Using Virtual Reality to Compare Design Alternatives Using Subjective and Objective Evaluation Methods

The movement of syringes and medication during anesthesiology delivery: An observational study in laparoscopic surgeries

The movements of syringes and medications during an anesthetic case have yet to be systematically documented. We examine how syringes and medication move through the anesthesia work area during a case. We conducted a video-based observational study of 14 laparoscopic surgeries. We defined 'syringe events' as when syringe was picked up and moved. Medications were administered to the patient in only 48 (23.6%) of the 203 medication or syringe events. On average, 14.5 syringe movements occurred in each case. We estimate approximately 4.2 syringe movements for each medication administration. When a medication was administered to the patient (either through the IV pump or the patient port), it was picked up from one of 8 locations in the work area. Our study suggests that the syringe storage locations vary and include irregular locations (e.g., patient bed or provider's pockets). Our study contributes to understanding the complexity in the anesthesia work practices.

The Impact of Design Factors on User Behavior in a Virtual Hospital Room to Explore Fall Prevention Strategies

OBJECTIVES

Falls in hospitals pose a significant safety risk, leading to injuries, prolonged hospitalization, and lasting complications. This study explores the potential of augmented reality (AR) technology in healthcare facility design to mitigate fall risk.

BACKGROUND

Few studies have investigated the impact of hospital room layouts on falls due to the high cost of building physical prototypes. This study introduces an innovative approach using AR technology to advance methods for healthcare facility design efficiently.

METHODS

Ten healthy participants enrolled in this study to examine different hospital room designs in AR. Factors of interest included room configuration, door type, exit side of the bed, toilet placement, and the presence of IV equipment. AR trackers captured trajectories of the body as participants navigated through these AR hospital layouts, providing insights into user behavior and preferences.

RESULTS

Door type influenced the degree of backward and sideways movement, with the presence of an IV pole intensifying the interaction between door and room type, leading to increased sideways and backward motion. Participants displayed varying patterns of backward and sideways travel depending on the specific room configurations they encountered.

CONCLUSIONS

AR can be an efficient and cost-effective method to modify room configurations to identify important design factors before conducting physical testing. The results of this study provide valuable insights into the effect of environmental factors on movement patterns in simulated hospital rooms. These results highlight the importance of considering environmental factors, such as the type of door and bathroom location, when designing healthcare facilities.

Impact of an immersive virtual reality simulator education program on nursing students' intravenous injection administration: A mixed methods study

BACKGROUND

Undergraduate nursing students often face limited opportunities to gain hands-on experience in performing invasive procedures and techniques. Immersive media tools may be helpful in training and enhancing skill development among nursing students.

OBJECTIVES

The specific aims of this study were threefold: (1) to describe the development process of an intravenous injection virtual reality simulator (IIVRS) program, (2) to determine the effect of the IIVRS program on intravenous injection knowledge, and (3) to examine the acceptability, learning motivation, and experience of the IIVRS program among nursing students.

METHODS

This study is a mixed method design, encompassing a one-group pre- and post-test approach and the utilization of reflection logs among 128 second-year nursing students enrolled at a university in northern Taiwan. An innovative gamification IIVRS program was developed by our research team. Knowledge of intravenous injection was assessed using a point visual analog scale at pre-and post-testing. Acceptability and motivation were assessed using items on a 5-point Likert scale. The IIVRS program experience was evaluated using open-ended questions of reflection. A paired t-test was used for comparing knowledge at pre-and post-tests, independent t-tests were conducted to compare levels of acceptance and learning motivation among different students' characteristics, and content analysis was used for qualitative data.

RESULTS

Students' knowledge of intravenous injection was significantly improved (Pre-test Mean = 3.08 vs. Post-test Mean = 4.96, p < 0.001). Students reported high levels of acceptance (Mean = 4.65) and learning motivation (Mean = 4.69). Students reported three themes of their experience: (1) attracts my attention and stimulates my motivation to learn, (2) enhanced memorization of the skill and process, and (3) a sense of presence and realism/unrealism.

CONCLUSION

The virtual reality program for intravenous injection administration can be an effective education tool, fostering students' motivation to learn and a heightened sense of accomplishment.

Generating Plan Layouts: A Case Study on Visualization of Implicit Knowledge by "Doctor Architects"

AIM

This article presents an opportunistic case with particular focus on instances from an extended procurement operation in which medical professionals run a proactive process involving the generation of layouts through distinct modes of representational practices without any actual collaboration with designers. The questions of inquiry involve an analysis on how the visualizations came into being and a discussion into the content of drawings that was shaped by individuals without any formal design education.

