This SoTL-project investigates the impact of a VR-based educational intervention on medical students’ competency of contextualizing care and their insight into social determinants of health using both questionnaire data and group reflections. 

Teaching context

Health outcomes are not only shaped by biology, but also by social determinants of health (SDH), such as nutrition and housing. Medical students should be able to align medical decision-making with the life circumstances of the patient, known as contextualizing care. While medical students learn about SDH in theory, they are barely exposed to these social determinants during their clerkships at the hospital. 

Learning intervention

To address this need for more experiential learning with respect to SDH, this SoTL-project introduces a VR-based educational intervention in a mandatory second-year module of the medicine master programme. In this VR-lesson, students are first presented to the patient’s case. Next, students experience two first-person scenarios from the perspective of a patient living in poverty: one scenario of visiting the doctor, and one scenario of the patient’s journey home. Both scenarios are followed by guided group discussions in which students share their experiences, together creating a complete picture of the patient’s context and its implications for her health.

 Learning mechanisms

The intervention is underpinned by two interrelated mechanisms

• Presence: the subjective sense of being in the virtual environment, which causes the experience to be processed (emotionally and cognitively) as real, increasing the likelihood that insights are used by the students.
• Perspective taking: the active cognitive effort to understand the world from another person’s standpoint. 

Learning outcomes

The aim of the intervention is that students understand the complex interplay of SDH as a lived reality and understand the urgency of contextualizing care. Moreover, this intervention hopes to create an intention to translate these insights into upcoming clinical clerkships.

Research question

To what extent and why does immersive VR presence and perspective taking contribute to students’ insight in the complex interplay of social determinants of health, their sense of urgency for contextualizing care and their intention to apply this in clinical practice?

Research method

To answer the research question, a mixed-methods design combining quantitative and qualitative data will be used. Presence and perspective taking will be measured after the VR-scenarios with adaptations of existing scales. The learning outcomes will be assessed before and after the VR-lesson using self-developed questionnaires based on SDH and contextualizing care literature. Intention to transfer will be measured using a single question. Finally, the guided group reflections held after each VR scenario will be audio-recorded, transcribed and analyzed. 

References

• S. J. Weiner (2022). Contextualizing care: An essential and measurable clinical competency. Patient Education and Counseling, 105(3), 594–598.
• Doobay-Persaud, A., Adler, M. D., Bartell, T. R., Sheneman, N. E., Martinez, M. D., Mangold, K. A., Smith, P., & Sheehan, K. M. (2019). Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review. J Gen Intern Med, 34(5), 720–730. https://doi.org/10.1007/s11606-019-04876-0
• Kukshinov, E., Gini, F., Mishra, A., Bowman, N., Rooney, B., & Nacke, L. E. (2025). Seeing is not thinking: Testing capabilities of VR to promote perspective-taking. IEEE Transactions on Visualization and Computer Graphics, 31(5), 2694–2703.
• Makransky, G., & Petersen, G. B. (2021). The Cognitive Affective Model of Immersive Learning (CAMIL). Educational Psychology Review, 33(3), 937–958.
• Jansen in de Wal, J., de Jong, B., Cornelissen, F., & Brabander, C. D. (2023). Predicting transfer of training through the unified model of task-specific motivation. The Learning Organization, 30(6), 834-856.