Curricular initiatives for dementia education

Dementia education can be an effective pedagogical tool to improve student perceptions of dementia and dementia care. In this article, we describe four evidence-based educational initiatives implemented in an undergraduate and graduate level social work course. Students participated in an informational presentation on dementia, a dementia simulation, and a virtual discussion board. They also conducted an interview with a person living with dementia and their caregiver. Twenty-nine students completed a pre- and postsurvey on their (a) prior contact with individual(s) living with dementia, (b) dementia-related knowledge, attitudes, and self-efficacy, and (c) willingness to support individuals living with dementia, and 43 students participated in a focus group. Comparison of pre- and post-participation scores indicated improvements in knowledge, attitude, and self-efficacy. Content analyses of focus group responses and discussion posts generated themes that shed light on students' (a) knowledge gains at cognitive and affective levels, (b) attitudes toward future practice in dementia care, (c) perceived value of interprofessional practice, and (d) perceptions of dementia related learning activities. Despite limitations in implementation and evaluation, the curricular initiatives provide a template to train future health professionals in dementia care, a vital area of practice.

The impact of simulation-based training in medical education: A review

Simulation-based training (SBT) has emerged as a transformative approach in medical education, significantly enhancing healthcare professionals' learning experience and clinical competency. This article explores the impact of SBT, tracing its historical development and examining the various types of simulations utilized today, including high-fidelity mannequins, virtual reality environments, standardized patients, and hybrid simulations. These methods offer a safe and controlled environment for students to practice and hone technical and non-technical skills, ultimately improving patient safety and clinical outcomes. The benefits of SBT are manifold, including enhanced skill acquisition, error reduction, and the opportunity for repeated practice without risk to actual patients. Immediate feedback and structured debriefing further solidify learning, making Simulation an invaluable tool in medical education. However, the implementation of SBT is challenging. It requires substantial financial investment, specialized equipment, and trained faculty. Additionally, there are concerns about the realism of simulations and the transferability of skills to real-world clinical settings. Despite these challenges, numerous case studies and empirical research underscore the effectiveness of SBT compared to traditional methods. Looking ahead, advancements in technology, such as artificial intelligence and improved virtual reality applications, promise to enhance the efficacy and accessibility of simulation training. The integration of Simulation with other training modalities and its adoption in diverse global contexts highlight its potential to revolutionize medical education worldwide. This article affirms the crucial role of SBT in preparing the next generation of healthcare professionals and its ongoing evolution driven by technological innovations.

Facilitators, barriers and impacts to implementing dementia care training for staff in long-term care settings by using fully immersive virtual reality: a scoping review protocol

INTRODUCTION

The rapid growth of the ageing population underscores the critical need for dementia care training among care providers. Innovative virtual reality (VR) technology has created opportunities to improve dementia care training. This scoping review will specifically focus on the barriers, facilitators and impacts of implementing fully immersive VR training for dementia care among staff in long-term care (LTC) settings.

METHODS AND ANALYSIS

We will follow the Joanna Briggs Institute's scoping review methodology to ensure scientific rigour. We will collect literature of all languages with abstracts in English from CINAHL, Medline, Scopus, Embase, Web of Science and ProQuest database until 31 December 2023. Grey literature from Google Scholar and AgeWell websites will be included. Inclusion criteria encompass papers involving paid staff (Population), fully immersive VR training on dementia care (Concept) and LTC settings (Context). Literature referring only to non-paid caregivers, non-fully immersive VR or other chronic diseases will be excluded. Literature screening, data extraction and analysis will be conducted by two reviewers separately. We will present a narrative summary with a charting table on the main findings.

ETHICS AND DISSEMINATION

This work does not require ethics approval, given the public data availability for this scoping review. Through a comprehensive overview of the current evidence regarding impacts, barriers and facilitators on this topic, potential insights and practical recommendations will be generated to support the implementation of VR training to enhance staff competence in LTC settings. The findings will be presented in a journal article and shared with practitioners on the frontline.

Exploring self-experience practices in dementia care: A scoping review

BACKGROUND

Recognised as essential for high-quality dementia service, person-centred care aims to understand and respect the unique needs of each individual. Self-experience practices may offer caregivers an opportunity to acquire knowledge, empathy, and skills related to person-centred care, especially through recreating experiences similar to dementia. Given the need to enhance the understanding of self-experience practices in dementia care, a more comprehensive investigation of these training interventions for (future) caregivers is needed.

