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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Bibliographic Details
Published in:PloS one Vol. 20; no. 10; p. e0331324
Main Authors: Olmos-Rodriguez, Madelyn, Anicete, Lynhea M., Wilson, Nova, Gutierrez-Mock, Luis, Bailenson, Jeremy N., Mirzazadeh, Ali, Harris, Orlando O., Dandu, Madhavi, Welty, Suzanne, Fernandez, Alicia, Rojo, Elizabeth M., Harris, Savanna, Taylor, Kelly D., Reid, Michael J. A.
Format: Journal Article
Language:English
Published: United States Public Library of Science 17.10.2025
Public Library of Science (PLoS)
Subjects:
Adult
Adults
Assessments
Bias
Clinical medicine
Clinical outcomes
College students
Computer applications
Effectiveness
Emotional responses
Emotions
Empathy
Ethnicity
Evaluation
Female
Females
Frame analysis
Graduate students
Health care
Health care disparities
Health care industry
Health disparities
Health Personnel - education
Health Personnel - psychology
Health services
Health status
Humans
Implementation
Implementation Science
Inclusion
Indigenous peoples
Institutional racism
Intervention
Interviews
Low income groups
Maintenance
Male
Measures
Medical personnel
Microaggressions
Middle Aged
Minority & ethnic groups
Novels
Participation
Patients
Physicians
Pilot Projects
Professionals
Qualitative analysis
Qualitative research
Race
Racial bias
Racism
Racism - prevention & control
Racism - psychology
Study and teaching
Training
Virtual Reality
Women
Young Adult
United States
United States > US
San Francisco California
ISSN:1932-6203, 1932-6203
Online Access:Get full text
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Summary: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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ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0331324