Virtual Simulations to Train Social Workers for Competency-Based Learning: A Scoping Review

Figures & data

Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Moher et al., 2009) provides an overview of articles we identified, screened, assessed for eligibility, and included. This process resulted in a total of 31 articles that focused on virtual simulations in social work that focused on teaching competency-based skills. In the text, we discuss our three research questions based on the findings presented in these articles.

Table 1. Overall summary of virtual simulation training articles in social work

Author(s) Year	Type of Virtual Simulation	Category of Competency-Based Skills or Educational Topic	Specific Skill/Topic Taught	Methodology	Measure(s) of Effectiveness	Results
Chamley et al., 2011	Virtual world	Providing Care in Unique Situations	Working with children, young people, and their families in palliative care	Not applicable	Did not report; not applicable	Did not report; not applicable
Driver & Ferguson, 2019	Virtual world	Providing Care in Unique Situations	Offering services to a client in a home environment; relationship building and empathy	Qualitative	Students completed reflections on the virtual reality experience.	Students reported the experience was interesting, useful, engaging, and facilitated understanding of threshold concepts.
Galambos & Neal, 1999	VLEs	Specific educational topics and skills (misc.)	General (social work curriculum)	Not applicable	Review; not applicable	Review; not applicable
Goldingay et al., 2018	Video diary	Interactive case studies	Violence and abuse in a relationship	Qualitative	Open-ended text comments about the simulation (coded for themes)	Virtual simulation promoted critical thinking, ethical behavior, and reflectivity.
				Posttest	Self-reported Likert scale to assess user acceptability (e.g., [simulation] helped me engage with key definitions about violence and abuse).	Virtual simulation helped students engage with key definitions.
Lee, 2014	Virtual world	Specific educational topics and skills (misc.)	Cultural competence, focus on labeling and stigmatization	Qualitative	Open-ended reactions to the simulation, posted in an online forum.	Students found virtual simulation to be a fun and unique way to interact; was entertaining, interesting, enjoyable, exciting, and eye-opening. However, some students had technical difficulties; felt it was hard to keep track of all the conversations happening at once; and was uncomfortable at times.
				Between-subjects	Self-reported Likert scale to assess perceived learning; extent to which exercise enhanced relationships with colleagues, family members, and neighbors; comfort level working with diverse population groups.	Students who completed virtual simulation reported greater learning about diversity concepts, issues and experiences; more gain in self-awareness about perceptions related to issues of diversity; better able to understand and resolve issues related to family and classmates as compared to in-person simulation.
Levine & Adams, 2013	Virtual world	Assessment/ interview skills	Case management intake	Pre–post	Self-reported self-efficacy for conducting a case management intake.	Students felt more confident in case management from pretest to posttest.
Martin, 2017	Virtual world	Assessment/ interview skills	Intake assessment; depression and anxiety	Qualitative	Open-ended text comments about the simulation.	Students found it confusing and did not know how to work it.
				Posttest	Self-reported Likert scale to assess user acceptability (e.g., liked the virtual clinic; allowed me to apply knowledge and skills).	Students did not feel like they were communicating with a real person, were not able to be expressive, did not like using the simulation, did not find it to be a useful experience.
O’Brien et al., 2019	Interacting with virtual humans	Assessment/ interview skills	Screening, Brief Intervention, And Referral to Treatment (SBIRT) for substance use	Pre–post	Students completed the SBIRT Attitudes, Self-Perception of Skills, and Knowledge survey.	No differences for subscales (confidence in skills, importance, or attitudes), but some improvement on individual items (e.g., I am confident in my ability to screen patients or clients for alcohol/drug problems).
				Between-subjects	Students completed the SBIRT Attitudes, Self-Perception of Skills, and Knowledge survey.	No significant differences found in students’ reports of SBIRT confidence in skills, importance, or attitudes between the online course as compared to the online course with the added simulation.
