Virtual reality enhanced behaviour-change training for healthcare-associated infection prevention
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1
University and University Hospital Zurich, Division of Infectious Diseases and Hospital Epidemiology, Switzerland
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2
University Hospital Zurich, Information and Communication Technology Directorate, Switzerland
Rationale: Healthcare associated infections (HAI) continue to pose an important risk to patient safety, resulting in prolonged length of stay, increased microbial resistance, long-term disability and mortality, as well as excessive costs for health systems, patients and families. A significant portion of HAI may be prevented through the application of evidence-based practices such as hand hygiene and basic precautions during invasive procedures. The successful introduction of such practices relies to a great extent on interventions to change healthcare provider behaviour. Several challenges arise, however, when attempting to measure the impact of multifaceted behaviour-change interventions, such as the difficulty to control for the many variables in complex healthcare settings. Such difficulties preclude the use of traditional study designs, such as randomised controlled trials, to study the factors that influence healthcare provider behaviour in the real world. As an innovative solution, the introduction of virtual reality technology creates an ideal setting for studying behaviour in a controlled virtual environment. To take the lessons learned from such studies a step further, a virtual setting also creates the opportunity to apply behaviour change interventions (e.g. introduce behaviour-shaping feedback which is not feasible in the real world) therefor producing a training environment that may have lasting effects on real world behaviour.
Aims: We aim 1) to establish a virtual healthcare environment which will serve as a virtual lab to study the impact of controlled variables on healthcare provider behaviour while working in the virtual reality; and 2) to test the impact of training in a virtual environment on healthcare provider behaviour in the real world (transfer).
Methodology: A virtual reality environment has been programmed that simulates a University Hospital Zurich standard patient room with high fidelity. To study potential determinants of healthcare provider behaviour, we will employ randomised controlled trials to measure the effect of changes in the physical (e.g. handrub dispenser placement, visual cues) and social environment (e.g. presence of additional avatars, patient appearance) on infection prevention behaviours (e.g. hand disinfection, donning of personal protective equipment). To test the impact of virtual reality training on real-world behaviour, we will employ a controlled before-and-after study.
Analysis: Randomised controlled trials to study determinants of healthcare worker behaviour will be analysed using logistic regression. The before-and-after study to measure the effect of virtual reality training on real-world behaviour will be analysed using difference-in-differences tests.
Conclusions: We anticipate that virtual reality will offer a useful controlled environment for studying determinants of healthcare provider behaviour. The identification of behaviour shaping variables is a natural transition to designing behaviour change intervention. Studying virtual reality training in terms of transfer to real world behaviour is an important step towards validating the merit of this novel technology.
Keywords:
virtual reality,
Patient Safety,
Infection prevention,
Behaviour Change,
Intervention Studies
Conference:
3rd UCL Centre for Behaviour Change Digital Health Conference 2017: Harnessing digital technology for behaviour change, London, United Kingdom, 22 Feb - 23 Feb, 2017.
Presentation Type:
Research abstract
Topic:
Digital Health
Citation:
Clack
L,
Wenger
M and
Sax
H
(2017). Virtual reality enhanced behaviour-change training for healthcare-associated infection prevention.
Front. Public Health.
Conference Abstract:
3rd UCL Centre for Behaviour Change Digital Health Conference 2017: Harnessing digital technology for behaviour change.
doi: 10.3389/conf.FPUBH.2017.03.00045
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Received:
22 Feb 2017;
Published Online:
22 Feb 2017.
*
Correspondence:
Ms. Lauren Clack, University and University Hospital Zurich, Division of Infectious Diseases and Hospital Epidemiology, Zurich, 8091, Switzerland, lauren.clack@usz.ch