BACKGROUND

Although the literature introduces examples of genuine participation, particularly in healthcare design practices, the instances in which nondesigners demonstrate accomplished skills in spatial reasoning and representation are limited.

METHOD

The research was formulated as a qualitative case study including a series of observations of the activities of the participants followed by interviews recorded at different locations. The investigation also focuses on the features of these authentic graphics which illustrate the intentions of the medical professionals concerning the function of spaces.

RESULTS

In this research, the participants went through a labor intensive and elaborate effort to produce "architectural representations" with the intention to convey their implicit professional expertise in the domain. The layouts were introduced to be the vital elements to visualize the implicit knowledge regarding the functioning of space.

CONCLUSIONS

The productive and creative engagement of clinicians within this research makes the case for a multidisciplinary approach that reframes the limits and potential contributions of participants alongside drawings, which are exclusively claimed by and strategically employed by architects as negotiation devices within participatory design processes.

Perceived Usability of Seating in an Outpatient Waiting Area: A Combined Approach Utilizing Virtual Reality and Actual Seating Prototypes

OBJECTIVE

This study proposed a combined methodology to evaluate the perceived usability of healthcare seats that were first selected in a virtual waiting room which provided the context of use for the seats.

BACKGROUND

There has been an increased interest in using virtual reality (VR) for evaluation of seating in interior environments. Although VR offers a less expensive approach compared to evaluating seats in situ, using VR has limitations as users cannot experience the actual seat prototypes.

METHOD

Participants (N = 92) experienced a virtual waiting room with various seat groupings and were prompted with four task-based scenarios through which they selected a seat. After the VR phase, they experienced their selected seats in a lab and used an online questionnaire to evaluate the seating. Semi-structured interviews were conducted to garner similarities and differences in participants' experience of virtual and real seats.

RESULTS

Three categories including comfort, support, and flexibility were extracted from the questionnaire. While support and comfort categories were highly ranked by participants, the category rankings varied depending on participants' age, gender, tasks, and seat types. Interviews revealed that there were differences in experience of the seating materials in VR versus reality, and therefore experiencing the real seats was useful in seating evaluation.

CONCLUSIONS

The findings suggest that the combined methodology using VR and real seating in a lab is a reliable tool for designers and furniture manufacturers to obtain users' perceived usability evaluation of seating during the design process while the actual context is absent.

Staff participation in design with multiple tools: Impact on design and POE results

OBJECTIVE

This is a concluding part of an action research study to evaluate the impact on healthcare staff participation in the design of a new intensive care unit (ICU). Staff participated with multiple tools in the design; during the predesign phase utilizing co-design and virtual mock-ups, and also participating in the predesign evaluation (PDE) and postoccupancy evaluation (POE). Both the ICU design and evaluations were based on the principles of evidence-based design studies.

METHOD

Staff satisfaction was evaluated with an online survey comprising 116 statements on 13 different topics used both in PDE and POE. There was space for open-ended comments after each topic.

RESULTS

There was a statistically significant difference (<.001) between PDE and POE results. There were considerable improvements in privacy, accessibility, safety and security, and acoustics. It was assumed that participation in the predesign phase would positively influence POE results, but there were no statistical differences in any topics. However, as a result of collaborative predesign phase, the staff was satisfied with these jointly designed patient rooms. Open-ended questions revealed the importance to continue functional and technical support for staff after commissioning and ensure that technical solutions are practical and well-functioning.

CONCLUSION

The use of PDE and POE assists to set predetermined criteria and evaluate the success of design. Healthcare providers should see POE as a valuable part of design and commissioning process. Additionally, the use of POE should be made more effortless and the results more easily accessible to promote increased interest and usage.

