Virtual Reality Teaches Students About Real Bias

Students are drawn to the health care professions because they want to help people. But neither the health care environment nor the practitioners are immune to bias and discrimination. So how do you teach students what bias may look like and how to communicate and respond appropriately in a clinical setting?

For students in the occupational therapy program at Columbia University Vagelos College of Physicians and Surgeons, such teaching happens with virtual reality simulations that help them recognize bias, discrimination, and microaggressions in interactions that may include patients and colleagues from many different backgrounds.  

The simulations are the foundation of a new course, “Diversity, Equity, and Inclusion and Professional Skills,” that was funded by the Columbia Provost’s Center for Teaching and Learning as part of a university-wide mission to enhance DEI in the classroom and in clinical practice. 

Inspired to teach students about bias and discrimination

Razan Hamed, PhD, associate professor of rehabilitation & regenerative medicine, was inspired by her own experiences to create the course. 

“I have been told blatantly that no matter how qualified I am I will likely never be offered a leadership position because of my last name,” Hamed says. “That made me want to fight discrimination and bias so that all OT experts, no matter what their background, can share their talents.” 

But talking openly about bias in a group setting isn’t easy, and learning about DEI through lectures may not be the most effective way to keep students engaged in this delicate and often personal topic. Instead, Hamed turned toward virtual reality.  

“The VR system is a generation-friendly immersive teaching tool that allows students to think in a non-traditional way about what bias looks like by letting them experience bias through an avatar.” 

Learning about bias is no game

With the help of Columbia’s emerging technology team, Hamed found a virtual reality software system that is used in many corporate settings to teach DEI concepts. 

Using the VR headset, students are shown a variety of realistic clinical scenarios including language and situations that are laden with bias or microaggressions. In one scenario, a white patient refuses care from a Black health care provider. In another, a health care professional asks an Asian colleague to work with a Chinese patient though the colleague had previously shared that he was born in the United States and doesn’t speak Mandarin. In some scenarios, the student adopts the role of the target, in others the role of the offender. In either case the avatar may have a different gender or identity than the student, which allows the students to empathize and understand what it feels like to be the target or perpetrator of microaggressions or bias.  

The students press the controller each time they think they have encountered bias in a scenario. Then they are prompted to pick a course of action.  

“Once the students put on the VR headset, they can experience these scenarios and practice addressing instances of bias at their own pace in a private, non-judgmental space, without the pressure of interacting with the instructor or classmates and articulating their thoughts on the spot,” Hamed says.  

When the scenario is over, students can compare how many instances of bias they identified with those identified by the software and reflect privately on what they missed and how they might respond if they encountered a similar situation in the clinic.  

“The group discussion we have after helps the students get into the mindset about what’s appropriate and what’s not in a clinical environment, which will help them transition into their roles as occupational therapists,” Hamed says.