VR in Senior Care, Part IV: Ongoing Training
Todd Maddox & Tim Fitzpatrick
This is the final report in our 4-part series focused on applications of virtual reality (VR) in senior care.Part 1 focused on the brain science behind VR for education and training. We showed that VR approaches to senior care are often superior to traditional approaches because VR broadly engages multiple learning systems in the brain (e.g., experiential, emotional, cognitive, and behavioral), whereas traditional approaches engage only the cognitive learning system in the brain.
Part 2 focused on the frontline senior care recruiting effort and showed that recruiters do not need to choose between recruits with “compassion” vs. “skill” because VR combined with traditional education and training can mitigate any weaknesses in a recruit’s compassion or skill level.
Part 3 focused on the onboarding process and getting new employees “up to speed” quickly and efficiently. We showed that VR is especially useful for onboarding because it relies on experiential learning.
This fourth and final installment in our series focuses on ongoing training for frontline senior care professionals. We argue that by combining VR with traditional approaches to education and training in an optimal fashion, well rounded and effective employees will emerge.
Once the onboarding process is complete, the next step is to initiate an ongoing education and training program. This program will provide frontline senior care professionals with the high-quality education and training required to assist seniors. This might include training on a) the rules, regulations, and standard operating procedures; b) the many physical, emotional and cognitive changes associated with normal aging; c) the people skills needed to ensure that staff are responsive to residents, communicate effectively, and show the empathy required to provide the best care; and d) proper care for a tracheostomy tube, drain, or central line, for instance.
Unfortunately, high-quality education and training can be difficult to find, harder still to replicate, and in too many cases, minimal and often ineffective training is provided. When training is made available, it usually comes in the form of textbooks, training manuals or possibly video. These are often difficult to process and can lead to poor initial learning.
Even if the training materials are well designed and frontline professionals show quick learning, there is still the problem of forgetting. The brain is hardwired to forget so what is learned to perfection today will be lost in the days to come. Thus, ongoing training is required to maintain competence and to build long term memory representations.
Finally, some skills that are critical to high-quality senior care are difficult to train with text or video. These are what are referred to as “people skills”. People skills are about what we do, how we do it and our intent. It is one thing to know “what” to do, but something completely different (and mediated by distinct learning systems in the brain) to know “how” to do it. People skills include showing empathy, communicating effectively, listening, and being responsive to residents’ needs. People skills are best learned through experience.
To build effective educational tools for senior care staff, one must leverage research on the cognitive neuroscience of learning. Two results stand out. First, one must “Train for Retention” to mitigate the brain’s natural tendency to forget. This is done by combining periodic testing of previously trained material followed by retraining. Second, one must complement traditional training tools such as text and video with experiential training such as live observation and simulation. By spending time with a senior, watching them struggle to avoid falling, seeing them depressed and lonely, or struggling to recall names and places staff gain an experiential understanding and also develop people skills.
Unfortunately, experiential learning through live observation and simulation is time-intensive, cost-intensive, and is difficult to do well and with consistency at scale. This is where VR comes in. VR trains through experience, but is time-effective, cost-effective and scalable. VR provides senior care staff with a first-person immersive experience. When combined with interactive storytelling the lines between real and virtual immersive experience blur to the point that the senior care worker has a sense of “presence”. They feel like they are somewhere else.
Given these considerations we now outline an approach to ongoing frontline staff education and training that is grounded in the cognitive neuroscience of learning.
First, there is no need to replace your current Learning Management System or abandon your current training content. Rather, you should augment/enhance/complement your current approach with VR.
Second, for training the rules, regulations and standard operating procedures, as well as the physical, emotional and cognitive changes associated with normal aging, you should start with your existing text- or video-based training content. However, in addition, make sure to incorporate spaced testing and targeted retraining to ensure that the information is stored in long-term memory. Many Learning Management Systems offer testing and spaced training and it is highly effective.
Third, train frontline staff with existing tools but complement them with VR experiences. For example, to strengthen the staff’s understanding of the standard operating procedures or physical and cognitive changes associated with normal aging, you might have staff don a VR headset and be instantly transported into a situation in which some regulations or standard operating procedures are violated while an experienced senior care staff “guide” explains what went wrong and how to fix it. Staff might then be transported into a situation in which they are shadowing an experienced senior care worker as she interacts with a depressed patient while also providing useful tips and demonstrating best practices for improving their mood. This might be followed by another experience where useful tips are provided for addressing memory loss, or where a senior care guide describes the changes that need to be made to fall proof a resident’s quarters. The applications are many and the potential for high quality education and training for senior care staff is high.
Finally, people skills training should start and end with VR. Simply put, text- and video-based training are relatively ineffective at training people skills whereas VR is ideal. With VR the staff member can “walk a mile in a senior’s shoes”. Imagine a VR experience in which the staff member is transported into the body of a senior who is experiencing the disorientation and frustration associated with poor memory functioning, visual impairments, or sundowning. Imagine having staff experience first-hand the senior’s frustration when a frontline worker states that they will “only be a minute”, but don’t return for ten to twenty minutes. Finally, imagine being present during the “end of life” experiences so often seen in palliative and hospice care. “Walking a mile in someone else’s shoes” engages emotional learning centers in the brain that quickly and effectively build empathy. These advantages are unique to VR and ought to be utilized to develop people skills.
As with any learning tool, it is important to measure its effectiveness. Subjective surveys and objective tests of knowledge acquisition can be administered following the VR experience while the learner is in the VR headset. The same approach can be taken with the Learning Management System content, and the ongoing education and training protocol can be adjusted accordingly. This way data is recorded quickly, accurately, and automatically and can be shared with senior care clinical education and nursing directors to provide immediate feedback on their staff’s learning progress.
This concludes our 4-part series focused on the uses of VR in frontline senior care. Interactive storytelling with VR offers an excellent complement to traditional training solutions to help address the challenges of continuous education and training. These tools will provide frontline workers with the resources they need to succeed – one experience at a time.
Reposted with permission from IKONA Health.