This Phase II application seeks to develop TEACH (Training to Enable & Achieve Culturally Sensitive Healthcare), a low-cost desktop-computer-based product for training culturally sensitive healthcare delivery. TEACH will serve patients from the African-American (and later other ethnic) communities confronting malignancy, as well as the clinicians who treat these patients. TEACH is based on a virtual environment that gives providers a non-threatening but realistic opportunity to practice cultural skills in a controlled manner, guided by well-validated precepts derived from studies of patients' socio-cultural context and expectations. TEACH is innovative in that it utilizes several lines of research in technologies and methods in the rapidly evolving domains of social simulation, cognitive modeling, virtual environments, and intelligent tutoring. Those lines of research are connected with emerging but currently manual methods for assessment and treatment, in the prototype for Phase II, of the African-American breast cancer patient (AABCP). When completed, this research will create a low-cost, easily-distributed, and replicable method for training in cultural competency. In addition, the technology developed here will be directly applicable to treatment of other social groups and disorders. In Phase II, focus group studies and validation studies of the efficacy of the TEACH system, both pre- and post-exposure, form the evaluative core. Data from these empirical feasibility assessment procedures will also be used to refine the TEACH Phase II design and build toward Phase III to create a fully-functional TEACH product that can be directly productized according to our commercialization plan, and whose clinical efficacy can be assessed in a formal Phase II assessment of TEACH to quantify its value to both patients and clinicians. The commercial potential for TEACH arises in large part from the increasing awareness of key distinctive aspects of the care of the AABCP, wherein both biological and socio-cultural factors impinge on our ability to furnish optimal care to a deserving population. This effort will produce a computer-based, game-like product that will provide trainees in house staff programs, including medical and surgical oncology fellows, with a realistic simulation experience of caring for African-American breast cancer patients (AABCP). Stress will be placed particularly on issues of cultural competency. The product will enable users, be they trainee or graduate physicians and other clinicians, to interact with game characters that provide the opportunity to enhance empathic understanding of the lived experience of illness from malignancy, as felt by patients in minority populations. When completed, the research will create a low-cost, easily-distributed and easily-replicated method for assessment and adjunctive management of AABCP. ? ? ? ?
