The use of virtual clients for training behavioral health providers: Promises, challenges and the way ahead

Providing opportunities for training behavioral health providers in clinical practice remains a challenge within the helping professions. To date, the field has relied mostly on role-playing and the use of standardized actors to provide realistic clinical simulations to students. Although highly utilized, both methods come with significant challenges. As technology rapidly develops, so does its role and application within the framework of behavioral health training. One such role is its potential use in providing realistic clinicalsimulations to develop clinicalskills. Along with reviewing the application as well asadvantagesand challenges to the current training models used to mimic clinical interactions, role play, and standardized actor patients, the purpose of this concept article is to present an alternate clinical skills training model, the use of a virtual client. Described is the use of virtual clients in behavioral health training, including how virtual clients work and their current applications, the advantages and challenges associated with their use and the way forward with their use in behavioral health training. Authors conclude virtual clients have potential as an impactful tool in the development of clinical skills

Polymeric enteral diets as primary treatment of active Crohn's disease: a prospective steroid controlled trial.

Thirty two patients with active Crohn's disease were included in a controlled randomised trial to determine the efficacy and safety of polymeric enteral nutrition compared with steroids, to achieve and maintain clinical remission. The polymeric diet was administered through a fine bore nasogastric tube by continuous, pump assisted infusion (2800 (SEM 120) kcal/day). The steroid group received 1 mg/kg/day of prednisone. Both treatments were effective in inducing clinical remission: 15 of the 17 patients given steroids and 12 of the 15 patients assigned to the polymeric diet went into clinical remission (defined by a Van Hees index < 120) within four weeks of treatment. The percentage reduction of the Van Hees index was 34.8 (4.9)% for steroids and 32.3 (5)% for enteral nutrition (mean difference 2.5%; 95% CI--11.8% to +16.8%). Mean time elapsed to achieve remission was similar in both groups (2.0 (1) v 2.4 (1.2) weeks). Tolerance of the enteral diet was excellent. Four patients in the steroid group had mild complications attributable to this treatment. Ten patients (66.6%) in the steroid group and five (41.6%) in the enteral nutrition group relapsed within a year of discharge, but no differences were found in the cumulative probability of relapse during the follow up period. These results suggest that polymeric enteral nutrition is as safe and effective as steroids in inducing short term remission in active Crohn's disease