Psychological Interventions for the Fear of Public Speaking: A Meta-Analysis

Rewinding the Clock: Preparing the Next Generation of Radiology Residents for Oral Boards

The replacement of the ABR in-person oral examination with the DR certifying examination affected approximately 15,000 radiologists, spanning from 2013 to 2027. This decision was motivated by better aligning with the timing of other American Board of Medical Specialty (ABMS) members, more closely reflecting real-world practice of radiology and narrowing training geared towards the trainee's subspecialty preference. However, in retrospect, this change may have subtracted from the quality and value of diagnostic radiology training as a whole with the de-emphasis on competence in general radiology, communication skills, and cognitive reasoning. In this paper, the authors lay out a blueprint necessary in order to rewind the clock of how diagnostic radiology programs can prepare their trainees for the new DR oral examination. Such a change will require substantial redactions affecting all designations, including radiology faculty, education teams, departmental leadership, academic institutions, ACGME, and ABR. The authors believe that implementing these modifications will not only effectively equip radiology candidates for the new DR oral examination but will also augment the significance of radiologists as indispensable members of multidisciplinary teams. The authors also outline the challenges that could emerge from these changes and speculate on the anticipated role of AI in future oral board examinations.

A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression

This systematic review aims to assess the effectiveness of virtual reality (VR) and gamification interventions in addressing anxiety and depression. The review also seeks to identify gaps in the current VR treatment landscape and provide guidelines for future research and development. A systematic literature search was conducted using Scopus, Web of Science, and PubMed databases, focusing on studies that utilized VR and gamification technology to address anxiety and depression disorders. A total of 2,664 studies were initially identified, 15 of those studies fulfilled the inclusion criteria for this systematic review. The efficacy of VR in addressing anxiety and depression was evident across all included studies. However, the diversity among VR interventions highlights the need for further investigation. It is advised to incorporate more diverse participant samples and larger cohorts and explore a broader spectrum of therapeutic approaches within VR interventions for addressing anxiety and depression to enhance the credibility of future research. Additionally, conducting studies in varying socioeconomic contexts would contribute to a more comprehensive understanding of their real-world applicability.

Gamification: a Novel Approach to Mental Health Promotion

PURPOSE OF REVIEW

Gamification has emerged as a novel technique for improving mental health and enhancing treatment effectiveness. This paper provides an overview of gamification approaches to mental health intervention, identifies factors that may be related to variations in treatment effectiveness, and discusses possible strategies for tailoring gamified interventions to clients' needs.

RECENT FINDINGS

Recent research has documented the potential of gamified mental health interventions for bolstering mental wellness and mitigating psychological symptoms. However, their effectiveness may vary depending on study design-related factors and gender-specific considerations. Literature reviews have also identified yet-to-be resolved issues surrounding the possible strengths and weaknesses of the personalization versus standardization of gamification, as well as the potential benefits of gamification for increasing engagement versus the potential risks of over-engagement and behavioral addiction to gamified components. This review highlights the need for careful planning and execution of gamified mental health interventions to optimize their effectiveness and suitability for meeting clients' individual needs and preferences.

Interventions That Target or Affect Voice or Speech Production During Public Speaking: A Scoping Review

OBJECTIVES

Public speaking (PS) is frequently necessary in many professional, educational, and personal settings. Mastering this communication skill is particularly important in today's society. Training techniques for PS have been described in the literature. Given that PS anxiety affects performance, especially voice characteristics and speech fluency, the purpose of this scoping review is to examine, map, and narratively summarize the available evidence on PS interventions that target or affect voice or speech.

METHODS

An extensive literature search was conducted in three bibliographic databases: Medline ALL/Ovid, PsycINFO/Ovid, and Eric/Ovid. Of the 850 studies identified, 22 met the eligibility criteria, and one was added from the reference lists of the included studies.