METHODS

We conducted a scoping review to map the evidence on the use of self-experience practices in dementia training. We systematically searched Cochrane Library, MEDLINE via PubMed, CINAHL, and Web of Science. We also searched for grey literature, as well as registry entries, and conducted backward citation tracking of included reviews. We analysed data on intervention characteristics, factors influencing the implementation, and learning outcomes based on Kirkpatrick's model.

RESULTS

We included 44 reports across 30 intervention programmes. The majority of reports (91%) were published from 2016 onwards, with 32% originating from the USA and 25% from the UK. We identified passive, interactive, immersive, and multicomponent self-experience interventions in dementia education and training. Learning outcomes based on Kirkpatrick's model were fairly distributed across all identified modalities. Both consumers and providers emphasised aspects related to the development and implementation of practices, particularly organisational-related considerations such as temporal and spatial planning of trainings.

CONCLUSIONS

Our review highlights diverse interventions incorporating self-experience practices, with an increasing role for technological tools. While self-experience interventions engage participants, the impact on individuals with dementia and organisational levels remain largely unreported. Our overview, informed by current literature, underscores unique considerations and challenges associated with dementia-related self-experience practices. Implementing and evaluating complex training interventions using self-experience practices should consider ethical aspects.

TRIAL REGISTRATION

Registry: Registered within the Open Science Framework (available at https://osf.io/fycxa/).

Virtual reality-based dementia educational programmes for formal and informal caregivers of people with dementia: A scoping review

AIM

To map evidence of the existing virtual reality-based dementia educational programmes and the effects of these educational programmes on dementia formal and informal caregivers.

DESIGN

A scoping review.

METHODS

A comprehensive search of nine databases was conducted to find studies from the inception of the databases to October 2023. Two authors independently screened the titles and abstracts related to the eligibility criteria. Full texts of potentially relevant studies were read by one author and checked by a second. Data extraction and synthesis using NVivo 12 were undertaken by one author and checked by two other authors.

RESULTS

Nineteen studies published between 2002 and 2022. The four randomised controlled studies and five qualitative studies were of moderate to good methodological quality. The 10 quasi-experimental studies were of weak to moderate quality. Fifteen virtual reality-based educational programmes had a positive influence on formal and informal caregivers, including improving caregivers' perceptions changing attitudes towards people with dementia, while the nursing competence of formal caregivers did not improve in short term. Educational programmes that covered dementia-related information and care strategies better improved the knowledge level of dementia formal and informal caregivers.

CONCLUSIONS

The qualitative and quantitative studies of moderate to good quality included in this study support the idea that virtual reality-based dementia educational programmes may be a safe and effective way and have potential benefits for improving knowledge, perceptions, attitudes and nursing competence.

IMPACT

This scoping review will provide an emerging teaching model for formal and informal caregivers of people with dementia and help them better understand the types and the influence of virtual reality-based dementia educational programmes.

REPORTING METHOD

PRISMA-ScR.

NO PATIENT OR PUBLIC CONTRIBUTION

Not required as this review in accordance with the aim to map existing literature from the dementia formal and informal caregivers' perspective.

Virtual reality-based simulation intervention for enhancing the empathy of informal caregivers of people with dementia: A mixed-methods systematic review

Dementia is a long-term and progressive syndrome that not only influences the person with dementia (PWD) but also the caregiver. However, informal caregivers are not always empathic and understand the symptoms of dementia, leading to destructive caregiving relationships and poor quality of caregiving. VR-based simulation interventions can provide a more realistic and memorable learning experience for caregivers to walk in PWDs' shoes. This review aimed to provide practitioners and researchers with insights on developing and/or adopting an effective VR-based simulation intervention for enhancing the empathy of informal caregivers of PWD. A mixed-methods systematic review was conducted. Quantitative, qualitative, and mixed-methods studies were searched from MEDLINE, PsycINFO, CINAHL, Scopus, Embase, and Cochrane Library updating. Standard JBI critical appraisal instruments were used for the quality appraisal. A convergent segregated approach was used to synthesize and integrate the data. A total of seven studies were included. Inconsistent quantitative results were reported on the effects of VR-based simulation on empathy enhancement. Significant effects were reported on knowledge of dementia and emotion-focused coping strategies. Two themes were generated from the qualitative studies, including "Informal caregivers gained better insight into problems encountered by older people with dementia" and "Thinking from the perspective of older people with dementia, leading to changes in attitudes and behaviours towards dementia". The qualitative synthesized evidence showed that informal caregivers gained better insight into problems encountered by PWD, but the quantitative synthesized results are inconsistent. Yet, informal caregivers experienced a change in attitude by thinking from the perspective of PWD.

