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Kim YM, Rhiu I. Development of a virtual reality system usability questionnaire (VRSUQ). APPLIED ERGONOMICS 2024; 119:104319. [PMID: 38797014 DOI: 10.1016/j.apergo.2024.104319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 05/01/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024]
Abstract
Virtual reality (VR) has gained significant attention as a technology that provides immersive experiences similar to the real world. In order for a VR system to be accepted, usability needs to be guaranteed. Accordingly, VR-related researchers are continuing their efforts to improve VR systems by conducting usability evaluations. However, existing studies have limitations in that they cannot comprehensively evaluate the detailed properties of VR systems by using questionnaires developed for general product usability evaluation or focusing only on some usability aspects of VR systems. This suggests it may be difficult to fully capture usability issues in a VR system, and that it is necessary to develop a usability evaluation tool that reflects the specific characteristics of the VR system. Therefore, this study develops and proposes the Virtual Reality System Usability Questionnaire (VRSUQ). In the development of the questionnaire, items were structured based on a literature review and discussions with experts. To account for the diverse characteristics of VR systems, the validity of the questionnaire was verified through both exploratory and confirmatory factor analysis, utilizing data obtained from three distinct experimental studies that employed different VR systems. In addition, by comparing the results of VRSUQ with the results from the System Usability Scale, which is widely used for perceived usability evaluation, alternative possibilities for using VRSUQ are presented. Further testing on various VR platforms is needed to ensure the reliability and validity of VRSUQ, and as results from using VRSUQ are accumulated, it is expected to be widely used as a more powerful and robust VR-specific perceived usability evaluation tool.
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Affiliation(s)
- Yong Min Kim
- Division of Interdisciplinary Studies in Cultural Intelligence (HCI Science Major), Dongduk Women's University, Seoul, South Korea.
| | - Ilsun Rhiu
- Division of Interdisciplinary Studies in Cultural Intelligence (HCI Science Major), Dongduk Women's University, Seoul, South Korea.
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Wu SC, Chuang CW, Liao WC, Li CF, Shih HH. Using Virtual Reality in a Rehabilitation Program for Patients With Breast Cancer: Phenomenological Study. JMIR Serious Games 2024; 12:e44025. [PMID: 38634461 PMCID: PMC11067444 DOI: 10.2196/44025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 10/31/2023] [Accepted: 12/30/2023] [Indexed: 04/19/2024] Open
Abstract
Background Surgery is an essential treatment for early-stage breast cancer. However, various side effects of breast cancer surgery, such as arm dysfunction and lymphedema, remain causes for concern. Rehabilitation exercises to prevent such side effects should be initiated within 24 hours after surgery. Virtual reality (VR) can assist the process of rehabilitation; however, the feasibility of applying VR for rehabilitation must be explored, in addition to experiences of this application. Objective This study explored patients' attitudes toward and experiences of using VR for their rehabilitation to determine the feasibility of such VR use and to identify potential barriers. Methods A phenomenological qualitative study was conducted from September to December 2021. A total of 18 patients with breast cancer who had undergone surgical treatment were interviewed using open-ended questions. The Colaizzi 7-step procedure for phenomenological analysis was used for data analysis. To ensure high study reliability, this study followed previously reported quality criteria for trustworthiness. Results Three themes were identified: (1) VR was powerful in facilitating rehabilitation, (2) early and repetitive upper limb movements were an advantage of VR rehabilitation, and (3) extensive VR use had challenges to be overcome. Most of the interviewed patients reported positive experiences of using VR for rehabilitation. Specifically, VR helped these patients identify appropriate motion and angle limits while exercising; in other words, knowledge gained through VR can play a key role in the rehabilitation process. In addition, the patients reported that the use of VR provided them company, similar to when a physiotherapist is present. Finally, the gamified nature of the VR system seemed to make VR-based rehabilitation more engaging than traditional rehabilitation, particularly with respect to early rehabilitation; however, the high cost of VR equipment made VR-based rehabilitation difficult to implement at home. Conclusions The interviewed patients with breast cancer had positive experiences in using VR for rehabilitation. The high cost of both VR equipment and software development presents a challenge for applying VR-based rehabilitation.