RESULTS

A total of 23 studies were included. The interventions identified aim to improve speaking skills either by explicitly targeting the voice or speech (direct intervention, n = 15) or by targeting the cognitive, behavioral, psychological, or physical environment impacting the speaker's production (indirect intervention, n = 8).

CONCLUSIONS

This scoping review provides the first published methodological summary of the characteristics of existing PS interventions that target or affect voice and speech. Heterogeneous characteristics were observed. Further studies are needed to determine which interventions are most effective.

Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review

Virtual reality (VR) can induce side effects known as virtual reality-induced symptoms and effects (VRISE). To address this concern, we identify a literature-based listing of these factors thought to influence VRISE with a focus on office work use. Using those, we recommend guidelines for VRISE amelioration intended for virtual environment creators and users. We identify five VRISE risks, focusing on short-term symptoms with their short-term effects. Three overall factor categories are considered: individual, hardware, and software. Over 90 factors may influence VRISE frequency and severity. We identify guidelines for each factor to help reduce VR side effects. To better reflect our confidence in those guidelines, we graded each with a level of evidence rating. Common factors occasionally influence different forms of VRISE. This can lead to confusion in the literature. General guidelines for using VR at work involve worker adaptation, such as limiting immersion times to between 20 and 30 min. These regimens involve taking regular breaks. Extra care is required for workers with special needs, neurodiversity, and gerontechnological concerns. In addition to following our guidelines, stakeholders should be aware that current head-mounted displays and virtual environments can continue to induce VRISE. While no single existing method fully alleviates VRISE, workers' health and safety must be monitored and safeguarded when VR is used at work.

Public Speech Anxiety among Medical Residency Trainees in Riyadh

Objective

The present study aimed at measuring the level of public speaking anxiety (PSA) among medical residents in Riyadh, in addition to identifying the factors influencing public speaking anxiety from the perspective of the medical residents.

Method

A cross-sectional survey was conducted over a sample of 203 medical residents in Riyadh. The study adopted the questionnaire as a data collection tool. The questionnaire consisted of a demographic data part, PSA scale (17 items) and a third part concerned with the factors influencing public speaking anxiety among medical residents.

Results

The results of the study revealed that medical residents in Riyadh had a low level of public speaking anxiety (47.3±11.32). The participants had a low PSA score on all scale domain; cognitive (23.28±5.43), behavioral (10.45±4.16), and physiological (13.54±3.44). Moreover, the findings of the study showed that stuttering (91.1%), negative perceptions of individuals’ own voice (77.8%), and language barriers (76.8%) were the main factors influencing the public speaking anxiety among medical residents. Finally, we found through linear regression analysis that PSA is not significantly predicted by participants’ living region, marital Status, gender, residency level, type of pre-college school, age or being previously diagnosed by a mental health issue.

Conclusion

There is a low level of public speaking anxiety among medical residents in Riyadh. In addition, the study concluded that stuttering, negative perceptions about voice and language barriers are negatively influencing the public speaking anxiety among medical residents in Riyadh.

The Effectiveness of Emotional Freedom Technique on Public Speaking Anxiety in University Student: An Integrated Review

Public Speaking Anxiety is the most frequently feared condition among university student in academic activities. Emotional freedom technique has gained increased popularity and appears as a promising way to reduce emotional distress in different setting and populations. However, limited review has examining EFT treatment on public speaking anxiety. This integrative review was to examine the effectiveness of EFT programs on public speaking anxiety in university students. The review was carried out using the framework for integrated reviews obtained from Google Scholar, PsycINFO, and PubMed. Articles were included when reporting primary studies on the efficacy of EFT programs on public-speaking anxiety for university students in Bahasa Indonesia and English. The total of 5 were evaluated critically and included in the review. Two of the studies were undertaken in the United Kingdom, and one each in Australia, Turkey, and Indonesia. Two of the studies were randomized controlled, two used mixed methods, and one queasy experiment design. A majority of the interventions were able to reduce public speaking anxiety.  This review shows that implementation of EFT, even within limited resources, is both achievable and worthwhile. EFT programs should be ­introduced early in the curriculum for university student in their first year of a Bachelor program

