In this episode of Perspectives on Health and Tech, Oracle Health sits down with Dr. Petal S. Abdool, Geriatric Psychiatrist and Medical Director of the Centre for Addiction and Mental Health (CAMH) Simulation Centre, to explore how virtual reality is transforming the way clinicians are trained to assess suicide risk and respond to opioid-related emergencies. Together, we discuss why immersive simulation is emerging as a powerful tool in mental health education, how VR creates a safe space for clinicians to practice complex and emotionally charged conversations, and what early insights reveal about its impact on learner confidence and preparedness. The conversation also looks ahead to how technologies like VR, AI, and connected clinical systems may shape the future of training the next generation of mental health professionals. ————————————————————- Episode Transcript: 00;00;13;09 – 00;00;30;03 Intro Welcome to Perspectives on Health and Tech podcast. Brought to you by Oracle Health. In this series, we have conversations on creating a seamless and connected health care world where everyone thrives. Let’s get started. 00;00;30;06 – 00;01;00;16 Steve Herron Hello everyone. I’m Steve Herron and I lead the continuum product group at Oracle Health. That includes behavioral and mental health rehabilitation, post-acute care, and social determinants of health. And today, I’m especially excited to talk about innovation at the intersection of mental health education, clinical readiness, and emerging technology. Suicide risk assessment is one of the most critical and most difficult skills clinicians must develop. 00;01;00;19 – 00;01;30;05 Steve Herron These are high stakes conversations that demand empathy, clinical judgment, and confidence, often formed under intense pressure. Yet historically, clinicians have had limited opportunities to practice these skills in a realistic but safe environment. That’s where innovation becomes essential. At Oracle Health, we’re fortunate to work with organizations that don’t just adopt technology, but thoughtfully reimagine how it can support clinicians and patients. 00;01;30;08 – 00;02;00;13 Steve Herron One of those organizations is the center for Addiction and Mental Health, or CAMH in Toronto, Ontario, Canada. During a recent visit, CAMH. I had the opportunity to tour their campus and spend time in their Virtual Reality Learning center. What stood out immediately was how VR is being used not as a novelty, but as a rigorous, evidence-based training tool to prepare clinicians for some of the most complex moments in mental health care. 00;02;00;15 – 00;02;29;19 Steve Herron So today, we’ll explore how CAMH is using virtual reality to train clinicians in suicide risk assessment and opioid overdose recognition. What they’ve learned so far, and what this means for the future of clinical education. I’m delighted to be joined by today’s guest, Doctor Petal Abdool geriatric psychiatrist, educator, faculty member at the University of Toronto and medical director of the CAMH Simulation Center. 00;02;29;22 – 00;02;33;18 Steve Herron Doctor Abdool, thank you so much for joining me. 00;02;33;20 – 00;02;44;21 Dr. Petal Abdool Thank you so much, Steve, for this wonderful invitation. It’s a true pleasure to be here and to have the chance to highlight this important work. 00;02;44;23 – 00;02;59;24 Steve Herron To start us off. For listeners who may not be familiar with CAMH or your role there, could you share a little bit about a CAMH’s mission and your work at the simulation center? Particularly as it relates to education and training in mental health? 00;02;59;26 – 00;03;45;01 Dr. Petal Abdool Absolutely. As you said, CAMH, which is Canada’s largest mental health teaching hospital, fully affiliated with the University of Toronto. And our mission is to transform the way we understand and treat mental illness to care; excellent care, research, education, and system advocacy. Our strategic mission is to get upstream advance care and to lift societal health. And at the simulation center, we see our role is to turn that mission into a concrete learning experience that can prepare clinicians for the realities of mental health and addiction care not just for today, but for tomorrow. 00;03;45;03 – 00;04;10;21 Dr. Petal Abdool In my role as a geriatric psychiatrist, an educator, and the inaugural medical director of the CAMH Simulation Center, I should also add that I’m the faculty lead for simulation at the University of Toronto. So, this gives me a wonderful position to oversee programs that use these modalities. And in the past, we’ve worked with standardized patients, team-based simulations. 00;04;10;23 – 00;04;40;11 Dr. Petal Abdool And now we’ve opened the door to technology enabled simulation like virtual reality. And this is in order to help our learners to practice high stakes communication, clinical reasoning and to afford collaborative care. A key focus that we have is to give our clinicians a safe space to rehearse difficult conversations, like the ones you mentioned around suicidal ideation, substance use, trauma, stigma. 00;04;40;13 – 00;05;03;24 Dr. Petal Abdool And we want to do this a bit before and alongside real clinical encounters with patients and families in terms of the gaps, we see a disconnect between what clinicians know on paper and how confident they feel when they’re in the room with patients, and especially as it pertains to mental health and addictions. With the advent of the pandemic. 