PG16 Virtual reality training for de-escalation of responsive behaviours

Introduction Caregivers of persons with dementia (PWD) frequently face physical assault and emotional abuse1,2. Providing experiential opportunities for these caregivers to develop skills that maximize safe, compassionate care is a key priority in healthcare. While simulation has been demonstrated to be more effective than didactic activities in developing clinical skills across many healthcare contexts3, in-person simulation has significant limitations. During in-person simulation, the full expression of behaviours must be limited to ensure that both learners and simulated patients (SP) are not physically harmed. While previous work in VR dementia simulations has demonstrated that taking different perspectives helps build empathy towards both the caregiver and the PWD4, VR solutions to date do not leverage a human SP, which limits the ability to explore complex behaviours. Methods The Michener Institute for Education, Baycrest Health Sciences and the Ottawa Hospital Research Institute collaborated to develop a Virtual Reality (VR) platform where simulations are delivered in a risk-free environment that fully leverages opportunities for de-escalation training, situational awareness, and empathy building. SPs enact distressed patients with dementia demonstrating fully responsive and complex behaviours that risk progressing to physical threat in real time with learner. Built into the design are opportunities for learners to take the perspective of the patient, the health care practitioner or a general observer of both. Results The objectives of this randomized controlled study are to 1) evaluate the usability and feasibility of virtual reality simulation training for clinical staff (including formal caregivers of persons with dementia, and/or those exhibiting responsive behaviours); and 2) to compare this format of training to standard training on key outcomes of interest (i.e., confidence in care; knowledge on de-escalation strategies; comfort with working with PWD). The findings will help us refine, and scale the VR training. Discussion and Conclusion This presentation will outline the objectives of the research, as well as provide a demonstration of the VR technology. The challenges of conducting this type of research during a pandemic will be discussed. References Bostrom A-M, Squires JE, Mitchell A, Sales AE, Estabrooks CA. Workplace aggression experienced by frontline staff in dementia care. Journal of Clinical Nursing. 2012 May;21(9–10):1453–65. Lachs MS, Rosen T, Teresi JA, Eimicke JP, Ramirez M, Silver S, et al. Verbal and physical aggression directed at nursing home staff by residents. J Gen Intern Med. 2013 May;28(5):660–7. Cook DA, Brydges R, Hamstra SJ, Zendejas B, Szostek JH, Wang AT, et al. Comparative effectiveness of technology-enhanced simulation versus other instructional methods: A systematic review and meta-analysis. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare 2012 Oct;7(5):308–20. Sokoloff L, Meyer R, Myers T. Virtual Reality Simulations: Building a Prototype for Dementia Education. Realities 360 Conference; 2017 Jul 26; San Jose, CA