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Affiliation(s)
- Shih-Chung Wu
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chia-Wen Chuang
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Wen-Chun Liao
- School of Nursing, College of Healthcare, China Medical University, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Fang Li
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Hsin-Hsin Shih
- School of Nursing, College of Healthcare, China Medical University, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
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Brassel S, Brunner M, Campbell A, Power E, Togher L. Exploring Discussions About Virtual Reality on Twitter to Inform Brain Injury Rehabilitation: Content and Network Analysis. J Med Internet Res 2024; 26:e45168. [PMID: 38241072 PMCID: PMC10837760 DOI: 10.2196/45168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/06/2023] [Accepted: 10/29/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Virtual reality (VR) use in brain injury rehabilitation is emerging. Recommendations for VR development in this field encourage end user engagement to determine the benefits and challenges of VR use; however, existing literature on this topic is limited. Data from social networking sites such as Twitter may further inform development and clinical practice related to the use of VR in brain injury rehabilitation. OBJECTIVE This study collected and analyzed VR-related tweets to (1) explore the VR tweeting community to determine topics of conversation and network connections, (2) understand user opinions and experiences of VR, and (3) identify tweets related to VR use in health care and brain injury rehabilitation. METHODS Publicly available tweets containing the hashtags #virtualreality and #VR were collected up to twice weekly during a 6-week period from July 2020 to August 2020 using NCapture (QSR International). The included tweets were analyzed using mixed methods. All tweets were coded using inductive content analysis. Relevant tweets (ie, coded as "VR in health care" or "talking about VR") were further analyzed using Dann's content coding. The biographies of users who sent relevant tweets were examined descriptively. Tweet data networks were visualized using Gephi computational analysis. RESULTS A total of 260,715 tweets were collected, and 70,051 (26.87%) were analyzed following eligibility screening. The sample comprised 33.68% (23,596/70,051) original tweets and 66.32% (46,455/70,051) retweets. Content analysis generated 10 main categories of original tweets related to VR (ie, advertising and promotion, VR content, talking about VR, VR news, general technology, VR industry, VR live streams, VR in health care, VR events, and VR community). Approximately 4.48% (1056/23,596) of original tweets were related to VR use in health care, whereas 0.19% (45/23,596) referred to VR in brain injury rehabilitation. In total, 14.86% (3506/23,596) of original tweets featured commentary on user opinions and experiences of VR applications, equipment, and software. The VR tweeting community comprised a large network of 26,001 unique Twitter users. Users that posted tweets related to "VR in health care" (2124/26,001, 8.17%) did not form an interconnected VR network, whereas many users "talking about VR" (3752/26,001, 14.43%) were connected within a central network. CONCLUSIONS This study provides valuable data on community-based experiences and opinions related to VR. Tweets showcased various VR applications, including in health care, and identified important user-based considerations that can be used to inform VR use in brain injury rehabilitation (eg, technical design, accessibility, and VR sickness). Limited discussions and small user networks related to VR in brain injury rehabilitation reflect the paucity of literature on this topic and the potential underuse of this technology. These findings emphasize that further research is required to understand the specific needs and perspectives of people with brain injuries and clinicians regarding VR use in rehabilitation.
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Affiliation(s)
- Sophie Brassel
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Melissa Brunner
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andrew Campbell
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Leanne Togher
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Western Sydney Local Health District, Sydney, Australia
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Kiegaldie D, Shaw L. Virtual reality simulation for nursing education: effectiveness and feasibility. BMC Nurs 2023; 22:488. [PMID: 38114940 PMCID: PMC10729454 DOI: 10.1186/s12912-023-01639-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023] Open
Abstract
Virtual Reality simulation (VRS) is an innovative and emerging technology that has the potential to offer increased numbers of pre-registration students authentic learning experiences compared to traditional simulation- based education (SBE) with simulated participants. The aim was to evaluate learner outcomes of SBE compared to 4 fully immersive VRS scenarios, for vocational and higher education nursing students at a training and further education institute in Melbourne, Australia. A mixed methods quasi-experimental design study was conducted over two semesters from 2019 to 2020. Participants were 675 pre-registration nursing students. The intervention group (VRS n = 393) received 4 three-dimensional, immersive VRS modules. The control group (SBE n = 282) received 4 face-to-face large group immersive simulations. In the VRS group 95% of students actively participated, compared to SBE (on average 15%). Knowledge test scores were initially significantly greater (p < 0.01) for VRS versus SBE students, but not maintained post clinical placement. Intervention students found VRS to be realistic and prepared them for clinical practice. Some technical difficulties were identified with VRS. VRS was found to be more cost effective than SBE. VRS fostered critical thinking and provided an efficient and sustainable platform for learning about complex clinical situations.
