Nancy Daraiseh, Aaron Vaughn, Ming Tang, Mikhail Nikolaenko, Madeline Aeschbury, Alycia Bachtel, Camryn Backman, Chunyan Liu, Maurizio Macaluso . Using Virtual Reality to Enhance Behavioral Staff Training for Interacting with Aggressive Psychiatric Patients. Poster. The 15th International Conference on Applied Human Factors and Ergonomics (AHFE 2024). Nice, France, July 24-27, 2024.

Objective: To conduct a pilot study to enhance staff training and confidence when interacting with aggressive psychiatric patients using a virtual reality (VR) training module depicting an escalating patient scenario.

Significance: Dysregulated emotional outbursts, reactive aggression, and self-injurious behaviors are common in psychiatrically hospitalized patients. These behaviors result in aggressive patient interactions (APIs) which are associated with increased risk of harm to the patient and staff. Minimal research has examined interventions for successful training to effectively reduce or prevent API events and subsequent harm. Despite intensive, standardized trainings in crisis de-escalation protocols, staff continue to experience high rates of API injuries. More realistic training and competency in a safe environment to practice implementation and utilization of de-escalation strategies to avoid APIs and patient harm are needed.

Methods Using a pre – post, quasi-experimental design, 40 Behavioral Health Specialists and Registered Nurses at a pediatric psychiatric facility will participate in VR training depicting a commonly experienced scenario when interacting with an aggressive patient. Participants are stratified by job experience, sex, and VR experience. Study aims are to: i) assess the feasibility and usability of VR training among this population and ii) obtain measures of learner satisfaction and performance. Surveys measure usability, learner satisfaction, and coping with patient aggression. Pre- and post-performance in training will be compared and assessed by percent correct answers on the first attempt; time to correct answer; and the number of successful and unsuccessful attempts.

Preliminary Results (full analyses in progress): Preliminary survey results (N=14) show that 64% perceived the VR experience to be consistent with their real-world experiences: 87% agree that the VR training would help with interactions with aggressive patients: 71% reported the training was effective in identifying de-escalation strategies: 79% stated the training was effective in recognizing stages of patient crisis; training included important skills used in their job; and would recommend the training. Finally, 100% would participate in future VR trainings.

Anticipated Conclusions: We plan to show that using VR to supplement in-place training programs for high-risk situations can improve users’ understanding of essential de-escalation and crisis techniques. We anticipate results will show an enhanced ability and confidence when interacting with aggressive patients. Future studies will expand on results and examine implications on staff and patient harm. 

Check more information on the  VR-based Employee Safety Training. Therapeutic Crisis Intervention Simulation