Virtual Reality Training Helps Physicians Discuss Firearm Safety with Caregivers

The following is an excerpt from The Cincinnati Children’s Community Impact Report. If you would like a printed copy of report, please email communityrelations@cchmc.org.

Firearm-related injuries are the leading cause of death in children in the United States. During well-child visits, pediatricians are urged to counsel about secure storage of firearms as Greater Cincinnati communities are affected by firearm injury.

Joe Real, MD, MEd, and Matt Zackoff, MD, MEd, who co-lead digital simulation in Cincinnati Children’s Center for Simulation and Research, developed a virtual reality training program to build physicians’ confidence in talking about firearm safety practices. “Pediatricians have long said our role is to keep kids safe, talking about bike helmets, pool safety, car seats,” Dr. Zackoff says. “Now we can counsel patients and families on what poses the highest risk for death for kids: firearms.”

During the 40-minute training, a learner and facilitator log on to a video call, where a physician’s office is shown with an avatar of a caregiver. Learners progress through four increasingly challenging cases, during which they practice speaking about secure firearm storage. If they do well, the avatar will respond positively. Facilitators offer feedback about how to make the conversation more effective and review secure storage devices such as cable locks, lock boxes and firearm safes.

If learners didn’t like how their words landed, they can try a different way in the virtual reality environment before they meet with a real family,” Dr. Real says. “By the end of the training, they know what they want to say and how they want to say it, increasing their confidence in discussing firearm safety with parents in practice.”

Jessica Trygier, MD, a general pediatrician, has taken the training and says caregivers appreciate the guidance about secure storage practices to keep their children safe. “The techniques in the training help facilitate a conversation, rather than just providing a huge amount of information that could be overwhelming,” Dr. Trygier says.

To develop the simulation’s messaging, the team sought input from community groups such as the West End Community Research Advisory Board and Moms Demand Action. “That co-creation really helped develop a product that was acceptable to families in Cincinnati,” Dr. Real says. “We’ve worked with rural, suburban and urban groups, really trying to make their conversation appropriate and acceptable to all those community members.”

The program is one of several efforts underway through the Cincinnati Children’s Firearm-Related Injury Task Force, which is working with the City of Cincinnati and UC Health to build the first joint pediatric and adult hospital-based violence intervention program.