00;05;03;29 – 00;05;27;06 Dr. Petal Abdool There were there was a decrease in the number of clinical encounters that many of our trainees had. And that was a gap that allowed us, to acquire funding to build a virtual reality suicide risk assessment training that you were referring to, as well as an opioid overdose management training. So, here we see the opportunity that afforded us. 00;05;27;09 – 00;05;57;10 Dr. Petal Abdool Learners are able to address that worry they have about seeing the wrong thing, or missing subtle cues or escalating distress in the patient. And because of the pandemic, back then, they only had a handful of supervised opportunities to manage these situations in their training. And so simulation actually became so crucial and powerful back then. It allowed us to design these opportunities for repeated structured practice that allowed for what we call mastery learning. 00;05;57;12 – 00;06;12;09 Dr. Petal Abdool And they get the feedback so that by the time they get to the bedside, they’re not having their very first high stakes conversation in a real with a real person in crisis. 00;06;12;11 – 00;06;38;05 Steve Herron Thank you. You know, one of the most compelling things that I saw during my visit was the intentional choice to use virtual reality. Not just simulation. More broadly, but immersive VR specifically. What led CAMH to explore VA VR as a training modality and what challenges or limitations in traditional training were you hoping it could help address, especially when it comes to suicide risk assessment? 00;06;38;07 – 00;07;03;01 Dr. Petal Abdool So the move to virtual reality really grew out of two observations. I mentioned that the pandemic had limited the ability for trainees to be in the clinical setting. Many of them had had to pivot to a virtual, platform in order to learn. And so that really allowed us to think, hey, how can we innovate here? How can we increase the authenticity of the virtual platform? 00;07;03;04 – 00;07;30;00 Dr. Petal Abdool And then the other thing is that suicide risk assessment is such a core competency for many clinicians. Yet the opportunities to practice are limited and variable and dependent on, you know, chance to a great extent. We see that the traditional methods that we’re using, like lectures, checklists, even roll, please don’t always capture that emotional weight and that complexity that you get when you have a real conversation. 00;07;30;03 – 00;07;45;12 Dr. Petal Abdool And so that’s where we felt that the opportunity to explore and study the effectiveness of virtual reality with something, CAMH as a leading institution in mental health needed to embrace and explore. 00;07;45;15 – 00;08;07;27 Steve Herron That’s exciting. And I’ll tell you that being there and experiencing it firsthand, it actually did. You know, I was surprised at how much it impacted me emotionally, being in that virtual reality. And even though I was an observer in the room, I wasn’t actually the one with the goggles on. But it still made my heart rate come up. 00;08;07;29 – 00;08;27;07 Steve Herron You know, as I observed what was happening in the room and the the situation as it was occurring. I am curious what other happens with other clinicians. So for clinicians who may feel skeptical about VR going into it, what tends to change once they experience that kind of immersive learning firsthand? 00;08;27;09 – 00;08;45;10 Dr. Petal Abdool Well, I’m really I’m happy to hear how moved you were by the experience. I will say that, we always do a brief with our learners, and we say, if you want to get the most out of this experience, you’ve got to suspend your disbelief and allow yourself to become immersed. And that’s where the true learning can happen. 00;08;45;12 – 00;09;07;03 Dr. Petal Abdool I have some funny stories where we we had trainees in and we built two experiences, two avatars, and you had to interview the avatars. And of course, as someone who is in the user testing phase of that virtual reality, my goal was to try to break it. So I’m in there doing all the wrong things to see how it would evolve. 00;09;07;05 – 00;09;30;25 Dr. Petal Abdool And I jumped in and I didn’t try to build rapport with the avatar, with the patient. And I just asked, you know, questions. And he moved his body in a very irritated manner. And I jumped because even though it was an avatar, like you said, it does still trigger that emotional response. And on one occasion we were training some pharmacy students and the time was up. 00;09;30;25 – 00;09;54;13 Dr. Petal Abdool We gave them a set amount of time to experiment and to play, and one of the students came up to me and she said, is she going to be okay in there? And I said, yeah, don’t worry about it. We’ve got it. We’ve got it under control. And so for me, it was so gratifying to have that question asked because I realized that she had truly invested and engaged with the with the experience. 00;09;54;13 – 00;10;03;26 Dr. Petal Abdool And so I do believe that is laying the groundwork for a really authentic and, evolutionary experience. 00;10;03;28 – 00;10;28;22 Steve Herron Yeah, I know it definitely had that impact on me. Question for you, two of the programs that really stood out to me, were the ones that focused on suicide risk assessment, and then opioid overdose recognition. Both are very emotionally complex, time sensitive situations. Can you walk us through what the VR experience actually looks like for a learner? 00;10;28;24 – 00;10;38;18 Steve Herron And how do avatar based patient interactions, guided feedback, and decision making moments come together to build a clinical skill? 