Competitive Debate as Innovation in Gamification and Training for Adult Learners: A Conceptual Analysis

Adult learners demand teaching innovations that are ever more rapid and attractive. As a response to these demands and the challenges of skills training, this article presents a conceptual analysis that introduces competitive debate as an impact training model. The aim is to learn whether debate can be considered to fall within the frame of gamification, so that the full potential of debate as gamification can be exploited. There is a significant research gap regarding competitive debate as a game, with the training mechanics for adult learners remaining practically unexplored. Through a conceptual analysis of game, game experience, and gamification, and their respective characteristics, we conclude that competitive debate is an ideal instrument for gamification.

360° Video virtual reality exposure therapy for public speaking anxiety: A randomized controlled trial

Public speaking anxiety (PSA) is a prevalent condition which is highly interrelated with social anxiety. PSA can be effectively treated with exposure therapy. Virtual reality exposure therapy (VRET) is increasingly being explored as a novel and cost-effective mode of treatment. No previous randomized controlled trial has examined whether stand-alone 360° video VRET is an effective intervention for treating PSA and interrelated disorder relevant fears. Further, studies have not explored whether 360° video content influences VRET outcomes. Participants with high PSA (n = 51) were randomly allocated to: 360° video VRET incorporating stimuli of audiences (360°Audience) (n = 17), 360° video VRET incorporating stimuli of empty rooms (360°Empty) (n = 16) and no treatment control (n = 18). Outcomes were measured over five time-points. Mixed ANOVA revealed a significant interaction between time and intervention group for PSA, social anxiety and fear of negative evaluation (FNE). Within-group analysis demonstrated there was a significant pre-intervention to post-intervention reduction across measures for both 360° video VRET groups: PSA 360°Audience (η_p² = .90, p<.001), 360°Empty (η_p² = .71, p < .001); social anxiety 360°Audience (η_p² = .49, p=.002), 360°Empty (η_p² = .39, p = .009); FNE 360°Audience (η_p² = .59, p<.001), 360°Empty (η_p² = .43, p = .006). Active intervention participants showed significant improvement from pre-intervention to 10-week follow-up on all measures. Findings illustrate that 360° video VRET is an efficacious way to significantly reduce PSA, social anxiety and FNE.

Measuring Public Speaking Anxiety: Self-report, behavioral, and physiological

Self-reports are typically used to assess public speaking anxiety. In this study, we examined whether self-report, observer report, and behavioral and physiological reactivity were associated with each other during a speech challenge task. A total of 95 university students completed a self-report measure of public speaking anxiety before and after the speech challenge. Speech duration (i.e., behavioral measure), physiological reactivity, as well as speech performance evaluated by the participants and observers were also recorded. The results suggest that self-reported public speaking anxiety predicts speech duration, as well as speech quality, as rated by the participants themselves and observers. However, the physiological measures were not associated with self-reported anxiety during the speech task. Additionally, we observed that socially anxious participants underrate their speech performance in comparison to their observers' evaluations.

A Meta-Analysis of the Efficacy of Virtual Reality and In Vivo Exposure Therapy as Psychological Interventions for Public Speaking Anxiety

Public speaking anxiety (PSA) is a prevalent condition with disabling occupational, educational, and social consequences. Exposure therapy is a commonly utilized approach for treating PSA. Traditionally, this intervention has been delivered as in vivo exposure therapy (IVET). Limitations inherent to in vivo as a mode of delivery have been identified and studies have increasingly explored the use of Virtual Reality Exposure Therapy (VRET) as an alternative. Understanding the efficacy of both VRET and IVET as psychological interventions for PSA is important. A systematic search identified 11 studies with 508 participants. Meta-analysis yielded a large significant effect wherein VRET resulted in significant reductions in PSA versus control of -1.39 (Z = 3.96, p < .001) and a similar large significant effect wherein IVET resulted in significant reductions in PSA versus control of -1.41 (Z = 7.51, p < .001). Although IVET was marginally superior to VRET, both interventions proved efficacious. Given the advantages of utilizing VRET over IVET future research and clinical practice could explore VRET as a treatment option for PSA.