Exploring medical students' perceptions of empathy after cinemeducation based on Vygotsky's theory

BACKGROUND

Medical students' empathy toward patients with Alzheimer's is rarely found in formal medical curricula. Based on Vygotsky's theory, watching films and reflection can be considered as effective methods to improve empathy. The present study aimed to explore medical students' perceptions of empathy toward patients with Alzheimer after participating in an educational program by using interactive video based on Vygotsky's theory.

METHODS

This qualitative study was conducted at Tehran University of Medical Sciences in 2022. The population included all 40 medical students. Firstly, the Still Alice movie which is about the feelings of a professor who was diagnosed with Alzheimer's disease was shown to the students. Secondly, the students reflected on their experiences of watching the movie. Thirdly, a session was held for group discussion on the subject of the movie, the patient's feelings, the doctor's attitude, the social environment surrounding the patient shown in the movie, and the necessity of empathy toward patients with Alzheimer's disease. The reflection papers were analyzed using the conventional qualitative content analysis method.

RESULTS

After analyzing 216 codes from 38 reflection papers, four categories, including communication with a patient with Alzheimer's, understanding the patient with Alzheimer's as a whole, medical science development, and the student's individual ideology, were extracted.

CONCLUSION

Reflection and group discussion after watching movie by providing opportunities for social interaction about personal interpretations will lead to active role in enhancing empathy. Based on the perceptions of the medical students, they gained a perspective to consider the patient as a whole and pay attention to establishing a proper relationship with the patient.

Virtual Reality and Simulation Videos as Effective Training Tools for Creating Safe and Inclusive Environments for Transgender People

BACKGROUND

University education is undergoing a paradigm shift towards active methodologies, such as virtual reality and training videos, which have proven to be valuable resources, especially in the health sciences. The scarcity of existing research on the topic prompted us to conduct this study, which seeks to measure the knowledge gained from the aforementioned tools by users, their level of satisfaction with them, and their perceived utility.

METHODS

This is a quasi-experimental intervention study analysing the impact of virtual objects as learning resources for undergraduate nursing students.

RESULTS

Fifty-four participants completed the training, yielding highly significant differences between their mean scores, with a high statistical power and a large effect size. A total of 85.46% of participants confirmed that the virtual resources helped them considerably to empathise with the experiences of trans people in healthcare settings. Students were comfortable using the virtual resources, very satisfied with the methodology employed, and would recommend the training received.

CONCLUSIONS

University teaching must adapt to meet the current legislations and changing health needs of society, and teaching staff must be prepared to implement new active teaching methodologies that make learning a more dynamic process. Considering these results, our study serves as a guide for other nursing educators who seek to promote inclusive healthcare regarding gender diversity. This study is not registered.

Dementia Simulation for Family Caregivers of Persons With Dementia: A Scoping Review

BACKGROUND

Alzheimer's disease and related dementias are becoming increasingly prevalent worldwide. Persons with dementia receive substantial assistance from family caregivers over extended periods of time. Family caregivers of persons with dementia are twice as likely to report physical, emotional, and financial challenges related to caregiving compared with other types of family caregivers. Empathy has been demonstrated to improve caregivers' quality of life and their relationships with care recipients.

OBJECTIVE

This scoping review examines the current literature on the effects of dementia simulation on empathy levels in family caregivers of persons with dementia.

METHODS

A librarian-assisted search of 4 databases-PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO, and Scopus-was conducted. Key terms included "dementia," "family caregivers," and "simulation." To broaden reference retrieval, "empathy" was not used as a key term but remained an inclusion criterion during reference screening. Data extraction of relevant references was completed.

RESULTS

The search yielded 212 citations. Seven eligible dementia simulation studies were identified, including 1 randomized controlled trial, 3 quasi-experimental studies, and 3 qualitative research studies. Only 3 of the 7 studies focused specifically on family caregivers of persons with dementia.

CONCLUSIONS

Qualitative data supported increased empathy in family caregivers, but quantitative findings on changes in empathy levels were inconclusive. Further research using quantitative or mixed-methods designs is necessary to support benefits of simulation on empathy for family caregivers of persons with dementia.

