Edith Cowan University has developed a new virtual reality training session featuring a violent patient.
Assaults on healthcare workers at Australian hospitals have risen dramatically over the last decade, but it turns out that training on how to deal with violence and abuse from patients has not kept pace.
The boffins at Edith Cowan University have noted that the number of hospital assaults increased by more than 40% across the three Eastern states between 2015 and 2018 and clinicians feel “inadequately prepared” to navigate aggressive and violent situations.
Ideally, nursing and medical students would be exposed to interactive roleplay experiences simulating an aggressive patient encounter.
Logistically, though, that is both tough to pull off, time consuming and very expensive. Not to mention the worrying potential for the participants of a violent role play scenario to get a little too into method acting…
Enter virtual reality (VR).
“Given the documented frequency of aggressive and violent incidents, with data clearly suggesting prevalence continues to intensify, and the clear acute and chronic impacts such incidents can have on healthcare workers and students, exploring alternative training approaches is crucial,” Edith Cowan University researchers wrote in Teaching and Learning in Nursing.
“VR has the capability to circumvent many of the challenges in implementing aggression and violence management training in nursing programs, offers learning outcomes comparable to traditional simulation-based learning environments, ensures consistent learning experiences, and potentially reduces resource needs.”
The VR training scenario designed by the Edith Cowan University simulation and immersive digital technology group was based on interviews with hospital-based work health and safety managers, frontline healthcare workers, workplace violence training coordinators, hospital management staff, security reports and video footage of violent incidents.
The program ultimately featured a branching narrative structure, where users were able to make different dialogue choices that would affect the scenario outcome, with the option to call security or trigger a distress alarm at any time.
“The primary scenario involves participants engaging with a simulated patient exhibiting aggressive behavior, which they must work to de-escalate,” the researchers wrote.
“Depending on the dialogue choices made, the patient may become more aggressive, disclose relevant contextual information, or show signs of de-escalation.
“The scenario offers 38 different dialogue choices with six possible endings, ranging from successfully de-escalating the patient and providing a handover to the nurse manager to the patient becoming increasingly agitated and turning physically violent.
“After the scenario is completed, a summary screen depicts a review of decisions made.”
The program, which is known as I-VADE, was tested on 221 undergraduate nursing students and resulted in a statistically significant improvement in their self-rated confidence in managing patient aggression.
A promotional video for I-VADE features various virtual patients calling the user a “stupid cow” and a “bloody crook”, with one virtual elderly lady going so far as to very slowly fling a cup toward the user.
Commercial trials of the product are expected later this year.
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