Experiencing schizophrenia symptoms through augmented reality: from assessing students needs to prototyping a simulation
Résumé
Background: The stigma of schizophrenia, in addition to being present among mental health professionals (for a review see Valery and Prouteau, 2020), is already present among students (Sideli et al., 2021) and even associated with the level of clinical experience (Fernandes, 2022). There are a whole host of technological interventions to train professionals: they have shown contradictory results, particularly in terms of impact on stigma (for a review see Rodriguez-Rivas et al., 2022 ; Tay et al., 2023). Some have actually proven counterproductive, increasing the desire of subjects for social distance from those with schizophrenia (Brown, 2020 ; Morgan et al., 2018 ; Rodriguez-Rivas et al., 2022 ; Silva et al., 2017). Rodriguez-Rivas et al. (2022) argue that these negative outcomes may be explained by the focus of the interventions on symptoms rather than the recovery process, which may increase stereotypes and prejudice. Moreover, it has been suggested that they should be used with caution and ideally in combination with educational or contact interventions (Ando et al., 2011). We aim at developing an augmented reality (AR) intervention for training mental health students. Nonetheless, there is no data on French mental health students' training needs. Our objectives were i) to explore the training needs of mental health students for an AR instrument and ii) to use this data to prototype a unique AR simulation of schizophrenia symptoms for training purposes.
Methods: A mixed participatory approach (qualitative and quantitative) was used to analyze students' needs and comprised two stages.
Following Traynor (2015) methodology, a focus group of N=6 psychology students was organized to identify i) the relevance of a survey on the training needs of health students and ii) create the survey content. A thematic analysis of the transcript was then carried out using QDA Miner Lite. Finally, items for a survey were generated with the focus group on the basis of the thematic analysis results. The resulting questionnaire comprised 20 questions divided into 5 categories: "satisfaction with mental health training and the role of clinical practice", "legitimacy", "satisfaction with schizophrenia training", "AR tool" and "suggestions and information". It was distributed via LimeSurvey to health and social work students at University of Bordeaux. We received and analyzed 288 responses.
Results: Almost 70% (69.4%) of the sample were moderately or not at all satisfied with the information they received on schizophrenia during their initial training course. Almost 90% (88.5%) of the sample were interested in an AR simulation of the positive and negative symptoms of schizophrenia. Participants also described how they thought the simulation should be implemented: preferably in small groups (80.2%), preceded by theoretical course and a post-intervention debriefing (86.8%), with third and first person symptom’s visualization (73.3%) and retracing different moments in the life of a person with schizophrenia (49.7%).
This, with the basis of the scientific literature, enabled us to develop the AR prototype. It is a simulation of different symptoms of schizophrenia (auditory hallucinations, anhedonia, delusions, etc.) in different life contexts (school work, telephone conversations, etc.). The poster will contain images and concrete examples of the content of the simulation.
Discussion: This study enabled us to obtain, create and design an AR prototype to simulate the symptoms of schizophrenia. This prototype was built not only on the basis of the scientific literature, i.e. what works best to educate and destigmatize, but also on the basis of the actual needs of the students who will be involved in this training. Future research will focus on testing the simulation in terms of training and destigmatizing efficacy.
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