Augmented reality-based affective training for improving care communication skill and empathy

It is important for caregivers of people with dementia (PwD) to have good patient communication skills as it has been known to reduce the behavioral and psychological symptoms of dementia (BPSD) of PwD as well as caregiver burnout. However, acquiring such skills often requires one-on-one affective training, which can be costly. In this study, we propose affective training using augmented reality (AR) for supporting the acquisition of such skills. The system uses see-through AR glasses and a nursing training doll to train the user in both practical nursing skills and affective skills such as eye contact and patient communication. The experiment was conducted with 38 nursing students. The participants were assigned to either the Doll group, which only used a doll for training, or the AR group, which used both a doll and the AR system. The results showed that eye contact significantly increased and the face-to-face distance and angle decreased in the AR group, while the Doll group had no significant difference. In addition, the empathy score of the AR group significantly increased after the training. Upon analyzing the correlation between personality and changes of physical skills, we found a significant positive correlation between the improvement rate of eye contact and extraversion in the AR group. These results demonstrated that affective training using AR is effective for improving caregivers' physical skills and their empathy for their patients. We believe that this system will be beneficial not only for dementia caregivers but for anyone looking to improve their general communication skills.

Preparing future health care workers for interactions with people with dementia: A mixed methods study

Strategies used in training future health professionals have expanded from traditional methods to a variety of approaches, including sensitivity training. Students who receive disease-specific sensitivity training are more compassionate to patients. Alzheimer's disease (AD) sensitivity training includes deficit-focused dementia tours that physically alter sensations. This embedded-experimental (between-subjects) variant mixed-methods study assessed the effectiveness of virtual reality as a delivery format for dementia tours compared to dementia tours that physically alter sensations. It also compared the effectiveness of deficit-focused dementia sensitivity training to reading strengths-focused case studies, a traditional instruction method. Forty-one university students were randomized into one of three conditions. All participants completed pre- and post-assessments and were interviewed. Quantitative results indicate that a dementia tour offered through virtual reality is as effective as a physical-based tour; however, compared to reading case studies, participants reported poorer attitudes about living with AD and feeling less prepared for caregiving. The qualitative results show an increase in empathy across all conditions. Integration of findings indicates that dementia tours in both formats are effective at encouraging empathy and that both strengths-based and deficit-based sensitivity training are important components of education for future health care workers.

A scoping review to assess the effects of virtual reality in medical education and clinical care

Due to the challenges and restrictions posed by COVID-19 pandemic, technology and digital solutions played an important role in the rendering of necessary healthcare services, notably in medical education and clinical care. The aim of this scoping review was to analyze and sum up the most recent developments in Virtual Reality (VR) use for therapeutic care and medical education, with a focus on training medical students and patients. We identified 3743 studies, of which 28 were ultimately selected for the review. The search strategy followed the most recent Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping review (PRISMA-ScR) guidelines. 11 studies (39.3%) in the field of medical education assessed different domains, such as knowledge, skills, attitudes, confidence, self-efficacy, and empathy. 17 studies (60.7%) focused on clinical care, particularly in the areas of mental health, and rehabilitation. Among these, 13 studies also investigated user experiences and feasibility in addition to clinical outcomes. Overall, the findings of our review reported considerable improvements in terms of medical education and clinical care. VR systems were also found to be safe, engaging, and beneficial by the studies' participants. There were huge variations in studies with respect to the study designs, VR contents, devices, evaluation methods, and treatment periods. In the future, studies may focus on creating definitive guidelines that can help in improving patient care further. Hence, there is an urgent need for researchers to collaborate with the VR industry and healthcare professionals to foster a better understanding of contents and simulation development.

Artificial intelligence technologies and compassion in healthcare: A systematic scoping review

Background

Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored.

Objectives

The aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare?

Materials and methods

A systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011-2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice.

Results

Searches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, n = 1 to 2021, n = 47 and from Jan-Aug 2022 n = 35 articles). Overarching themes related to the review questions were: (1) Developments and debates (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) How AI technologies enhance compassion (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) Gaps in knowledge (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) Key areas for development (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships.

Conclusion

There is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a human-AI system of intelligent caring comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships.

Implications

In a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.

Virtual reality to foster empathy in disability workers: A feasibility study during COVID-19

BACKGROUND

Empathy is a critical skill required by disability workers. Virtual reality may increase access to staff training to foster empathy.

METHOD

A mixed methods feasibility study investigated a custom-built virtual reality program, IMercyVE, which aimed to immerse a disability worker in a first-person perspective of having intellectual disability. Data were collected through online surveys (n = 9) completed before and after use of IMercyVE, and by videoconference focus groups (n = 6).

RESULTS

Qualitative findings included that IMercyVE delivered a novel experience for participants and a distinctive mode of learning that assisted participants to deepen their levels of empathy. Descriptive analyses of the surveys indicated that participants' empathy increased after engaging with IMercyVE.

CONCLUSIONS

IMercyVE has the potential to be offered as a remotely delivered and flexible staff training modality suitable for building empathy. Further research with a larger sample is warranted.

