Design, development, usability testing and feasibility study of VITAL-COMS
: a 3D-virtual simulator to improve weight-related communication skills training for healthcare professionals

Student thesis: Doctoral Thesis


Overweight and obesity is classified as a global health crisis. The related challenges are complex and difficult to address. Healthcare professionals (HCPs) working across different settings have opportunities to engage in weight-related discussions, but often there are perceived barriers to communication. This PhD addresses the topic of communication about weight in healthcare settings. The aim of this PhD was to design, develop and evaluate a virtual training tool for HCPs to improve weight-related communication with people who live with overweight and obesity.

The study design used a pragmatic sequential mixed-methods approach guided by the Medical Research Council (MRC) guidelines for complex interventions. Drawing on HCPs from across the UK, the study incorporates personal and public involvement (PPI) over five phases. Phase 1 was a literature review to identify the evidence base. Phase 2 was a training needs analysis involving the public and HCPs through a Twitter chat (n=25) and interviews with HCPs (n=12). Phase 3 was the iterative design and development of the virtual training tool. Phase 4 was usability testing with healthcare students (n=10) using validated usability measures. Phase 5 was a feasibility study with UK-based HCPs (n=31) using a feasibility questionnaire and reflective practice interviews along with a pre- and post-training weight-related self-assessment survey.

A training tool for HCPs to improve their weight-related communication skills was developed as a virtual simulator – VITAL-COMS, an acronym for Virtual Training and Assessment for Communication Skills. The usability testing identified several changes to VITAL-COMS, which focused on improving the breadth and depth of the conversations with the virtual characters and the training videos. The feasibility study demonstrated the high acceptability of VITAL-COMS and showed statistically significant improvements in pre-training to post-training scores in weight-related communication skills for all HCPs.

VITAL-COMS showed potential for improving weight-related communication skills for HCPs who discussed weight with patients who have overweight or obesity in healthcare settings. Participants rated VITAL-COMS as a novel and engaging tool that made them reflect on their current practice and helped to reduce barriers to communication. VITAL-COMS has potential to be used in other areas of sensitive health communication skills training.
Date of AwardJun 2023
Original languageEnglish
SponsorsDepartment for the Economy
SupervisorAnne Moorhead (Supervisor), Raymond Bond (Supervisor), Toni McAloon (Supervisor) & Huiru (Jane) Zheng (Supervisor)


  • Obesity
  • Healthcare professionals
  • Virtual simulation
  • Health communication

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