Otters & Hollander, 2018	Family simulations	Providing Care in Unique Situations	Counseling family members in multigenerational household	Posttest	Self-reported Likert scale to assess user acceptability (e.g., learning more about family life with an older adult in the home was very helpful today to me as a social worker).	Students found the simulation to be helpful to them as a social worker.
Patterson & Yaffe, 1994	CAI/IVD programs	Assessment/ interview skills	General, statistics, diagnostic skills	Not applicable	Review; not applicable	Not applicable
Patterson & Yaffe, 1993	CAI/IVD programs	Assessment/ interview skills	Diagnostic and Statistical Manual diagnoses of personality disorders	Posttest	Self-reported Likert scale to assess user acceptability (e.g., how easy the simulation was to use; how much they liked it overall).	Students liked this form of learning, but found it was more difficult to use as compared to traditional trainings.
				Pre–post	Diagnostic case studies.	Students improved in their diagnostic accuracy pre- to posttest.
				Between-subjects	Diagnostic case studies.	Students did not improve their diagnostic accuracy more than the traditional training group.
Peters, 1999	VLEs	Interactive case studies	Treatment/service planning	Pre–post	Students created service plans, which were then evaluated/coded.	Students improved in their service planning skills from pre- to posttest.
				Between-subjects	Students created service plans, which were then evaluated/coded.	Students did not improve their service planning skills more than the traditional training group.
Phillips et al., 2018	VLEs	Assessment/ interview skills and specific educational topics and skills (misc.)	Diagnostic and Statistical Manual assessment and diagnosis; motivational interviewing; problem-solving therapy; cognitive behavioral therapy; managing risks; ethical dilemmas; navigating evidence-based intervention clearninghouses; case management; self-care strategies; community activism; documentation	Between-subjects	Teacher report of skills assessment (professionalism, ethics, thinking and judgment, cultural competency, social justice, evidence-based practice, person in environment, policy, current trends, and practice skills).	Students did just as well as traditional students and in fact performed better in key areas (social justice, evidence-based practice, policy).
Putney et al., 2019a	Interacting with virtual humans	Assessment/ interview skills	SBIRT for substance use with underrepresented minority groups [avatar was an African American client]	Pre–post	The SIMmersion (2018) simulation assessment was used to score students’ skills in creating a motivating conversation, using motivational interviewing principles and using tools effectively.	Students’ skills improved skills in all areas from pre- to posttest. However, cannot conclude if improvement is due to simulation or the classroom component. Descriptive information suggests students who practiced the simulation more frequently showed the highest posttest scores.
Putney et al., 2019b	Interacting with virtual humans	Assessment/ interview skills	SBIRT for substance use	Pre–post	The SIMmersion (2018) simulation assessment was used to score students’ skills in screening, brief intervention, patient management, motivational interviewing mechanisms, change planning, and patient engagement.	Students’ skills improved in all areas from pre- to posttest, with the exception of patient management. However, cannot conclude if improvement is due to simulation or the classroom component.
Reeves et al., 2015	Interacting with virtual humans	Interactive case studies	Home visit with child neglect	Between-subjects	Ability to identify signs of neglect; ability to maintain neutral facial expressions when observing signs of child neglect (using Noldus FaceFeader).	Not applicable; did not compare changes from pre- to posttest, but rather compared a group of social workers as compared to lay people.
Reinoehl & Shapiro, 1986	CAI/IVD programs	General review; not applicable	Not applicable	Not applicable	Not applicable	Not applicable
Reinsmith-Jones et al., 2015	Virtual world	Specific educational topics and skills (misc.)	To better understand oppression, discrimination, social justice. To develop skills in critical thinking, group decision making.	Qualitative	Journaling about SecondLife weekly; coded for themes.	Simulations generated real emotions, helped with empathetic understanding of events, critical thinking, reflected on their own discrimination.
				Posttest	Self-reported Likert scale to assess user acceptability (e.g., overall, SecondLife would be a good way to teach social work values and skills).	Students felt the simulations were good exercises to teach them about discrimination, group processes and decision making, strengths perspective, oppression, social work values and skills.
