Avatar-based simulation in the evaluation of diagnosis and management of mental health disorders in primary care

[Display omitted] ► Innovative tool to access cognitive reasoning and decision-making was developed. ► Avatar-based assessment tool developed to train physicians to diagnose MDD and PTSD. ► Assessed diagnostic and management capabilities: avatar method vs. text-based method. ► The avatar group performed better than the text group in diagnosis and management. ► Avatars can be used to train physicians to diagnose mental health in primary care. Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD) are highly prevalent illnesses, but the literature suggests they are under-detected and suboptimally managed by primary care practitioners (PCPs). In this paper, we propose and use an evaluation method, using digitally simulated patients (avatars) to evaluate the diagnostic and therapeutic reasoning of PCPs and compared it to the traditional use of paper-based cases. Verbal (think-aloud) protocols were captured in the context of a diagnostic and therapeutic reasoning task. Propositional and semantic representational analysis of simulation data during evaluation, showed specific deficiencies in PCP reasoning, suggesting a promise of this technology in training and evaluation in mental health. Avatars are flexible and easily modifiable and are also a cost-effective and easy-to-disseminate educational tool.