Effects of a dementia virtual reality-based training with peer support for home care workers: A cluster randomized controlled trial

OBJECTIVES

Home care workers who are the first-line care workers for community-dwelling dementia patients often have limited dementia knowledge, skills, and empathy towards those with dementia. Research is sparse on dementia care training using virtual reality (VR) technology and support network for home care workers.

METHODS

This cluster randomized controlled trial evaluated the effects of a dementia VR-based training with peer support on dementia knowledge, attitude, competence, and empathy of home care workers. Each home care worker team was used as the unit for randomization. Sixteen teams were randomly assigned to either VR group or non-VR control group There was a total of 124 participants completed the study, the VR group (n = 61) received a dementia VR-based training consisted of 3-month dementia care e-book modules, dementia VR-based activity and 1-h monthly face-to-face peer support group meetings. The non-VR control group (n = 63) only receive the 3-month dementia care e-book modules and 1-h monthly regular staff meetings with no VR activity. Outcome measures were assessed at three time points: baseline, the end of the 3-month intervention, and 1-month post intervention.

RESULTS

Generalized estimating equations results indicate that the improvement in dementia knowledge, attitudes, competence, and empathy over time is significant in the VR group compared to the non-VR control group. The effects remained significant 1 month after the end of the 3-month intervention.

CONCLUSIONS

Innovative and accessible dementia training using VR technology with peer support is a promising training approach to improve dementia knowledge, attitudes, competence, and empathy of home care workers.

Increasing understanding of environmental modifications using the Virtual Dementia Experience for professional carers of people living with dementia

Modifications to the environment can have a positive impact on the person living with dementia. The purpose of this study was to examine the effects of a virtual reality (VR) educational workshop on improving understanding of the impact of environments for people living with dementia for carers in residential aged care facilities in Australia. Participants were nonrandomly allocated to one of two conditions: a VR condition which enabled them to take the perspective of a person living with dementia as they navigate a home environment (n = 40), or to a non-VR condition, in which participants received equivalent information in a classroom without the use of VR (n = 56). Participants completed a purpose-built pictorial measure of their understanding of environmental factors that could impact on people with dementia before and after the workshop. Following education, an analysis of covariance revealed that compared to non-VR education, those who received VR education identified a significantly greater number of appropriate environmental modifications, after adjusting for practice test scores. The results from this study demonstrate the utility of VR as a promising tool to improve carers' understanding of the ways in which the environment can be modified to assist people living with dementia.

Systematic Bibliometric Analysis of Research Hotspots and Trends on the Application of Virtual Reality in Nursing

Background

With the emergence of the metaverse, virtual reality, as a digital technology, must be getting hotter. High quality virtual reality related nursing knowledge scene learning is gradually replacing traditional education and intervention skills.

Objective

This systematic study aimed to gain insights into the overall application of virtual reality technology in the study of nursing.

Methods

Citations downloaded from the Web of Science Core Collection database for use in VR in nursing publications published from January 1, 2012, to December 31, 2021, were considered in the research. Information retrieval was analyzed using https://bibliometric.com/app, CiteSpace.5.8. R3, and VOS viewer.

Results

A total of 408 institutions from 95 areas contributed to relevant publications, of which the United States is the most influential country in this research field. The clustering labels of cited documents were obtained from the citing documents. Virtual simulation, virtual learning, clinical skills, and dementia are the clustering labels of co-cited documents. The burst keywords represented the research frontiers in 2020–2021, which were knowledge and simulation.

Conclusion

Virtual nursing has had an impact on both nurses and clients. With the emergence of the concept of the metaverse, the research and application of virtual reality technology in nursing will gradually increase.

Use of virtual and augmented reality-based interventions in health education to improve dementia knowledge and attitudes: an integrative review

OBJECTIVES

Immersive technologies such as virtual (VR) and augmented reality (AR) can potentially help health professionals and trainees understand psychological symptoms and responsive behaviours associated with dementia within a safe and supportive learning environment. This integrative review sought to ascertain the types of VR and AR-based interventions used in dementia education and training and its efficacy to improve knowledge and attitudes of health professionals or trainees.

DESIGN

The protocol was submitted to PROSPERO and literature published from 2000 onwards was searched in eight databases: CINAHL, MEDLINE, Web of Science, Cochrane, Embase, PsycINFO, ERIC and Scopus. A total of 19 articles were included and assessed with the Mixed Methods Appraisal Tool. Methodological quality varied across studies.

RESULTS

VR rather than AR-based intervention are used in dementia education and training for health professional and trainees. Immersive virtual learning potentially enhance knowledge, attitudes, empathy and sensitivity of health professionals and trainees.