Seabury & Maple, 1993	CAI/IVD programs	Interview/ assessment and providing care in unique situations	Crisis counseling; group treatment	Posttest	Self-reported Likert scale to assess user acceptability (e.g., felt it was a positive learning experience).	Students felt the simulation increased their interest in and knowledge of the subject matter.
Seabury, 1995	CAI/IVD programs	Assessment/ interview skills and specific educational topics and skills (misc.)	Crisis counseling; sexism and racism	Posttest	Self-reported Likert scale to assess user acceptability (e.g., felt it was a positive learning experience).	Students felt the simulation increased their interest in and knowledge of the subject matter.
Shibusawa et al., 2006	Virtual learning environments	Assessment/ interview skills	Couples therapy	Qualitative	Focus group to assess usefulness.	Students were positive and enthusiastic about the simulation; believed it facilitated learning by allowing them to practice at their own pace. However, there was criticism that the simulation did not offer closed captioning for students with hearing difficulties.
				Posttest	Self-reported Likert scale to assess user acceptability (e.g., ease of use, whether it helped students improve communication of subject matter with classmates, effectiveness of technology for learning).	Students felt the simulation helped improve their understanding of assessment skills, general interview skills, and specific interview skills for couples, and that the design facilitated communication with their classmates regarding role plays. However, they were dissatisfied in their ability to access the simulation from home (some students reported technical difficulties).
Shorkey & Uebel, 2014	Reviews various types (CAI/IVDs, video recordings, VLEs)	Review; not applicable	Not applicable	Not applicable	Not applicable	Not applicable
Tandy et al., 2017	Virtual world	Assessment/ interview skills	Interviewing skills	Qualitative	Informal reflective paper and quasifocus groups to assess user acceptability.	Students enjoyed the experience, found it engaging and fun, and felt as if they were really there
Thurston, 1993	CAI/IVD programs	Providing Care in Unique Situations	Serving children and families in rural locations	Not applicable	Not applicable	Not applicable
Vernon et al., 2009	Virtual world	Review; not applicable	Not applicable	Not applicable	Not applicable	Not applicable
Washburn & Zhou, 2018	Interacting with virtual humans and virtual world	Review; not applicable	Not applicable	Not applicable	Not applicable	Not applicable
Washburn et al., 2016	Interacting with virtual humans	Assessment/ interview skills	Assessment skills for mental health issues (anxiety, depression, posttraumatic stress disorder)	Qualitative	Students answered open-ended questions to assess what could be improved about the simulation.	Students reported the simulation helped reduce their anxiety about doing assignments; however, it was suggested that the voice recognition software could be improved.
				Posttest	Students completed a usability feedback form.	Students reported the simulation helped them to work with actual clients, that it had a positive effect on their clinical skills, that it was easy to use, that they had confidence in the simulation, and intended to use it frequently.
				Pre–post	Students completed a diagnostic rating form, which was then coded/scored. Students also completed a basic clinical assessment skills survey.	Students improved in diagnostic accuracy and basic clinical assessments skills from pre- to posttest.
Wastell et al., 2011	VLEs	Specific educational topics and skills (misc.)	Navigating electronic systems used in children’s statutory services	Qualitative	Interview to assess user acceptability.	Students felt the simulation was convincing and engaging.
Wilson et al., 2013	Virtual world	Interactive case studies	Home visiting	Qualitative	Quasifocus groups to assess user acceptability.	Students felt the simulation was realistic and helped them practice skills in a realistic setting. However, they wanted more time to practice and wanted more support before doing the simulation.
Wodarski & Kelly, 1988	CAI/IVD programs	Review; not applicable	Not applicable	Not applicable	Not applicable	Not applicable
Wodarski et al., 1996	CAI/IVD programs	Review; not applicable	Not applicable	Not applicable	Not applicable	Not applicable

Note. CAI = computer-assisted instructional; IVD = interactive videodisk; SBIRT = screening, brief intervention, and referral to treatment; VLE = virtual learning environments.

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