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Affiliation(s)
- Debra Kiegaldie
- Eastern Health Clinical School, Monash University, Victoria, 3128, Australia
| | - Louise Shaw
- Centre for Digital Transformation of Health, University of Melbourne, Grattan Street, Parkville, Vic, 3010, Australia.
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Aksoy ME, Özkan AE, Kitapcioglu D, Usseli T. Comparing the Outcomes of Virtual Reality-Based Serious Gaming and Lecture-Based Training for Advanced Life Support Training: Randomized Controlled Trial. JMIR Serious Games 2023; 11:e46964. [PMID: 37768719 PMCID: PMC10570891 DOI: 10.2196/46964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/04/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Simulation-based Advanced Cardiac Life Support (ACLS) or Advanced Life Support (ALS) training for health care professionals is important worldwide for saving lives. Virtual reality (VR)-based serious gaming can be an alternative modality to be used as a part of simulation-based ALS training. OBJECTIVE The aim of this study is to investigate whether a VR-based ALS serious game module can replace classroom-based ALS lectures, the latter being part of existing conventional ALS training protocols in addition to skills training. METHODS Participants were students from Acibadem Mehmet Ali Aydinlar University's Vocational School for Anesthesiology (N=29) randomly divided into 2 groups with 15 (conventional training group) and 14 (VR-based training group) participants each. Participants in the conventional training group had to complete the pretest consisting of multiple-choice questions at the beginning of the study. Afterward, they took part in an interactive classroom-based ALS lecture. The next step involved skills training with task trainers to teach them compression skills. Following this, the conventional training group was divided into Code Blue teams, each consisting of 5 participants for the simulation session. Two independent instructors evaluated video recordings in terms of technical and nontechnical skills. The score acquired from the manikin-based simulation session was considered the main performance indicator in this study to measure the learning outcome. A similar workflow was used for the VR-based training group, but this group was trained with the VR-based ALS serious game module instead of the theoretical lecture. The final stage of the study involved completing the posttest consisting of multiple-choice questions. A preference survey was conducted among the study participants. Mann-Whitney U and Wilcoxon signed-rank tests were used to analyze the 2 groups' performances in this study. RESULTS The improvement in posttest results compared with pretest results was significant in the conventional training group (P=.002). Hands-on technical scores of the conventional training group were higher than those of the VR-based training group during manikin-based simulation, but total scores, including those for technical and crisis resource management skills, acquired from the manikin-based simulation session did not reveal any significant difference between the 2 groups. The results of the VR preference survey revealed that the majority of the participants prefer VR-based serious game-based training instead of classroom lectures. CONCLUSIONS Although hands-on technical scores of the conventional training group during the manikin-based simulation session were higher than those of the VR-based training group, both groups' total performance scores, including those for technical and crisis resource management skills, did not differ significantly. The preference survey reveals that the majority of the participants would prefer a VR-based ALS serious gaming module instead of lecture-based training. Further studies are required to reveal the learning outcome of VR-based ALS serious gaming. TRIAL REGISTRATION ClinicalTrials.gov NCT05798910; https://clinicaltrials.gov/study/NCT05798910.
