Therapist Guided Exposure Treatment for Vaginismus: Simulation and Immersive Learning Applications [36M]

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Efficacious and cost-efficient non-pharmacologic treatments, i.e., therapist guided exposure therapy for penetration disorders (GET-PEN), are available and in widespread use outside of the U.S. While therapists commonly provide guided desensitization therapy for other phobias, the GET-PEN treatment has not yet been implemented within the U.S.- largely due to a lack of medical education and training opportunities and appropriate supervisory resources. Simulation based immersive learning techniques may offer an innovative mechanism for bridging this educational gap.


We developed a brief simulation-based/immersive learning protocol designed to train a cohort of interdisciplinary teams (i.e., gynecology + mental health) to correctly implement GET-PEN. Next, we piloted this training protocol with our selected clinical teams who then implemented the protocol with professional simulators (PSs). All teams were evaluated on the implementation of GET-PEN by an international team of instructors. Three core outcomes were emphasized: self-efficacy for communicating with patients about sexual pain disorders, adherence to the treatment protocol, and quality of sexual education provided in response to PS’s questions.


Teams showed significant pre-post training skill gains in communication self-efficacy (p < .05), quality of sexual education (p < .05), and fidelity ratings of > 85%. However, not all teams trained to adequate fidelity ratings at the same rate, and those that required additional training repeated the simulation to achieve proficiency.


Simulation based/immersive learning techniques are an efficient mechanism for training interdisciplinary teams to implement GET-PEN. Our next steps include implementation and evaluation of this treatment in U.S. patients presenting with vaginismus.

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