VR for Leadership Training in Healthcare
As any patient or healthcare provider will attest, effective healthcare leadership instills confidence and satisfaction, reduces anxiety and stress, and increases the likelihood of positive outcomes. This is critically important in healthcare because outcomes often involve life or death.
So, what makes an effective healthcare leader?
(Un)common qualities of effective leaders in healthcare:
- Strong behavioral repertoire
- Excellent communicators and active listeners
- An uncanny ability to behave appropriately in challenging situations
- Cultivate meaningful connections with coworkers, patients and families
- Know how and when to lead, but also how and when to be team players
- Embrace diversity, show genuine compassion, and empathetic toward others
- An ability to read situations well, think on their feet, anticipate and adjust accordingly
It is one thing to be a healthcare leader who has a cognitive understanding of leadership and can verbalize what a good leader does, but it is entirely another to know how to be a leader, to have the necessary behavioral leadership repertoire, and the situational awareness to adjust one’s behavior on the fly.
Some healthcare professionals are natural leaders, showing an innate aptitude for leadership, but all leaders, regardless of predisposed talent, have to work to become strong leaders. Unfortunately, most leadership development and training in healthcare is garnered from on-the-job experience. This requires months and years of cumulative individual interactions, and most importantly, puts healthcare professionals, patients and their families at risk. A better approach is to incorporate experiential training into the healthcare curriculum.
Surprisingly, most leadership training solutions focus on providing a cognitive understanding of leadership instead of training behavior and situational awareness directly. The assumption is that knowing what to do, will ultimately lead to behavior change and situational awareness. This assumption is not supported by the neuroscience because the learning, memory and performance systems in the brain that mediate a cognitive understanding are distinct from those that train behavior and situational awareness.
Four Learning Systems
As we have elaborated in detail in other research reports, there are four distinct learning systems in the brain. Each system is optimally tuned to specific types of learning, and critically, the training tools that most effectively recruit each learning system are different.
The cognitive skills learning system has evolved to learn facts and figures, and to acquire knowledge. Cognitive skills learning relies on working memory and attention and is mediated by the prefrontal cortex. The behavioral skills learning system has evolved to learn behaviors, and does not rely on working memory and attention. In fact, “overthinking it” hinders behavioral skills learning. Behaviors are learned through gradual, incremental, dopamine-mediated reward/punishment feedback learning in the basal ganglia. The emotional learning system has evolved to work in combination with the cognitive and behavioral learning systems to add emotional and motivational context to learning that is critical for situational awareness. Situational awareness is about nuance, but nuance that is critical to success. It is about knowing what to do and when. The critical brain regions are the amygdala and other limbic structures. Learning is about experience, and the experiential learning system provides the critical sensory and perceptual scaffolding upon which to develop cognitive, behavioral and situational awareness abilities. The experiential learning system is mediated by the occipital, temporal and parietal lobes.
One method that is effective for training healthcare leadership behaviors and situational awareness is role play and simulation. Effective role play engages cognitive, behavioral, emotional and experiential systems in the brain in synchrony. One can be in a safe learning environment and can practice the leadership skills necessary to be successful. Although an excellent training tool, role play and simulation are not consistent, scalable or available 24/7. Behavioral learning and situational awareness require extensive practice, and role play simulation is simply too costly in time and manpower to provide the necessary repetitions.
This is where immersive technologies like virtual reality (VR) can be of value. Like role play and simulation, VR engages cognitive, behavioral, emotional and experiential systems in the brain in synchrony. However, VR is consistent, scalable and available 24/7 providing the leader-in-training with effectively unlimited cost-effective opportunities for repetition training.
Healthcare Leadership Training with Patients
Suppose you are training the healthcare leadership skills needed to interact with patients and to put them at ease. You might put healthcare professionals in a broad range of situations and from multiple perspectives including their own, that of the patient, and that of a patient’s family member. For example, you might be immersed in a virtual healthcare situation where a doctor or a nurse is explaining a complex medical condition and the subsequent medical procedure to a patient and their family. In one scenario, the medical professional (who you are embodying at the time) might be showing poor communication skills by speaking too fast, using extensive jargon, and being distracted by their mobile device and medical charts in front of them. When the medical professional (you) do look up at the patient and their family, the patient and their family clearly look confused, want to interrupt to ask questions, and eventually have a look of disgust, but you continue on oblivious to their nonverbal cues of dissatisfaction.
Midway through the interaction you might embody the patient. From this new perspective, you now hear what the patient hears. They hear the medical professional speaking way too fast with the speech being almost completely incoherent. Using voice over, the patient is talking to themselves (you) and is voicing significant frustration, stress, and a lack of compassion from the healthcare professional. In this VR scenario, you are “walking a mile in each person’s shoes” and are gaining a deep understanding of what it is like for the patient. You are experiencing first hand poor communication skills, a lack of active listening, and a lack of empathy and compassion.
You might next be transported into a new healthcare situation with a different healthcare professional, patient and family members. Again, you will be immersed from multiple perspectives. In this case, the healthcare professional speaks slowly, uses plain English as much as possible, makes eye contact with the patient and each family member, and stops periodically to ask if anyone has any questions or needs any clarification. When you embody the patient or a family member you hear clear, effective and empathetic communication from the healthcare professional. Using voice over, the patient is talking to themselves (you) and is voicing relief and satisfaction in their care. Although the patient voices concern about their upcoming medical procedure, they feel very confident in their doctor, in large part because the doctor is showing the leadership needed to put them and their loved ones at ease.
Leadership Training with Fellow Healthcare Professionals
Suppose you are training the healthcare leadership skills needed to interact with other healthcare professionals whether in the emergency department, a surgical theater or around the hospital or health clinic. As with the scenarios involving patients, leadership training in professional-to-professional interactions would involve a broad range of situations and multiple perspectives including that of the leader and other healthcare professionals. For example, you might be immersed in a virtual emergency department with a head nurse who gives vague directions, provides no opportunity to ask for clarification, and is condescending and disrespectful. While embodying this nurse, you can see the stress and anxiety in the targets of her ineffective leadership style, and lack of confidence that it instills. You can embody one member of her nursing staff and can literally “feel” the anxiety rising. Using voiceover you can hear the staff member struggling to understand the instructions, verbalizing to themselves a lack of certainty about what they need to do, but also a fear of the retribution that they will feel should they ask for clarification. This whole interaction could lead to a nearly fatal administration of the wrong medicine to a patient that demonstrates the problems inherent in poor healthcare leadership.
You might next be transported into a new healthcare situation with a different head nurse and staff. In this case, the head nurse speaks slowly, makes eye contact with fellow workers, pauses for questions, and shows, through verbal and non-verbal behavior, that the rest of the team is highly valued. When you embody the other healthcare professionals you hear clear, effective and empathetic communication from the head nurse, and using voice over, you hear the team members voicing confidence and respect in their leader.
These are just two of many VR experiences that could be constructed to build leadership skills in healthcare professionals. The strength of VR is that it broadly engages multiple learning, memory and performance systems in the brain in synchrony that train the critical behavioral repertoire and situational awareness needed in healthcare leaders. Healthcare leadership can be trained at scale, 24/7, and in a cost-effective manner – one experience at a time.