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Affiliation(s)
- Mehmet Emin Aksoy
- Department of Biomedical Device Technology, Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Arun Ekin Özkan
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Dilek Kitapcioglu
- Department of Medical Education, Medical Faculty, Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Tuba Usseli
- Vocational School for Anaesthesiology Technicians, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Hrynyschyn R, Prediger C, Lyk P, Majgaard G, Helmer SM, Stock C. Adolescents' perceptions and user experiences with a virtual reality-based alcohol prevention tool in Germany: A focus group study. Front Public Health 2023; 11:1054015. [PMID: 36969627 PMCID: PMC10038231 DOI: 10.3389/fpubh.2023.1054015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/23/2023] [Indexed: 03/12/2023] Open
Abstract
Background Excessive alcohol consumption is a major public health problem, with substance use early in life contributing to higher levels of use later in life. Virtual reality (VR) is an innovative technology for alcohol prevention among adolescents that could solve the problem of insufficient outreach to the target group of young people. The co-created German Virtual LimitLab simulation is one of the few examples of VR-based alcohol prevention tools and consists of a virtual house party simulation. The aims of Virtual LimitLab are to increase the users' awareness of how social pressure can influence their own decision-making as well as to enable various actions and communication strategies in order to train competencies when dealing with alcohol. The present study thus aims to explore adolescents' content- and technique-specific perceptions of Virtual LimitLab in order to gain insights into user experiences and to test the prototype with the German target group. Methods Four semi-structured focus groups with adolescents aged 15-18 years (n = 13) were conducted and analyzed using thematic analyses. A user experience questionnaire (UEQ-S) was applied in order to quantitatively assess adolescents' satisfaction with Virtual LimitLab. Results Three main themes were identified (VR experience, content, and technical aspects). Participants positively assessed both the content and the technical aspects of Virtual LimitLab. This trend was also seen by the UEQ-S data, which yielded positive ratings for both pragmatic and hedonic quality. The broad variety of options in the simulation that allow the user to try new behaviors was perceived particularly positively. In general, Virtual LimitLab was regarded as an innovative tool that encourages adolescents to think critically about their personal alcohol consumption. Technical errors in the simulation and users' difficulties in identifying with the simulation were the main points of criticism. Conclusions Feedback from adolescent users revealed positive and therefore promising results when using Virtual LimitLab as a gaming alcohol-prevention tool. Some technical aspects still need to be improved in order to further refine the prototype, and suggestions for expanding the content of the application have already been made.
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Affiliation(s)
- Robert Hrynyschyn
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
- Leibniz Science Campus Digital Public Health, Bremen, Germany
| | - Christina Prediger
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Patricia Lyk
- University of Southern Denmark, Game Development and Learning Technology, The Maersk Mc-Kinney Moller Institute, Odense, Denmark
| | - Gunver Majgaard
- University of Southern Denmark, Game Development and Learning Technology, The Maersk Mc-Kinney Moller Institute, Odense, Denmark
| | - Stefanie Maria Helmer
- Leibniz Science Campus Digital Public Health, Bremen, Germany
- University of Bremen, Human and Health Sciences, Bremen, Germany
| | - Christiane Stock
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
- University of Southern Denmark, Unit for Health Promotion Research, Esbjerg, Denmark
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Moore N, Ahmadpour N, Brown M, Poronnik P, Davids J. Designing virtual reality experiences to supplement clinician Code Black education. Simul Healthc 2022. [DOI: 10.54531/dnzc8446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Nathan Moore
- 1Digital Health Solutions, Western Sydney Local Health District, North Parramatta, Australia
| | - Naseem Ahmadpour
- 2Affective Interactions Lab, School of Architecture, Design and Planning, University of Sydney, Sydney, Australia
| | - Martin Brown
- 3FMH Media Lab, Education Innovation, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Philip Poronnik
- 3FMH Media Lab, Education Innovation, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jennifer Davids
- 4Research and Education Network, Western Sydney Local Health District, Westmead, Australia
