Improvements to Virtual Reality Trainings for Healthcare Practitioners to De-Escalate Challenging Behaviors in Persons With Dementia: Interviews With Experts (Preprint)

Abstract

A common problem among healthcare practitioners (HCPs) for persons with dementia is difficult behaviours associated with dementia, which cause burnout and stress. One intervention to help HCPs de-escalate these behaviours is virtual reality (VR) trainings, which simulate those stressful behaviours. However, current VR trainings lack important elements; these trainings are unrealistic and users cannot practice skills or interact with the virtual environment.

This study sought to formulate improvements to VR trainings in order to enhance HCPs’ skills. The goal was to increase interaction between the user and virtual environment in order to induce anxiety, generate feedback, and evaluate the user’s skills.

The three areas for improvement are in the clinical, technological, and educational assessment aspects of this training. To inform next steps, thirteen experts were interviewed using a questionnaire developed around six themes: practical skill acquisition; feedback; evaluation of the user; measurement of skills/knowledge; interaction between the user and the virtual environment; realism; and elicitation of emotion from the user.

A total of eight experts participated in this research and their responses led to the identification of several themes related to, and building on, the original themes: interaction, feedback, evaluation, realism, elicitation of emotion, and practical considerations. Potential ideas for the next stage of this intervention include introducing branching scenarios, adapting the intervention for informal caregivers, and creating standardized evaluation, debriefing, and screening tools.

VR simulations for HCPs of persons with dementia must include greater opportunities for practicing de-escalation through interaction, using a variety of tools and methods.