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Virtual reality tool helps UT Southwestern physicians learn to de-escalate tense situations

Nationwide rise in aggressive encounters in the ER prompts physicians to develop training program

Dr. Gilberto Salazar of UT Southwestern (left) and Dr. Todd Polk of UT Dallas partnered to develop a virtual reality tool to train health care workers on how to respond to workplace violence.

DALLAS – Jan. 10, 2023 – An innovative virtual reality (VR) training tool – developed by UT Southwestern Medical Center’s Department of Emergency Medicine in partnership with UT Dallas – could soon play a major role in helping physicians recognize and respond to potentially violent patient encounters.

The training tool places physicians inside a virtual hospital examination room and presents a series of realistic patient encounters, allowing them to practice proven de-escalation tactics. The effort to develop the program was prompted by the nationwide rise in threats to health care workers.

Recent data from the Bureau of Labor Statistics show health care workers are five times more likely than employees in other industries to experience workplace violence, ranging from verbal abuse to physical violence.

Because of the stress and pain involved in many emergency room visits, ER physicians and staff are more likely to experience patient aggression than their counterparts in other health care settings. A 2022 survey by the American College of Emergency Physicians found that 85% of emergency physicians reported an increase in violent activity in their ERs in the past five years. Two-thirds of the nearly 3,000 emergency room doctors surveyed reported being assaulted in the past year.

Gilberto Salazar, M.D.

“The ongoing exposure to workplace violence is detrimental to the mental and physical health of health care workers,” said Gilberto Salazar, M.D., Associate Professor of Emergency Medicine and in the School of Health Professions. “We owe it to ourselves as medical professionals to find better ways to address this issue. Through virtual reality, we can immerse the users in real-life situations and teach them the most effective way to respond.”

Three UTSW Emergency Medicine residents – Andrew Stratton, M.D., Maria Box, M.D., and Philip Jarrett, M.D. – developed the evidence-based training curriculum, drawn from a broad range of disciplines, including emergency medicine, nursing, psychiatry, and pharmacology. The curriculum included instructions on how to recognize the early signs of aggression and de-escalate a situation involving an aggressive individual.

To develop the VR program, the team partnered with UT Dallas’ UTDesign Program, which pairs North Texas companies and organizations with senior UT Dallas engineering and computer science students to solve engineering problems.

The goal was to design a tool that not only put the user in a hospital room, but also allowed the person to “feel” what was happening, said Todd Polk, Ph.D., UTDesign Director for Bioengineering. That was achieved by including a vest and gloves with haptic feedback, mimicking the sensation of touch, along with the VR headset.

“When the VR individual swings at your chest, you actually feel like you’ve been hit,” Dr. Polk said. “You get physical feedback to go along with the virtual reality image.”

Drs. Salazar and Polk began collaborating in 2020 on the project, which was awarded a $10,000 Simulation Innovation Award from UT Southwestern for further development.

The project has since received Institutional Review Board (IRB) approval to further study health care workplace violence and compare the tool’s effectiveness with other training methods. The next iteration of the VR training module is being developed by Austin-based Augmented Training Systems. It will be used for the IRB study and potentially become a key element in training physicians and staff at UT Southwestern and elsewhere.

About UT Southwestern Medical Center

UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits a year.