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Experts from Maimonides Medical Center, SUNY Downstate, and Columbia University partnered to develop an immersive workshop on the Cultural Formulation Interview (CFI) for the AADPRT 2026 conference. For the development of the experience, the group led by Dr. Lucia Roitman leveraged Wonda Pro and conversational AI to create interactive, virtual human simulations.

Useful Definition: The Cultural Formulation Interview (CFI), is a semi-structured, person-centered interview included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a handbook published by the American Psychiatric Association that provides standard criteria and codes for diagnosing mental disorders. CFI  is used alongside standard diagnostic tools to improve diagnostic accuracy, engagement, and treatment planning, especially when there are cultural differences or communication barriers between clinician and patient.

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Objective

The purpose of using conversational AI is to to train psychiatric residents and clinicians to practice CFI skills in a safe, low-stakes environment, receive immediate, structured feedback, and engage in deliberate practice over time. Unlike traditional role-play, AI simulations are scalable, reproducible, and available on demand—minimizing faculty burden while maximizing learner engagement.

For the immersive learning component specifically, the intention was to give learners an opportunity to better understand the complexity of culturally informed care through immersive practice:

• Familiarizing themselves with the DSM-5 CFI, a semi-structured tool featuring 16 questions across 4 domains.
• Identifying what troubles the patient most and exploring the social and cultural factors that shape their understanding of illness and distress.
• Practicing the CFI with virtual patients from diverse cultural backgrounds.
• Reviewing performance feedback from chatbot simulations to identify strengths and areas for improvement in cultural assessment skills.

Solution

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The team has designed a program that guides learners through authentic cases using browser- and mobile-compatible simulations. The experience includes:

1. Introduction to the Framework: Learners receive a refresher on the CFI's 4 core domains: Cultural Definition of the Problem; Causes, Context and Support; Self Coping Skills and Past Help Seeking; and Current Help Seeking and Preferences.
   
   
2. Virtual Patient Conversations: Trainees get to speak in real time with an AI Character. By holding down the spacebar to talk (or by typing their messages), learners deploy the CFI questions. Simulations feature distinct characters, such as a South Asian Muslim adult male presenting with somatic complaints, and "Dina," a 58-year-old Eastern European woman.
   
   
3. Feedback Assessment: At the end of the virtual patient visit, the trainee receives a personal feedback assessment report.
   
   
4. Group Discussion: Learners participate in a debriefing session to reflect on their experiences, thoughts, and challenges during the simulation.

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Outcome

With this learning experience, the program aims to yield better clinical outcomes by building trust, reducing misunderstandings, identifying barriers to care, and improving alignment between the patient and care team. 

The simulation-based practice also supports overall residency skills development through direct alignment with ACGME Milestones that describe the knowledge, skills, attitudes, and performance levels residents and fellows are expected to demonstrate from the start of their training through graduation to unsupervised practice.

Beyond the CFI, this interactive model serves as a foundation for teaching other core clinical interviewing skills, such as suicide risk assessments, motivational interviewing, trauma-informed conversations, and delivering difficult news.

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Check the Demo Simulations:
‍https://www.wonda.pro/aadprt-workshop

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