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Ezenwa BN, Umoren R, Fajolu IB, Hippe DS, Bucher S, Purkayastha S, Okwako F, Esamai F, Feltner JB, Olawuyi O, Mmboga A, Nafula MC, Paton C, Ezeaka VC. Using Mobile Virtual Reality Simulation to Prepare for In-Person Helping Babies Breathe Training: Secondary Analysis of a Randomized Controlled Trial (the eHBB/mHBS Trial). JMIR MEDICAL EDUCATION 2022; 8:e37297. [PMID: 36094807 PMCID: PMC9513689 DOI: 10.2196/37297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/14/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Neonatal mortality accounts for approximately 46% of global under-5 child mortality. The widespread access to mobile devices in low- and middle-income countries has enabled innovations, such as mobile virtual reality (VR), to be leveraged in simulation education for health care workers. OBJECTIVE This study explores the feasibility and educational efficacy of using mobile VR for the precourse preparation of health care professionals in neonatal resuscitation training. METHODS Health care professionals in obstetrics and newborn care units at 20 secondary and tertiary health care facilities in Lagos, Nigeria, and Busia, Western Kenya, who had not received training in Helping Babies Breathe (HBB) within the past 1 year were randomized to access the electronic HBB VR simulation and digitized HBB Provider's Guide (VR group) or the digitized HBB Provider's Guide only (control group). A sample size of 91 participants per group was calculated based on the main study protocol that was previously published. Participants were directed to use the electronic HBB VR simulation and digitized HBB Provider's Guide or the digitized HBB Provider's Guide alone for a minimum of 20 minutes. HBB knowledge and skills assessments were then conducted, which were immediately followed by a standard, in-person HBB training course that was led by study staff and used standard HBB evaluation tools and the Neonatalie Live manikin (Laerdal Medical). RESULTS A total of 179 nurses and midwives participated (VR group: n=91; control group: n=88). The overall performance scores on the knowledge check (P=.29), bag and mask ventilation skills check (P=.34), and Objective Structured Clinical Examination A checklist (P=.43) were similar between groups, with low overall pass rates (6/178, 3.4% of participants). During the Objective Structured Clinical Examination A test, participants in the VR group performed better on the critical step of positioning the head and clearing the airway (VR group: 77/90, 86%; control group: 57/88, 65%; P=.002). The median percentage of ventilations that were performed via head tilt, as recorded by the Neonatalie Live manikin, was also numerically higher in the VR group (75%, IQR 9%-98%) than in the control group (62%, IQR 13%-97%), though not statistically significantly different (P=.35). Participants in the control group performed better on the identifying a helper and reviewing the emergency plan step (VR group: 7/90, 8%; control group: 16/88, 18%; P=.045) and the washing hands step (VR group: 20/90, 22%; control group: 32/88, 36%; P=.048). CONCLUSIONS The use of digital interventions, such as mobile VR simulations, may be a viable approach to precourse preparation in neonatal resuscitation training for health care professionals in low- and middle-income countries.
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Affiliation(s)
| | - Rachel Umoren
- Department of Pediatrics, University of Washington, Washington, WA, United States
| | | | - Daniel S Hippe
- Clinical Research Division, Fred Hutchinson Cancer Center, Washington, WA, United States
| | - Sherri Bucher
- Department of Pediatrics, Indiana University School of Medicine, Indiana, IN, United States
| | - Saptarshi Purkayastha
- Department of BioHealth Informatics, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, United States
| | - Felicitas Okwako
- Department of Paediatrics, Alupe University College, Busia, Kenya
| | - Fabian Esamai
- Department of Paediatrics, Alupe University College, Busia, Kenya
| | - John B Feltner
- Department of Pediatrics, University of Washington, Washington, WA, United States
| | - Olubukola Olawuyi
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Annet Mmboga
- Department of Paediatrics, Alupe University College, Busia, Kenya
| | | | - Chris Paton
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford, United Kingdom
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Abstract
With concepts such as immersion and presence, known as hedonistic qualities of importance in the virtual reality (VR) experience, the question arises whether the more pragmatic heuristics are effective in the evaluation of an artifact. However, despite the importance of the heuristics for artifact evaluations, the available studies do not provide a rigorous review of these heuristics and their efficiency. Thus, this review aims to look at how heuristics have been applied in various virtual learning environments (VLEs) that involve virtual reality learning activities, either for use in heuristic evaluations or as design principles. In addition, it examines how these heuristics support the evaluation of a more hedonistic quality, such as presence, and lastly, the aim is to gauge the estimated efficiency of heuristics as an evaluation method. This article is a systematic review of research investigating using heuristics in a virtual reality learning context. The review includes articles published from January 2017 to February 2022, and from the screened records, twelve articles were analyzed in full-text form. This review shows the versatility of heuristics and their applications as well as the key concepts that are vital to the user’s experience in a virtual reality learning context. This review indicates that heuristic evaluation is a valuable tool, as it provides a clear summary of what needs to be handled in the next iteration of the application.
