Feasibility and Acceptability of a Virtual Reality Curriculum to Support Firearm Safety Counseling Skills Among Pediatric Residents

<b>Background</b> Firearm-related injury is the leading cause of death among US children and adolescents. Residents across specialties report low preparedness to provide firearm safety counseling. Virtual reality (VR) may offer a modality to support residents' skills through deliberate practice in a simulated setting. <b>Objective</b> To describe a novel screen-based VR curriculum on firearm safety counseling and report feasibility and acceptability outcomes, including residents' perceptions. <b>Methods</b> Fifteen senior pediatric residents were recruited from 2 large children's hospitals. The curriculum included 4 simulated scenarios in VR during which residents verbally counseled graphical caregivers who responded in real time, driven by a human facilitator. The curriculum focused on introducing firearm safety, discussing storage devices, and navigating the conversation through motivational interviewing. Following participation, residents completed the Measurement, Effects, Conditions Spatial Presence Questionnaire (MEC-SPQ) to indicate the degree of immersion in the virtual environment. Additional study data were derived from semistructured interviews. We used a constructivist general inductive approach to explore perspectives via coding and pattern identification. <b>Results</b> Quantitatively 14 of 14 residents completing the survey indicated notable attention allocation and spatial presence in the VR environment. During the 15 interviews, residents identified VR as an acceptable modality for deliberate practice of firearm safety counseling skills in a realistic, scaffolded manner. They indicated the rehearsal of specific verbiage as critical to supporting behavior change. Notably, residents reported that the training helped overcome prior barriers to counseling by providing a framework for efficient counseling. <b>Conclusions</b> Among pediatric residents, VR proved a feasible and acceptable modality for training on firearm safety counseling.