ABSTRACT
The efficacy of home visiting of adolescent who are at risk of self-harm has a great dependency on the communication between the patient and the healthcare professional. Face-to-face encounters with health care professional and patients have heightened importance to counteract negative COVID-19 related social isolation effect. One alternative to simulated learning is to use video sequences to recreate a variety of communication-based scenarios that may be encountered. The aim was to repurpose a web-based Reusable Learning Object (RLO) into an interactive 360° environment. This provides an immersive and interactive sense of interactivity with an adolescent. The usability of the immersive resource evaluated with 24 medical students from several institutions around the European Union. The ASPIRE framework was adapted for conversion of the initial material as the steps are flexible enough to adapt to the unique characteristics of 360° video and interactive elements. The System Usability Score (SUS) suggested the RLO had above average usability (73.5) and the Slater-Usoh-Steed Presence Questionnaire (SUS-PQ) results showed a moderate to high feeling of presence (4.6). The SUS scale suggested the RLO’s strengths were its ease of use, simplicity and rapid uptake. These 16 questions had a Cronbach’s alpha coefficient of 0.85 indicating good reliability of capturing the users’ experiences of the RLO. Discussion involved limitations of functionality and potential for Virtual Reality (VR), but with strength in the ASPIRE adaptions to facilitate the new direction of online co-creation processes. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Background: Advance care planning (ACP) is a process of discussion to help people make and record choices about their future care and treatment. COVID-19 has increased the need for ACP, as life and death decisions are made with and for vulnerable people who are likely to die from the virus. There is sparse evidence about how ACP is being managed in nursing homes (NHs) and hospices during the pandemic. Aims: The study aimed to explore the views and experiences of frontline healthcare staff in NHs and hospices in England, to identify challenges, training and support needs in relation to ACP. Methods: We used a sequential mixed methods design in two phases. In Phase 1, in-depth telephone interviews were conducted with staff from hospices and NHs. Interview data were transcribed, analysed thematically using NVivo, and used to inform an online survey, which was distributed to NHs in all nine regions of England and 147 adult independent hospices in Phase 2. Numerical survey data were analysed using descriptive statistics, and free text data were analysed thematically. Results: In Phase 1, 10 interviews took place with hospice (n=6) and NH (n=4) staff. In Phase 2, 98 surveys were completed, the majority (69.4%) by hospice staff. Findings from both phases of the study showed differences between hospices and NHs in terms of infrastructure (culture, organisational processes, communication and sharing of information across the health and social care system);autonomy and agency of staff;educational preparation;the ACP process (initiating, documenting, sharing ACPs);and access to and use of technology. In all these areas, hospice staff reported better training, resources and support than NH staff, and higher levels of confidence in facilitating ACP discussions. Conclusion: Despite local initiatives to provide training around ACP at the start of the pandemic, there remains a need to develop national training and documentation to support ACP in all organisations.