Background:

-How people respond to drugs depends in part on their genes. For some drugs, doctors can use an individuals genetic background to help in dosing the drug. Researchers want to know how doctors incorporate personalized or genomic medicine into clinical practice.

Objective:

-To study how physicians make personalized treatment decisions

Eligibility:

-Healthy adult primary care physicians who are internal (or family) medicine residents.

Design:

• Participants will complete a screening form.
• Participants will put on a headset, called a head-mounted display, showing a virtual reality environment.
• The environment will contain an exam room and the virtual patient.
• After interacting with the virtual patient, participants will complete a series of survey measures.
• Participation will last for about 60 minutes. The virtual patient interaction and follow-up questions will be audio taped.

This study will examine factors related to primary care physicians clinical decision-making. Using a virtual clinical interaction experiment, we aim to better understand physicians decision-making processes and to explore their communication behaviors toward patients in the clinical encounter. Physician participants will enter a virtual exam room where they will be asked to respond to a virtual patient, acting as her primary care physician in a follow-up visit to evaluate her for depression. Various aspects of physician communication in the virtual clinic and self-report measures related to decision-making will be analyzed.

• INCLUSION CRITERIA:
• All physicians will be healthy adult volunteers who are medical residents in the internal medicine specialty.

EXCLUSION CRITERIA:

1. persons with seizure or vestibular disorders;
2. persons who are highly prone to motion sickness;
3. those without normal or normal to corrected vision or hearing;
4. all current and past employees and contractors of NHGRI; and
5. persons who have received information about the study purpose or procedure from a past participant.

NHGRI employees are excluded for this protocol because they are likely to have specialized genomic knowledge and may think differently about genomics in the clinical interaction.

Internal medicine and family medicine residents will be recruited from diverse national sites for the study, and the virtual reality environment will be brought to them through the use of a head-mounted display and laptop

We will provide data contingent on special requests form other researchers.