@Article{info:doi/10.2196/38669,
author="Moore, Nathan
and Ahmadpour, Naseem
and Brown, Martin
and Poronnik, Philip
and Davids, Jennifer",
title="Designing Virtual Reality--Based Conversational Agents to Train Clinicians in Verbal De-escalation Skills: Exploratory Usability Study",
journal="JMIR Serious Games",
year="2022",
month="Jul",
day="6",
volume="10",
number="3",
pages="e38669",
keywords="virtual reality; code black; verbal de-escalation; violence and aggression; education; clinical training; conversational agent",
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. ",
issn="2291-9279",
doi="10.2196/38669",
url="https://games.jmir.org/2022/3/e38669",
url="https://doi.org/10.2196/38669",
url="http://www.ncbi.nlm.nih.gov/pubmed/35793129"
}