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Accepted for/Published in: JMIR Human Factors

Date Submitted: May 16, 2025
Date Accepted: Feb 28, 2026

The final, peer-reviewed published version of this preprint can be found here:

An Automated Curriculum to Support Behavioral Health Counseling Among Pediatric Residents: Usability Study

Fleck L, Herbst R, Meisman A, Talbot T, Glisson M, Remington M, Cheek W, Goldson M, Real F

An Automated Curriculum to Support Behavioral Health Counseling Among Pediatric Residents: Usability Study

JMIR Hum Factors 2026;13:e77438

DOI: 10.2196/77438

PMID: 42019041

An Automated Curriculum to Support Behavioral Health Counseling Among Pediatric Residents: Usability Study

  • Liam Fleck; 
  • Rachel Herbst; 
  • Andrea Meisman; 
  • Thomas Talbot; 
  • Michael Glisson; 
  • Max Remington; 
  • Walter Cheek; 
  • Micah Goldson; 
  • Francis Real

ABSTRACT

Background:

Behavioral health concerns are common in pediatric practice with pediatricians reporting a lack of skills related to providing effective behavioral management strategies to parents. A prior human-facilitated, screen-based virtual reality (VR) training curriculum proved effective in enhancing behavioral health communication skills among pediatric residents. However, barriers to spread and scale of the curriculum included the need for human facilitation.

Objective:

This study explored the usability an automated VR-based behavioral health anticipatory guidance curriculum for pediatric residents.

Methods:

Through partnership with BreakAway Ltd., an automated prototype was developed that required verbalization by users to support progress through simulated scenarios and included receipt of personalized feedback to enable deliberate practice of communication skills. Usability of the prototype was assessed using mixed methods that included in-person completion of the prototype, a semi-structured interview, and completion of survey instruments including the System Usability Scale and the Measurement, Effects, Conditions: Spatial Presence Questionnaire.

Results:

Nine individuals completed usability testing. Qualitatively, users indicated that the system was easy to use, realistic, gamified, and likely most helpful for novice learners. Quantitatively, the ease of system usability was rated highly with some limitations related to spatial presence noted.

Conclusions:

Usability testing of an automated curriculum to support behavioral health counseling skills in pediatric residents was completed providing data to support adaptations in preparation for implementation.


 Citation

Please cite as:

Fleck L, Herbst R, Meisman A, Talbot T, Glisson M, Remington M, Cheek W, Goldson M, Real F

An Automated Curriculum to Support Behavioral Health Counseling Among Pediatric Residents: Usability Study

JMIR Hum Factors 2026;13:e77438

DOI: 10.2196/77438

PMID: 42019041

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