CONCLUSIONS

While promising, there remains a lack of conclusive and robust evidence to fully recommend the introduction and inclusion of immersive virtual learning in dementia education and training. Additional rigorously designed research studies with larger sample sizes are needed to confirm the benefits on attitudes, empathy, sensitivity and knowledge.

PROSPERO REGISTRATION NUMBER

CRD42020182083.

Experiential Learning Through a Dementia Simulation

Health care providers do not always possess the knowledge and skills necessary to optimally manage behavioral symptoms in patients with Alzheimer's disease (AD). The purpose of the current project was to evaluate the use of a simulated virtual reality AD experience on nursing staff sensitivity, awareness, and perceptions of caring for patients with AD. A quasi-experimental design was used. The Long Tour Survey and Approaches to Dementia Questionnaire were administered pre and post simulation and the Perceptions of Caring surveys were administered 3 to 6 weeks post-intervention. Total scores, although not statistically significant, revealed a slight change in the total score and hope subscale, representing more optimism toward people with dementia. The virtual reality AD simulation was a beneficial experience but unable to demonstrate a real change for the majority of participants. [Journal of Gerontological Nursing, 47(11), 39-47.].

The Effects of Virtual Reality-Based Education on Empathy and Understanding of the Physical Environment for Dementia Care Workers in Australia: A Controlled Study

BACKGROUND

There is support for the effectiveness of virtual reality (VR) technology in dementia education. However, it is not yet known if VR is a useful tool for improving empathy and understanding of dementia care environments among dementia care workers.

OBJECTIVE

This study compared learning outcomes of VR versus non-VR (control) workshops for dementia care workers of different ages and English-speaking backgrounds.

METHODS

Dementia care workers enrolled in workshops on dementia care principles. Once participants were enrolled, workshops were assigned at random to deliver non-VR or VR-based education. Participants (N = 114, 91.8%female, mean age = 46.4; SD = 13.2; n = 60VR condition, 54control condition) completed self-report measures of empathy towards people living with dementia, understanding of dementia care environments, dementia knowledge, and attitudes towards dementia at pre- and post-workshop.

RESULTS

Significant pre-post main effects were observed for empathy, understanding of dementia care environments, and attitudes. Interaction effects were not found; improvements in outcomes were similar between conditions. However, interaction effects were observed for subgroups. Empathy improved significantly more in the VR condition for older participants. Understanding of dementia care environments improved more in the VR condition for younger and non-English-speaking background participants.

CONCLUSION

Using VR may not augment teaching outcomes for all learners. VR may differentially assist leaners of different ages and English-speaking backgrounds. More research is needed to understand for which variables and for whom VR is a useful teaching tool.

Impact of immersive virtual reality simulations for changing knowledge, attitudes, and behaviors

BACKGROUND

Virtual reality has promise as a training method within the affective domain, but investigation is still needed for intention to change behaviors based on social determinants of health.

OBJECTIVE

The objective of this study was to describe the self-reported changes in knowledge and/or attitudes and planned behavior changes by healthcare workers for their future care of persons with challenges to their social determinants of health following completion of a first-person virtual reality experience.

DESIGN

A descriptive qualitative design was used.

SETTINGS

This study was conducted in clinics and private practice settings in Ohio (United States).

PARTICIPANTS

This study was conducted with 206 healthcare workers.

METHODS

Participants completed a virtual reality simulation followed by qualitative, open-ended questions about changes to their knowledge, attitudes, and behaviors. Responses were analyzed using a content analysis method.

RESULTS

Four overarching themes were derived from the qualitative data: (1) Acknowledgement of Social Determinants of Health, (2) An Improved Provider Experience for Patients, (3) Patient as a Person with Complex Needs, and (4) The Learning Experience.

CONCLUSION

Findings suggest virtual reality has strong merits for impacting affective domain of learning demonstrated by increased empathy. Virtual reality along with increased empathy also helps improve attitudes and behaviors for the betterment of patients.

Nursing Interns' Attitudes Toward, Preferences for, and Use of Diabetes Virtual Simulation Teaching Applications in China: National Web-Based Survey

BACKGROUND

Diabetes has placed heavy social and economic burdens on society and families worldwide. Insufficient knowledge and training of frontline medical staff, such as nurses, interns, and residents, may lead to an increase in acute and chronic complications among patients with diabetes. However, interns have insufficient knowledge about diabetes management. The factors that affect interns' current level of diabetes-related knowledge are still unclear. Therefore, understanding the behavioral intentions of interns is essential to supporting the development and promotion of the use of virtual simulation teaching applications.