Breathing therapy and emotional freedom techniques on public speaking anxiety in Turkish nursing students: A randomized controlled study

BACKGROUND AND OBJECTIVE

Public speaking is a common challenge that university students have to face. This study aims to determine the effects of Breathing Therapy and Emotional Freedom Techniques (EFT) on public speaking anxiety in Turkish nursing students.

METHODS

This randomized controlled study included 76 nursing students. Data were collected using the Descriptive Characteristics Form, Subjective Units of Disturbance Scale, The State-Trait Anxiety Inventory, and the Speech Anxiety Scale.

RESULTS

Before the administration of Breathing Therapy and EFT, the students' median scores from the Subjective Units of Disturbance Scale, the State-Trait Anxiety Inventory, and the Speech Anxiety Scale were similar. However, the median scores of the Subjective Units of Disturbance Scale, the State-Trait Anxiety Inventory, and the Speech Anxiety Scale scores significantly decreased in both of the experimental groups after the interventions (p <0.001). EFT (d = 3.18) was more effective than Breathing Therapy (d = 1.46) in reducing Speech anxiety.

CONCLUSION

It was found that Breathing Therapy and EFT are effective methods to reduce stress, anxiety, and speaking anxiety.

Virtual reality exposure therapy for adolescents with fear of public speaking: a non-randomized feasibility and pilot study

BACKGROUND

Public Speaking Anxiety (PSA) is a common anxiety with onset in adolescence and early adulthood. With the advent of consumer virtual reality (VR) technology, VR-delivered exposure therapy is now a scalable and practical treatment option and has previously been shown to be efficacious with adults. In this non-randomized feasibility and pilot trial, we explore the effect of one-session (90 min) VR-delivered exposure therapy for adolescents (aged 13-16) with PSA.

METHODS

A total of 27 adolescents were recruited from Norwegian high schools and completed self-report measures of PSA twice prior to treatment, 1 week after treatment, and at 1 and 3 month follow-up. Heart rate was recorded during the treatment session. A low-cost head-mounted VR display with a custom-built VR stimuli material depicting a cultural and age appropriate classroom and audience were used when a series of speech (exposure exercises) were performed.

RESULTS

Linear mixed effects model revealed a significant decrease in PSA symptoms (Cohen's d = 1.53) pre-post treatment, and improvements were maintained at follow-ups. Physiological data revealed a small increase in heart rate during exposure tasks. Based on feedback from the adolescents, the feasibility of the intervention was increased during the trial.

CONCLUSIONS

The results show that low-cost, consumer VR hardware can be used to deliver efficacious treatment for PSA in adolescents, in a feasible one-session format.

A randomized clinical trial of group and individual Cognitive-Behavioral Therapy approaches for Social Anxiety Disorder

To compare the effectiveness of two Cognitive-Behavioral Therapy (CBT) interventions-an individual and a group intervention-in Social Anxiety Disorder therapy. We compared the two treatment groups against a waitlist condition in a randomized clinical trial with 86 young adults. The individual CBT intervention was Trial-Based Cognitive Therapy (TBCT) developed by De-Oliveira, a novel technique in which the therapist engages the patient in a simulated judicial trial with the goal of identifying and changing core dysfunctional beliefs. The group intervention consisted of exposition therapy based on the Hofmann and Otto protocol (Group CBT) to restructure negative and dysfunctional cognitions regarding social situations. Both interventions reduced psychiatric symptoms from pre- to post-test and primary social anxiety and depression symptoms relative to waitlist controls. The interventions were recently introduced in Brazil, and this is the first randomized control trial to compare TBCT and this Group CBT, which were effective in assessing changes in social anxiety symptoms as well as co-occurring psychiatric symptoms.