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Moore N, Ahmadpour N, Brown M, Poronnik P, Davids J. How can virtual reality (VR) based conversational agents be designed to train clinicians in verbal de-escalation skills: An Exploratory Usability Study (Preprint). JMIR Serious Games 2022; 10:e38669. [PMID: 35793129 PMCID: PMC9301562 DOI: 10.2196/38669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/17/2022] [Accepted: 06/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Violence and aggression are significant workplace challenges faced by clinicians worldwide. Traditional methods of training consist of “on-the-job learning” and role-play simulations. Although both approaches can result in improved skill levels, they are not without limitation. Interactive simulations using virtual reality (VR) can complement traditional training processes as a cost-effective, engaging, easily accessible, and flexible training tool. Objective In this exploratory study, we aimed to determine the feasibility of and barriers to verbal engagement with a virtual agent in the context of the Code Black VR application. Code Black VR is a new interactive VR-based verbal de-escalation trainer that we developed based on the Clinical Training Through VR Design Framework. Methods In total, 28 participants with varying clinical expertise from 4 local hospitals enrolled in the Western Sydney Local Health District Clinical Initiative Nurse program and Transition to Emergency Nursing Programs and participated in 1 of 5 workshops. They completed multiple playthroughs of the Code Black VR verbal de-escalation trainer application and verbally interacted with a virtual agent. We documented observations and poststudy reflection notes. After the playthroughs, the users completed the System Usability Scale and provided written comments on their experience. A thematic analysis was conducted on the results. Data were also obtained through the application itself, which also recorded the total interactions and successfully completed interactions. Results The Code Black VR verbal de-escalation training application was well received. The findings reinforced the factors in the existing design framework and identified 3 new factors—motion sickness, perceived value, and privacy—to be considered for future application development. Conclusions Verbal interaction with a virtual agent is feasible for training staff in verbal de-escalation skills. It is an effective medium to supplement clinician training in verbal de-escalation skills. We provide broader design considerations to guide further developments in this area.
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Affiliation(s)
- Nathan Moore
- Digital Health Solutions, Western Sydney Local Health District, North Parramatta, Australia
| | - Naseem Ahmadpour
- Design Lab, Sydney School of Architecture, Design and Planning, The University of Sydney, Sydney, Australia
| | - Martin Brown
- Faculty of Medicine and Health Media Lab, Education Innovation, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Philip Poronnik
- Faculty of Medicine and Health Media Lab, Education Innovation, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jennifer Davids
- Research and Education Network, Western Sydney Local Health District, Westmead, Australia
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Sadeghi AH, Peek JJ, Max SA, Smit LL, Martina BG, Rosalia RA, Bakhuis W, Bogers AJ, Mahtab EA. Virtual Reality Simulation Training for Cardiopulmonary Resuscitation After Cardiac Surgery: Face and Content Validity Study. JMIR Serious Games 2022; 10:e30456. [PMID: 35234652 PMCID: PMC8928050 DOI: 10.2196/30456] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/04/2021] [Accepted: 12/03/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Cardiac arrest after cardiac surgery commonly has a reversible cause, where emergency resternotomy is often required for treatment, as recommended by international guidelines. We have developed a virtual reality (VR) simulation for training of cardiopulmonary resuscitation (CPR) and emergency resternotomy procedures after cardiac surgery, the Cardiopulmonary Resuscitation Virtual Reality Simulator (CPVR-sim). Two fictive clinical scenarios were used: one case of pulseless electrical activity (PEA) and a combined case of PEA and ventricular fibrillation. In this prospective study, we researched the face validity and content validity of the CPVR-sim. OBJECTIVE We designed a prospective study to assess the feasibility and to establish the face and content validity of two clinical scenarios (shockable and nonshockable cardiac arrest) of the CPVR-sim partly divided into a group of novices and experts in performing CPR and emergency resternotomies in patients after cardiac surgery. METHODS Clinicians (staff cardiothoracic surgeons, physicians, surgical residents, nurse practitioners, and medical students) participated in this study and performed two different scenarios, either PEA or combined PEA and ventricular fibrillation. All participants (N=41) performed a simulation and completed the questionnaire rating the simulator's usefulness, satisfaction, ease of use, effectiveness, and immersiveness to assess face validity and content validity. RESULTS Responses toward face validity and content validity were predominantly positive in both groups. Most participants in the PEA scenario (n=26, 87%) felt actively involved in the simulation, and 23 (77%) participants felt in charge of the situation. The participants thought it was easy to learn how to interact with the software (n=24, 80%) and thought that the software responded adequately (n=21, 70%). All 15 (100%) expert participants preferred VR training as an addition to conventional training. Moreover, 13 (87%) of the expert participants would recommend VR training to other colleagues, and 14 (93%) of the expert participants thought the CPVR-sim was a useful method to train for infrequent post-cardiac surgery emergencies requiring CPR. Additionally, 10 (91%) of the participants thought it was easy to move in the VR environment, and that the CPVR-sim responded adequately in this scenario. CONCLUSIONS We developed a proof-of-concept VR simulation for CPR training with two scenarios of a patient after cardiac surgery, which participants found was immersive and useful. By proving the face validity and content validity of the CPVR-sim, we present the first step toward a cardiothoracic surgery VR training platform.