OBJECTIVE

This study aimed to identify the determinants of nursing interns' intentions to use simulation-based education applications.

METHODS

From December 1, 2020, to February 28, 2021, the web-based survey tool Sojump (Changsha Xingxin Information Technology Co) was used to survey nursing interns in hospitals across China. Two survey links were sent to 37 partner schools in 23 major cities in China, and they were disseminated through participants' WeChat networks. Multiple regression analysis was used to determine the association between demographic information and basic disease information and the use of the application for treating adult patients.

RESULTS

Overall, 883 nursing interns from 23 provinces in China responded to the survey. Among them, the virtual simulation utilization rate was 35.6% (314/883) and the awareness rate was 10.2% (90/883). In addition, among the interns, only 10.2% (90/883) correctly understood the concept of virtual simulation, and most of them (793/883, 89.8%) believed that scenario-simulation training or the use of models for teaching are all the same. Multiple regression analysis showed that the educational level, independent learning ability, and professional identity of the interns were related to use of the application (P<.05). Skills and knowledge that the interns most wanted to acquire included the treatment of hypoglycemia (626/883, 70.9%), functional test simulation (610/883, 69.1%), and blood glucose monitoring technology (485/883, 54.9%). A total of 60.5% (534/883) of the interns wanted to acquire clinical thinking skills, while 16.0% (141/883) wanted to acquire operational skills. Nursing trainees believed that the greatest obstacles to virtual simulation included limited time (280/883, 31.7%), the degree of simulation (129/883, 14.6%), the demand for satisfaction (108/883, 12.2%), and test scores (66/883, 7.5%).

CONCLUSIONS

The understanding and usage rate of diabetes virtual simulation teaching applications by Chinese nursing interns is very low. However, they have high requirements regarding this teaching method. Conducting high-quality randomized controlled trials and designing applications that are suitable for the needs of different nurse trainees will increase students' interest in learning and help improve diabetes knowledge among nursing interns.

Virtual Reality as a Tool for Eliciting Empathetic Behaviour in Carers: An Integrative Review

BACKGROUND

Empathy is an essential behavioural competency required of healthcare providers. It is included in the Canadian National Competency Profile for Medical Radiation Technologists; supporting patient-centered care and the development of therapeutic relationships between carers and care recipients. This review synthesizes evidence on Virtual Reality (VR) as a tool for eliciting empathetic behaviour in carers.

METHODS

Six Electronic databases (PubMed, EMBASE, PsycInfo, ERIC, Academic Search Premier and CINAHL) were searched for studies published from 1997-2020. Studies with MeSH terms "Empathy" and "Virtual Reality", and conducted on adult carers, were eligible for inclusion. The Cochrane risk of bias tool guided the assessment of study quality. Prospero review registration number: CRD42020210049 RESULTS: Seven studies, with 485 carers, were included in this review. Studies were heterogeneous in terms of interventions and tools for collecting outcome measures. All seven studies demonstrated VR could elicit empathetic behaviour in carers. Studies included one randomized controlled trial, three non-randomized controlled trials, two with quasi-experimental designs, and one non-experimental design. All studies had a moderate to high risk of bias.

CONCLUSION

This review suggests that VR may be an appropriate method for eliciting empathetic behaviours in carers. Future studies employing appropriately powered multicentere randomized controlled designs should seek to determine which VR experiences are the most effective in evoking empathetic behaviours.

Taking ‘A walk through dementia’: exploring care home practitioners’ experiences of using a virtual reality tool to support dementia awareness

Emerging research has outlined the possibility for virtual reality (VR) experiences, which situate users into the perspective of someone living with dementia, to enhance dementia awareness. Currently, there is limited VR research that engages care home practitioners. It is imperative this population has high levels of dementia education given their requirements to provide care and support to residents, many of whom will be living with the condition. This paper reports on an exploratory qualitative study designed to elicit the experiences of care home practitioners who engaged with the VR application: ‘A walk through dementia’. Twenty practitioners, across four care homes in the United Kingdom, watched the VR scenarios and provided their views on the experience and the potential for the VR tool to be developed into a wider training programme to support dementia awareness. Data were collected via focus group discussions. Following an inductive thematic analysis, we constructed three themes. These suggested participants perceived the VR application offered them a convincing and immersive experience that was insightful and evocative, and provided ‘next-level’ dementia-awareness training that enabled them to reflect on care practices. Although the findings highlight important challenges for practitioners and developers wishing to use VR within dementia care, they suggest this application may be an engaging experiential learning tool that can provide care home staff with deeper cognitive and emotional awareness of living with dementia. Further work, drawing on these preliminary insights, is required to ensure the VR tool can be incorporated into a training programme that can positively contribute to the ‘dementia-friendly communities’ agenda.