00;10;38;20 – 00;11;02;26 Dr. Petal Abdool That’s a great question. So we built two different trainings. One is a suicide risk assessment that it was geared towards clinicians. So frontline clinicians who want to acquire that comfort and expertise with asking difficult and sensitive questions. And so the two training scenarios that we built were two very different patients. One was a male, one was a female. 00;11;02;28 – 00;11;27;03 Dr. Petal Abdool They had different levels of risk, and one had, a comorbid substance use. And what we wanted to do was try to mirror the complexity of our everyday interactions with patients and sort of that holistic approach to asking not just about what their thoughts were like, but about their lifestyle, their stressors, and their supports in the community. 00;11;27;05 – 00;11;52;05 Dr. Petal Abdool So in the training, it’s a typical the learner enters a virtual clinical space and they interact with a preceptor, a nurse educator who introduces herself and explains that she was running a group and she was worried about one of the patients. And then she gives them a clipboard with, you know, demographic information and then invites the learner to go in and have a conversation with the avatar, with the patient. 00;11;52;08 – 00;12;22;22 Dr. Petal Abdool And then, once they’ve explored the learner is guided throughout the experience by selecting drop down a questions from a drop down box. And these these questions and the responses that they receive are aligned with evidence based assessment domains. Things like exploring suicidal thoughts, intention plan, access to means, past history, whether there’s substance use, what are the protective factors that that patient may have, might have. 00;12;22;24 – 00;12;46;27 Dr. Petal Abdool And another objective of the training is to help the learner learn to convey empathy and validation and to build rapport, which is so crucial for people to open up and reveal their innermost thoughts. So, the patient will respond not just with words, but in terms of their tone, their body language, and the emotional cues change depending on how the learner engages with them. 00;12;47;00 – 00;13;10;14 Dr. Petal Abdool Once they’re done that training, they come back out. They meet with the preceptor avatar, who then acts as though they’re a virtual supervisor, prompting the learner to make sure they didn’t miss any key risks or domains, and then gently challenging them to move on. And so that’s really, a beautiful opportunity for the learner to pause, reflect, and then continue. 00;13;10;17 – 00;13;37;23 Dr. Petal Abdool And at the end they get a summary with regard to the risk of the patient. The other thing is that we built the virtual reality with the understanding that maybe not every learner wants to put on a headset and engage in such an immersive environment. And so we also have a complimentary desktop training that anyone can access and go through the same content, and hopefully get the same learning experience. 00;13;37;26 – 00;13;54;11 Steve Herron Can you talk about that a little bit? How does the VR headset based simulation compare with those other, asynchronous or more flexible delivery models in terms of, you know, access to it, but also then learning impact? 00;13;54;14 – 00;14;22;03 Dr. Petal Abdool So we did study, the virtual reality experience, and compared it to just the desktop experience. What we found were, you know, pretty interesting in that the learning outcomes were very comparable between both trainings. But learners found the VR to be more engaging, more immersive, more appealing, especially for the younger folks who grew up, you know, in that, digital world. 00;14;22;06 – 00;14;50;12 Dr. Petal Abdool However, there were also and this aligns with the what we see in the published literature, there were about 10 to 30% of participants who might have had mild to moderate what we call cyber sickness symptoms, you know, feeling a little bit nauseous or just not wanting to be in that environment. And so that’s why we were very grateful that we had the opportunity to offer people, the option to not don the headset and to to sit with a desktop instead. 00;14;50;14 – 00;15;19;15 Dr. Petal Abdool I would say the learning outcomes were comparable in terms of confidence, and the learning objectives that we, we designed the training to achieve were completed equally effectively in both. I think the advantage of the virtual we out of the desktop is that we can disseminated more widely right here in Canada, we have a lot of different people in the North who may not have access to conferences or training opportunities. 00;15;19;19 – 00;15;39;00 Dr. Petal Abdool So we can share links to the desktop, and they can do this training. The virtual reality you would have to order headset we’d have to share that content with you, or you’d need to come to the sim center physically to engage with it. And so I think that, there are advantages and disadvantages to both. 00;15;39;02 – 00;16;07;09 Steve Herron Yeah, that’s amazing that it’s got that ability to be able to be pushed out to literally anybody who’s got access to a desktop, to be able to receive the same training. So that’s great. As demand for mental health services grows. Access to high quality training becomes just as important as the access to care. What lessons has CAMH learned about scaling simulation based education? 00;16;07;12 – 00;16;16;20 Steve Herron And how do you see technologies like VR and potentially AI and connected clinical systems shaping the future of clinician training? 