Creating Patient Context: Empathy and Attitudes Toward Diabetes Following Virtual Immersion

Pandemic circumstances created challenges for doctor of physical therapy (DPT) students to understand social determinants of health (SDH) in clinical rotations. Instead of canceling clinical rotations, a virtual reality cinema (cine-VR) education series was implemented. The purpose of this project is to describe the effect of this simulated immersion on student empathy and attitudes toward diabetes.

The DPT students (n=59) participated in 12 cine-VR education modules, completing surveys at three time points as part of coursework. The students completed baseline measures of the Diabetes Attitude Scale-Version 3 (DAS-3) and Jefferson Empathy Scale (JES), and then were immersed in 12 cine-VR modules. One week after module completion, students participated in a class discussion about the modules. The students repeated the JES and DAS-3 scales at postclass and six weeks later. Three subscales from the Presence Questionnaire (PQ) were used to measure the virtual experience.

Student scores on three DAS-3 subscales significantly improved on posttest: Attitude toward patient autonomy, Mean: 0.75, SD: 0.45; t(58) = 12.742, P < .001; Psychosocial impact of diabetes, Mean: -0.21, SD: 0.41; t(58) = -3.854, P < .001; and Seriousness of type 2 diabetes, Mean: -039, SD: 0.44; t(58) = -6.780, P < .001, with lower scores six weeks later. Student scores increased on the JES and remained high (P < .001). High subscale scores on the PQ demonstrated immersion and involvement in the virtual experience.

These modules can allow for a shared student experience that improves diabetes attitudes, increases empathy, and fosters meaningful classroom discussion. The cine-VR experience is flexible, and modules allow students to engage in aspects of a patient's life that were not available otherwise.