sequence: 3 givenname: Nova surname: Wilson fullname: Wilson, Nova – sequence: 4 givenname: Luis surname: Gutierrez-Mock fullname: Gutierrez-Mock, Luis – sequence: 5 givenname: Jeremy N. surname: Bailenson fullname: Bailenson, Jeremy N. – sequence: 6 givenname: Ali surname: Mirzazadeh fullname: Mirzazadeh, Ali – sequence: 7 givenname: Orlando O. surname: Harris fullname: Harris, Orlando O. – sequence: 8 givenname: Madhavi surname: Dandu fullname: Dandu, Madhavi – sequence: 9 givenname: Suzanne surname: Welty fullname: Welty, Suzanne – sequence: 10 givenname: Alicia surname: Fernandez fullname: Fernandez, Alicia – sequence: 11 givenname: Elizabeth M. orcidid: 0000-0002-3640-3069 surname: Rojo fullname: Rojo, Elizabeth M. – sequence: 12 givenname: Savanna surname: Harris fullname: Harris, Savanna – sequence: 13 givenname: Kelly D. orcidid: 0000-0001-7785-1397 surname: Taylor fullname: Taylor, Kelly D. – sequence: 14 givenname: Michael J. A. orcidid: 0000-0001-6777-9619 surname: Reid fullname: Reid, Michael J. A. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/41105600$$D View this record in MEDLINE/PubMed |
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| DOI | 10.1371/journal.pone.0331324 |
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| Title | Evaluation of a novel virtual reality training intervention to address implicit bias among healthcare workers, using an implementation science framework |
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