Effects of Simulation on Nursing Students' Dementia Knowledge and Empathy: A Mixed Method Study

The experience of living with dementia is multifaceted while unique to the individual. Dementia education must empower nursing students to recognize the complexity of the experience while also emphasizing the need for person centered care. Participation in Dementia Live^® provides nursing students a glimpse into the life of a person living with dementia incorporating common symptoms associated with dementia and time for reflection regarding the experience. The purpose of the study was to determine the effects of dementia simulation on nursing students' dementia knowledge and empathy for people living with dementia. This convergent mixed methods study involved a convenience sample of 65 undergraduate nursing students. A pretest/posttest design was used to collect quantitative data while thematic analysis of focus group discussions was used for qualitative data collection. Quantitative results reported a significant increase in empathy. Qualitative findings supported the quantitative findings with themes identifying four of the six components of empathy. This study adds to the understanding of teaching and learning about dementia care and highlights the contributions a seven-minute simulation made to improve empathy.

Innovation in dementia education within undergraduate healthcare programmes: A scoping review

OBJECTIVES

The increase in the number of people living with dementia has resulted in a greater need for healthcare professionals from all disciplines to meet the needs of those living with the condition. This means a workforce which is competent in delivering dementia care which is person-centred, regardless clinical specialism. The aim of scoping review is to provide an overview of the novel education models being used to ensure the future healthcare workforce are able to meet this aspiration.

DATA SOURCES

Online databases PubMed, Web of Science, CINAHL, Medline, PsychInfo, ERIC were used.

REVIEW METHODS

Search terms 'Healthcare Student(s)', 'Dementia or Alzheimer's Education' were used. Inclusion criteria included papers published in English between 2009 and September 2019, with data pertaining to the assessment of dementia knowledge and attitudes among healthcare students. Abstracts were reviewed and identified for inclusion for full-text review. Included studies were assessed using the MMAT (Mixed Methods Appraisal Tool).

RESULTS

27 studies were included within the review. These were groups into five educational categories; long term experiential (n=5), activity-centered programmes with people with dementia (n=11), interprofessional education (IPE) (n=5), immersive conference style programmes (n=3) and dementia simulation (n=3). Long term experiential and activity centered programmes gave students the greatest increase in perceived confidence, and improvement in dementia attitudes. Programmes were most effective when directly involving people living with dementia.

CONCLUSION

The majority of the education programmes showed a potential benefit in improving either knowledge, confidence, attitude, or all three among healthcare students. This highlights the benefit that novel experiential programmes may have in aiding a culture of positive attitudes among future healthcare professionals who will be treating people with dementia. This review also demonstrates the positive benefit that directly involving people living with dementia within education can have on both student learners.

Increasing awareness, sensitivity, and empathy for Alzheimer's dementia patients using simulation

BACKGROUND

Alzheimer's Disease (AD), a type of dementia that interferes with memory, thinking, and behavior is the most common type of dementia. As a result, it is a leading contributor to death and disability for those over the age of 65. Therefore, future nurses must have the knowledge and skills to manage patients with AD in any setting spanning the healthcare continuum.

OBJECTIVE

The goal of this project was to evaluate perceptions of awareness, knowledge and sensitivity of future nurses concerning AD patients before and after participation in a simulated virtual reality dementia experience.

DESIGN/PARTICIPANTS

A quasi-experimental repeated measure pre-post design was used with a convenience sample of 163 undergraduate baccalaureate nursing students from three different courses at large public university in the Midwest.

METHODS

Students were placed in teams of four to participate in a 45-minute interactive simulated virtual reality dementia experience. Each session started with a 15-minute team pre-briefing session, followed by a 10-minute individual simulation, which was then followed by a 30-minute team debriefing session facilitated by faculty using the Plus/ Delta debriefing technique. The Dementia Attitudes Scale (DAS), The Knowledge About Memory Loss and Care Test (KAML-C), and the Healthcare Tour Survey were administered pre/post participation. Qualitative data was also collected from student reflections.

RESULTS

Statistically significant changes (p < 0.001) were noted in the pre/post DAS survey and the Healthcare Tour Survey. No significant change was noted on the KAML-C, although there was a trend towards improvement. No differences were noted between courses on any of the surveys.

CONCLUSION

Using a virtual reality dementia experience proved to be a valuable strategy to increase student perceptions of awareness, knowledge, and sensitivity of AD. Further exploration is warranted to establish how these may be further facilitated to translate into improved care for those with AD.