Using Virtual Reality (VR) Mock-Ups for Evidence-Based Healthcare Facility Design Decisions

(1) Background: There are many complexities and trade-offs that design teams consider when designing or renovating a built environment for healthcare. Virtual reality (VR) mock-ups can allow design teams to evaluate the planned design. This study aimed to examine the overall value of using VR mock-ups to conduct a simulation-based mock-up evaluation. (2) Methods: Data collected from scenario enactments within a VR mock-up was compared to data collected from an existing medication room with the same design to assess predictive validity. Outcomes regarding quality and patient safety were also examined as a result of design modifications to the VR mock-up which were identified through a post-occupancy evaluation (POE) of the existing medication room. Survey data from participants, hospital design stakeholders, and POE recommendation recipients captured perceptions regarding the evaluation process. Specifically, this included perceptions regarding mock-up and scenario realism as well as utility of the evaluation process. (3) Results: Evidence-based data collected using the VR mock-up accurately assessed workflow (link analysis), bumps, impediments, interruptions, and task completion times. Collecting data pertaining to selection errors and equipment placement were identified after procuring the VR software and therefore the accuracy of these measures was not assessed. Searching behaviours were not possible to capture using the VR software. A 506% return on investment was achieved through the VR mock-up evaluations. (4) Conclusion: Organizations should consider what evaluation objectives are planned and how they will be measured for a mock-up evaluation to determine if VR is appropriate.

A Comprehensive Evaluation of Township Hospitals in the Severely Cold Areas of China

OBJECTIVE

The aims of this study are to establish an evaluation system and find the existing problems in the architectural design of township hospitals in the severely cold regions of China.

BACKGROUND

Due to the geographical location and economic factors, development still has some key problems, such as inadequate construction, old facilities, and backward technology, which are more prominent in the severely cold regions.

METHODS

First, evaluation factors have been selected and determined by literature review and on-site investigation. Evaluation rules have been determined using fuzzy membership function. Then, the analytic hierarchy process is used to determine the weights of the evaluation factors at all levels. Finally, take a township hospital as an example to calculate the comprehensive evaluation results.

RESULTS

A comprehensive evaluation index system with 28 elements and 76 factors for the township hospitals in severely cold regions including the basic health service capacity, the emergency capacity, and the climate fitness.

CONCLUSIONS

The establishment of the comprehensive evaluation system of township hospitals in severely cold areas in this study aims to find out the problems through the evaluation of the existing township hospitals in the severely cold areas and provide guidance for the transformation of existing township hospitals in the severely cold areas. By comparing the scheme evaluation for building hospitals, we shall look for the optimal solution to provide reference for future development in the construction of township hospitals.

Modular composite building in urgent emergency engineering projects: A case study of accelerated design and construction of to COVID-19 pandemic

Wuhan Leishenshan/Leishenshan ("Leishenshan" for short) hospital is a makeshift emergency hospital for treating patients diagnosed with the novel coronavirus-infected pneumonia (NCIP). Engineering construction uses modular composite building finished products to the greatest extent, which reduces the workload of field operations and saves a lot of time. The building information model (BIM) technology assists in design and construction work to meet rapid construction requirements. Besides, based on the unmanned aerial vehicles (UAVs) data analysis and application platform, digitization and intelligence in engineering construction are improved. Simultaneously, on-site construction and overall hoisting were carried out to achieve maximum efficiency. This article aims to take the construction of Leishenshan Hospital as an example to illustrate how to adopt BIM technology and other high-tech technology such as big data, artificial intelligence, drones, and 5G for the fast construction of the fabricated steel structure systems in emergency engineering projects.

Nurses' Participation in the Design of an Intensive Care Unit: The Use of Virtual Mock-Ups

BACKGROUND

Co-design with multiple tools is useful when end users' knowledge is important, especially when designers work with people unfamiliar with design. Many studies have highlighted the importance of nurses' participation in design, and such participation requires the development of techniques and tools to facilitate collaboration. This article analyzes how nurses participated in designing a general intensive care unit in a walk-in virtual environment (VE) and examines how their work-related knowledge can be transferred to the design process of spaces.

METHOD

In this action research study, the design process was conducted by using virtual mock-ups, which were evaluated by multi-occupational groups in a walk-in VE. Nurses were the largest occupational group. Their work processes were under modification, since existing multi-patient rooms were being redesigned as single-patient rooms. The design of single-patient rooms was performed in three iterative cycles in the walk-in VE.

RESULTS

The nurses could specify their requirements in the walk-in VE, and their suggestions were incorporated into the architectural design process. The nurses were satisfied with their role in the design process.

CONCLUSION

Co-design with virtual mock-ups in walk-in VE is appropriate when designing new healthcare facilities and when the opinions of workers are important. Virtual mock-ups in walk-in VE can be used collaboratively, facilitating simultaneous feedback from multiple users. Virtual reality (VR) technology has evolved, and changes can be made rapidly and at a lower cost. Another advantage of VR is that it allows one to design larger spaces, thus providing larger layouts of facilities for evaluation.