Phase I:
In order to assess feasibility and measure success in development, the team will recruit 20
providers in training from multiple sites around the United States to utilize the Intake
Module to determine if the product changes provider knowledge. SIMmersion and their
collaborators successfully used this methodology in a prior SBIR Fast-Track proposal to train
health care providers in suicide assessment skills (R44 MH114710).
Hypothesis: The investigative team hypothesizes that there will be a positive gain score on
the knowledge assessment for a majority of the participants after interacting with the
training simulation for one hour.
Outcome Data:
Demographics: Participants will complete a demographic questionnaire related to age, sex,
race, ethnicity, area of licensure, years of experience, prior training experience and
experience with TGNC populations.
Usage Data: Each participant will be asked to complete the simulated conversation within the
module a minimum of two times. The program will automatically store their usage data.
Product Evaluation: Upon completion of the post-test knowledge assessment, participants will
be asked to provide feedback related to the usefulness, feasibility, scalability,
appropriateness, ability to practice, and engagement level of the simulation using Likert
scales (0-10) and open-ended questions.
Phase II:
Control Group: Students randomized to the control group will be given an electronic copy of
the Guidelines for Psychological Practice with Transgender and Gender Non-Conforming People
(APA, 2015) and asked to take notes in the pdf document. The amount of time students spend on
the document and note-taking will be recorded and notes will be analyzed for content. As an
incentive, the participants in the control group will be given access to TTACS after they
complete the post-intervention assessment.
Educational Intervention: The educational intervention will be TTACS, the training program
with simulated roleplays. Each participant will be asked to schedule 10 hours of time to
utilize the simulation. In order to ensure all participants adhere to the minimum
intervention requirements, each will be asked to schedule training time with a member of the
research team. Participants will attend an initial training session where each participant
will receive a short orientation about the product and its capabilities. Participants will
attend an initial training session at one of two sites Psychology Department at Towson
University or SIMmersion's office in Columbia, MD based on participant preference. Subsequent
training sessions may be completed at Towson, SIMmersion or can be completed individually.
Participants will receive confirmation emails the day before a scheduled session and a phone
call to reschedule any missed sessions.
While the program will be set up as a ready-to-use training package, prior research efforts
have shown that requiring participants to utilize the training product in a computer lab
provides consistent compliance rates which lead to a more accurate evaluation of the
product's efficacy. However, given the demanding nature of practicing students' schedules,
requiring all intervention usage at our two sites may be difficult for participants. The
research team anticipates that the proposed method will accommodate for participant schedules
while still ensuring intervention compliance.
Demographic Collection: All training participants will complete a questionnaire designed to
gather background information on demographic characteristics and other important
characteristics. Information collected will include age, gender, race, program enrollment,
prior exposure/training in working with TGNC individuals, and current coursework. This data
will permit between-group comparability during subsequent data analysis.
Performance Improvement Assessment Using Standardized Patient Methodology (H1-H4). The skills
test will consist of two Standardized Patient (SP) testing stations, as described above. Each
station is set up in 30-minute units. Prior to counseling each SP, participants will have 5
minutes to review scenario instructions. This will provide background information on the
client's previous encounters with the clinician, if any. Then, the participant will have 25
minutes to work with the SP.
Ten SPs will be recruited and trained by the staff at Towson University and Dr. Mastroleo.
Training will be conducted in 3-hour sessions and include scenario, demonstration role-plays
and/or videotapes, observed script practice sessions, group discussion of the character they
are portraying and the questions that may be asked. They will also be taught how to time and
score (using the checklist) the sessions.Dr. Mastroleo has been training SPs for intervention
trials for the past 10 years and is well equipped to do so for this project.
Methods to Ensure Reliability of Standardized Patient Performance: All SP interactions will
be audio recorded for review and further evaluation. The research team will review the first
5 tapes of each SP and every 5th tape thereafter to ensure the SPs are following the script
and scenario protocol. It is the researchers' experience that 10-20% of SPs are not able to
follow the script despite extensive training. Utilizing this review methodology identifies
these SPs immediately so they can be replaced with SPs that can adhere to the study
protocols.
Training Experience Questionnaire: Upon completion of the post-intervention SP encounters,
each participant in the intervention arm will be asked to complete a Training Experience
Questionnaire (TEQ) which will allow them to evaluate TTACS using a series of 5-point Likert
scale questions and open-ended prompts. The research team anticipates that participants will
indicate agreement or strong agreement on the TEQ that the product is (H5) an acceptable
training tool (i.e., easy-to-use, realistic, relevant) and contributes to their skill
development.