HD HAPPENINGS: Interview with Joe Paparo on New eLearning and Virtual Reality Training Program

How can eLearning and virtual reality improve physicians' communication of brain death diagnoses? We recently sat down with Joe Paparo, Senior Hospital Services Coordinator at Gift of Life Donor Program, to find out.

“Determination of Brain Death and Family Communication Physician Training Program” (BDT4P) is an eLearning and Virtual Reality (VR) program designed to guide physicians through the various components of a brain death exam and how to communicate the meaning of these tests to a patient’s family. Developed by Gift of Life Institute (GOLI), the eLearning portion utilizes a scenario-based format, where a physician avatar narrates and guides the learning experience. Combined with a proprietary VR platform, the learner is then immersed in the ICU space as they prepare a family member for the brain death exam, perform a bedside neurologic examination, and conduct an apnea test on a virtual patient.

On August 17, 2023 BDT4P was recognized by Brandon Hall Group for excellence in hybrid learning and best use of games or simulations with the following awards: “GOLD: Best Hybrid Learning Program” and “SILVER: Best Use of Games or Simulations for Learning.”

We recently sat down with Joe Paparo, Senior Hospital Services Coordinator at Gift of Life Donor Program, to find out more about this initiative, and how he and his team rolled out the program to physicians and interns at Temple University Hospital in Philadelphia, PA.

GOLI: Numerous studies have shown variability in the determination of brain death. Additionally, many physicians lack the confidence or skill in helping families to understand this diagnosis. Have you observed these issues in your hospitals?

Joe Paparo: Absolutely. When a family is in the process of losing a loved one, the grief they are experiencing can make understanding something as complex as brain death a challenge. It often takes extra time and attention from the medical team to help families come to terms with this diagnosis. Other studies have shown that if a family does not understand brain death, they are far less likely to say yes to organ donation when the opportunity is presented. We see many families every year say no for this reason alone and we know that sometimes a more thorough explanation of brain death could have made a difference.

GOLI: How do you think this training program can help close these knowledge gaps?

JP: In addition to detailed learning about how to conduct brain death exams, the program gives essential lessons about the importance of having a family understand brain death, and provides examples of language that can be used to have conversations about this diagnosis with families.

GOLI: Let’s talk about the rollout of this program. What were some strategies that you and your colleagues in Hospital Services used to introduce the initiative?

JP: The first step was getting in front of influential hospital leaders across the region to let them know that this program is a new offering for their teams, and that it was provided at no cost. Then, our team took several steps and different approaches to show off the virtual reality component of the training to our hospital partners in various presentations and meeting forums. The Hospital Services team continues to seek out opportunities to meet with other program leaders across the region to determine how this program can be integrated into existing trainings within their health systems.

GOLI: Tell us about the potential pairing of this training with other training offered by Gift of Life Donor Program.

JP: I have begun using this module as a prerequisite to my education with groups of medical residents at Temple. My education primarily focuses on best practices for supporting the organ donation process.

GOLI: Did you encounter any obstacles while introducing the training to your hospitals?

JP: The main challenge was differentiating our training from existing programs that neurologists were familiar with. I needed to communicate some key differences between those programs and ours. This program is offered at no cost to the hospital, takes a shorter time to complete, and has the virtual reality component. Another feature is that BDT4P is a tool that can be accessed again and again by the learner as a real-time reference when completing a brain death exam. The program is very user friendly, hands on, and can be completed by someone if they do not have a neurology background. 

GOLI: The Gift of Life Donor Program rolled out the program to more than five hundred physicians and interns within its network of hospitals. You were responsible for gaining participation from Temple University Hospital. What can you tell us about this process?

JP: This rollout has certainly been an ongoing goal for us at Temple throughout 2023. I’ve had meetings with Temple’s CMO and Organ Donation Council to discuss strategies for using and rolling out our programs, and we’re still having internal discussions about how we can get this in front of as many teams as possible.

GOLI: When most people think of Virtual Reality, big bulky headsets come to mind. This program is unique in that it doesn’t require any equipment; it can be easily accessed through a cellphone, tablet, or computer. What have you heard from participants about the experience navigating the training?

JP: I honestly had that same thought when I heard of the development of this program. I was thinking, “how are we going to get everyone to use those big VR goggles to do this training?” The fact that this can be done on a cellphone or tablet is very unique, and I’ve heard only positives from participants about navigating through it. It’s a very simple process.

GOLI: What other feedback have you received?

JP: I’ve heard that it is short, easy to complete, and the VR component makes the program enjoyable and interesting.

GOLI: Do you have anything else you’d like to share about the program?

JP: I think this program can be beneficial not only for residents and new practitioners, but for attending physicians as well. The attendings are the ones who are conducting brain death exams most often, and they are the ones communicating results with families. Some of these doctors are only doing brain death exams once or twice a year, so even though this is a great tool to teach new residents about brain death declaration, it can also be a great refresher and resource for more veteran attendings.

Joe Paparo, Senior Hospital Service Coordinator

For more information contact:

Theresa A. Daly TDaly@giftoflifeinstitute.org

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