00;16;16;22 – 00;16;49;24 Dr. Petal Abdool Well, you’re absolutely right that access to training is a critical equity issue, especially as it pertains to mental health care. At camp, one of our priorities has really been to design simulation programs that can reach learners beyond our own walls. We’ve recently launched what we call the CAMH Global Learning Academy, which means that we’ve created a learning platform system that can allow us to really, offer programing and training across not just Ontario, across disciplines and across other stages of training. 00;16;50;01 – 00;17;32;07 Dr. Petal Abdool And hopefully that that could mean that we would have a global impact and global reach. Some of the key lessons I think that we learned is that a technology has to follow pedagogy. Like we want to start with clear competencies. We want to make sure that, what we actually want clinicians to do in practice, translates to what we are using the virtual reality or the technology enabled simulation for meaning it’s not just a desire to be cool or innovative, but it’s also to fill a gap and to do so in a way that, supersedes or equates to what we were doing before. 00;17;32;09 – 00;18;01;28 Dr. Petal Abdool Secondly, I think usability matters enormously. If if hardware is hard to access, or if the support is limited, even the best design simulation will just sit on the shelf. I think we had to think carefully about, workflow, onboarding, making sure we had the technical support, especially for busy clinicians, to make sure that anything that we designed and developed would actually become useful and sustainable. 00;18;02;00 – 00;18;29;02 Dr. Petal Abdool I think the other lessons that we learned is that collaborating is essential. We collaborated with other academic institutions, health systems. We had a huge team of content experts, lived experience advisers, and that allowed us to really build something that could be scaled and that could be applicable across many domains. And it also opened us up to opportunity to study the impact and to continuously improve it. 00;18;29;04 – 00;18;49;19 Steve Herron That’s great. In summary here, before we wrap up, I do want to ask you for two quick takeaways. One insight you’d want clinicians to remember about suicide risk assessment training. And also one takeaway for healthcare leaders that are thinking about innovation in education. 00;18;49;21 – 00;19;16;23 Dr. Petal Abdool The one insight that relates to suicide risk assessment training is, I think that a skillful suicide risk assessment is not just a checklist, it’s a conversation, one that creates a sense of safety validation and a pathway to support. And the more that we allow our clinicians to practice these conversations in a safe environment, the more present and effective we can be, especially when we are with someone who is struggling. 00;19;16;26 – 00;19;46;04 Dr. Petal Abdool I think that with regard to your second question, I think innovation and education isn’t optional. I think technology enabled simulation, is key. If we want to prepare our workforce for the complexity of mental health and for the future ahead of us. I think that things like VR, artificial intelligence, chat bots, all these things that are on the horizon and that are getting better and better with each passing month. 00;19;46;07 – 00;20;01;15 Dr. Petal Abdool I think these are powerful enablers of more equitable, scalable and high quality training, especially when it comes to high stakes things like suicide, risk assessment and opioid overdose management. 00;20;01;17 – 00;20;13;03 Steve Herron Perfect. Assuming someone wants to learn more about this, Doctor Abdool, where can listeners go to learn more about CAMH’s virtual reality training programs? 00;20;13;05 – 00;20;34;22 Dr. Petal Abdool So I’m happy to say that you can just go online and Google camh.ca. You can access our Global Learning Academy if you want to try out any of our trainings. And our opioid overdose. I didn’t speak about it too much, but it’s not just designed for clinicians. We also have a training for patients, families and caregivers. 00;20;35;00 – 00;20;44;17 Dr. Petal Abdool So there is opportunity to upskill yourself. If you think this is an important, area for you to learn about. 00;20;44;19 – 00;21;21;02 Steve Herron Well, Doctor Abdool, thank you again for sharing your insights and for the important work you and your colleagues are doing at CAMH. Seeing this program in action reinforced for me how powerful technology can be when it’s grounded in clinical excellence, evidence and compassion at Oracle Health. Our role is to support organizations like CAMH with modern, connected digital systems that enable high quality mental health care, education and research partnerships like this, where innovation extends beyond the EHR and into how clinicians are trained, are what truly move the field forward. 00;21;21;05 – 00;21;47;12 Steve Herron For our listeners who may want to learn more about CAMH makers virtual reality programs, including suicide risk assessment training. We encourage you to explore other resources at camh.ca. And as always, if you or someone you love is in a mental health crisis, the 988 Suicide and Crisis Lifeline is available 24 over seven in the U.S. and in Canada. 00;21;47;14 – 00;22;16;26 Outro That’s all for this episode of Perspectives on Health and Tech podcast. Be sure to subscribe to catch all our future episodes. For more information from industry experts, visit oracle.com, forward slash Health and oracle.com/life hyphen Sciences or follow Oracle Health and Oracle Life Sciences on social media. Thank you for listening and join us again for the next insightful episode of Perspectives on Health and Tech.