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Affiliation(s)
- Amir H Sadeghi
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jette J Peek
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands.,Educational Program Technical Medicine, Leiden University Medical Center, Delft University of Technology, Erasmus University Medical Center Rotterdam, Leiden, Delft, Rotterdam, Netherlands
| | - Samuel A Max
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands.,Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Liselot L Smit
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bryan G Martina
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Rodney A Rosalia
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Clinical Research, Zan Mitrev Clinic, Skopje, the Former Yugoslav Republic of Macedonia
| | - Wouter Bakhuis
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ad Jjc Bogers
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Edris Af Mahtab
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
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12
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Janssen A, Fletcher J, Keep M, Ahmadpour N, Rouf A, Marthick M, Booth R. Experiences of Patients Undergoing Chemotherapy With Virtual Reality: Mixed Methods Feasibility Study. JMIR Serious Games 2022; 10:e29579. [PMID: 35188474 PMCID: PMC8902671 DOI: 10.2196/29579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/19/2021] [Accepted: 11/13/2021] [Indexed: 01/26/2023] Open
Abstract
Background Current research into virtual reality (VR) use during chemotherapy shows that it can be an effective distraction intervention. However, there is limited research in adult patients and to investigate how VR can be sustainably implemented in health care organizations. Objective The aim of this study was to explore the feasibility and acceptability of using VR for adult patients undergoing chemotherapy, and to identify the factors that would enable the sustained use of VR during chemotherapy in health care organizations. Methods Patients undergoing chemotherapy were recruited to participate in a VR intervention during chemotherapy infusion. Participants were observed during the session and completed a postintervention survey. Each participant was invited to participate in a semistructured interview about their experience. Results A total of 18 patients participated in the study, 5 of whom participated in semistructured interviews. Findings indicated that the use of VR was acceptable for patients undergoing chemotherapy and the intervention was also feasible. Some participants felt that the VR was an effective distraction during chemotherapy infusion, although most still seemed to be aware of how long their treatment was taking. Although VR was acceptable and feasible to patients, interviews identified several barriers to sustained implementation, including access to a reliable app library and impact on staff workloads. Conclusions VR was acceptable to patients with a diagnosis of cancer undergoing chemotherapy treatment. Patients found VR beneficial for breaking up the monotony of treatment, to provide an additional choice of activity in addition to other recreation, and in some instances as a distraction from the treatment itself. However, there are challenges to address if VR is to be implemented in practice for this patient group.
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Affiliation(s)
- Anna Janssen
- Research in Implementation Science and eHealth Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jennifer Fletcher
- Education Enterprise and Engagement, The University of Sydney, Sydney, Australia
| | - Melanie Keep
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Naseem Ahmadpour
- School of Architecture, Design and Planning, The University of Sydney, Sydney, Australia
| | - Anika Rouf
- Faculty of Science, The University of Sydney, Sydney, Australia
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13
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Moore N, Dempsey K, Hockey P, Jain S, Poronnik P, Shaban RZ, Ahmadpour N. Innovation During a Pandemic: Developing a Guideline for Infection Prevention and Control to Support Education Through Virtual Reality. Front Digit Health 2021; 3:628452. [PMID: 34713100 PMCID: PMC8521867 DOI: 10.3389/fdgth.2021.628452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Nathan Moore
- Research and Education Network, Western Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kathy Dempsey
- Clinical Excellence Commission, Sydney, NSW, Australia
| | - Peter Hockey
- Research and Education Network, Western Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Susan Jain
- Clinical Excellence Commission, Sydney, NSW, Australia
| | - Philip Poronnik
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.,Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia.,New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Ministry of Health, Sydney, NSW, Australia
| | - Naseem Ahmadpour
- Design Lab, School of Architecture, Design, and Planning, The University of Sydney, Sydney, NSW, Australia
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