Use and Design of Virtual Reality-Supported Learning Scenarios in the Vocational Qualification of Nursing Professionals: Scoping Review.

BACKGROUND: Numerous reviews advocate using virtual reality (VR) in educational contexts. This medium allows learners to test experiences in realistic environments. Virtually supported scenarios offer a safe and motivating way to explore, practice, and consolidate nursing skills in rare and critical nursing tasks. This is also cited as one of the reasons why VR can significantly increase the knowledge acquisition of nursing students. Nevertheless, studies are limited in their significance owing to the chosen design. Despite great interest, this results in a low level of confidence in VR as a curricular teaching method for nursing education. Therefore, defining concrete design and didactic-methodological parameters that support teachers in the use and implementation of VR is more relevant. OBJECTIVE: This scoping review aims to provide an overview of significant design aspects for VR scenario conception and its transfer to generalist nursing education to generate value for the development of teaching scenarios and their sustainable implementation in teaching. METHODS: A comprehensive literature search was performed using the MEDLINE (via PubMed) and CINAHL databases, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist was applied. The search was conducted from May to July 2022, using a specific search principle corresponding to the focus and the growing study corpus. A previously defined "population, concept, and context" scheme was employed as the basis for the double-blind review of all relevant international German and English publications released up to May 1, 2022. RESULTS: In accordance with the predefined selection procedure, 22 publications were identified. The identified aspects aided in the development of design, didactic, and research recommendations. The intuitive operation of realistically designed VR scenarios, which are standardized, reliable, and modifiable, as well as clear instructions and specific multimodal feedback functions were described positively. The same applied to the linear structure of the sequences with graduated demands and high image quality for increased immersion with low sensory overload. Changes in perspectives, multiuser options, dialogs, and recording functions can contribute to an interactive care practice. On the research side, it is advisable to define VR terminologies. In addition to considering larger samples, varying settings, and financial issues, it is recommended to conduct long-term studies on knowledge acquisition or improved patient outcomes. CONCLUSIONS: VR scenarios offer high potential in the context of nursing education if teachers and learners develop them co-creatively according to design features and implement them by means of a well-conceived concept. VR enables trainees to develop practical skills continuously in a standardized way. In addition, its deployment supports the sensitization of trainees to digital nursing technologies and the expansion of their digital skills in a practical setting. Furthermore, it allows sustainability issues to be addressed.

Virtual Reality Applications for the Implementation of Domestic Respiratory Rehabilitation Programs for Patients With Long COVID and Post-COVID Condition: Scoping Review.

BACKGROUND: Due to a high number of patients affected by long COVID or post-COVID condition, an essential step to address the long-term effects of COVID-19 lies in the development and implementation of flexible and accessible rehabilitation programs. Virtual reality (VR) technologies offer the potential to support traditional therapies with individualized at-home programs. OBJECTIVE: This study aims to provide an overview of existing scientific evidence on the development and implementation of VR-assisted respiratory rehabilitation programs for patients with long COVID and post-COVID condition and to synthesize the results. METHODS: We conducted a scoping review of studies from 6 databases. PubMed, CINAHL, Cochrane, ScienceDirect, Web of Science Social Sciences Citation Index, and PEDro were searched using an exploratory search strategy. The search, which was last updated in February 2024, included peer-reviewed studies on immersive VR applications providing respiratory rehabilitation programs for patients with chronic obstructive pulmonary disease and long COVID or post-COVID condition. Exclusion criteria were studies in clinical or inpatient settings, telemedicine, nonimmersive VR applications, and gray literature. Nine publications were included in this review. Findings were extracted and summarized from the studies according to the JBI (Joanna Briggs Institute) method and thematically categorized. Topics covered were study characteristics, physiotherapeutic concept, clinical parameters, as well as usability and acceptability. RESULTS: The 9 publications included in the qualitative analysis were published in 2019-2023. Eight empirical studies were included: 4 followed a mixed methods design, 3 were qualitative studies, and 1 followed a quantitative method. One scoping review was included in the data analyses. Four of the included studies were on patients with chronic obstructive pulmonary disease. The 9 studies demonstrated that VR-supported respiratory rehabilitation programs result in positive initial outcomes in terms of physical as well as psychological parameters. Particularly noteworthy was the increased motivation and compliance of patients. However, adverse effects and lack of usability are the barriers to the implementation of this innovative approach. CONCLUSIONS: Overall, VR is a promising technology for the implementation of individualized and flexible respiratory rehabilitation programs for patients with long COVID and post-COVID condition. Nevertheless, corresponding approaches are still under development and need to be more closely adapted to the needs of users. Further, the evidence was limited to pilot studies or a small number of patients, and no randomized controlled trials or long-term studies were part of the study selection. The included studies were performed by 4 groups of researchers: 3 from Europe and 1 from the United States.

Identifying Factors of User Acceptance of a Drone-Based Medication Delivery: User-Centered Design Approach.

BACKGROUND: The use of drones in the health care sector is increasingly being discussed against the background of the aging population and the growing shortage of skilled workers. In particular, the use of drones to provide medication in rural areas could bring advantages for the care of people with and without a need for care. However, there are hardly any data available that focus on the interaction between humans and drones. OBJECTIVE: This study aims to disclose and analyze factors associated with user acceptance of drone-based medication delivery to derive practice-relevant guidance points for participatory technology development (for apps and drones). METHODS: A controlled mixed methods study was conducted that supports the technical development process of an app design for drone-assisted drug delivery based on a participatory research design. For the quantitative analysis, established and standardized survey instruments to capture technology acceptance, such as the System Usability Scale; Technology Usage Inventory (TUI); and the Motivation, Engagement, and Thriving in User Experience model, were used. To avoid possible biasing effects from a continuous user development (eg, response shifts and learning effects), an ad hoc group was formed at each of the 3 iterative development steps and was subsequently compared with the consisting core group, which went through all 3 iterations. RESULTS: The study found a positive correlation between the usability of a pharmacy drone app and participants' willingness to use it (r=0.833). Participants' perception of usefulness positively influenced their willingness to use the app (r=0.487; TUI). Skepticism had a negative impact on perceived usability and willingness to use it (r=-0.542; System Usability Scale and r=-0.446; TUI). The study found that usefulness, skepticism, and curiosity explained most of the intention to use the app (F3,17=21.12; P<.001; R2=0.788; adjusted R2=0.751). The core group showed higher ratings on the intention to use the pharmacy drone app than the ad hoc groups. Results of the 2-tailed t tests showed a higher rating on usability for the third iteration of the core group compared with the first iteration. CONCLUSIONS: With the help of the participatory design, important aspects of acceptance could be revealed by the people involved in relation to drone-assisted drug delivery. For example, the length of time spent using the technology is an important factor for the intention to use the app. Technology-specific factors such as user-friendliness or curiosity are directly related to the use acceptance of the drone app. Results of this study showed that the more participants perceived their own competence in handling the app, the more they were willing to use the technology and the more they rated the app as usable.

[Using the DFree device for balanced bladder management]. / Der Einsatz des DFree-Ultraschallsensors für ein ausgewogenes Blasenmanagement.

BACKGROUND: Bladder dysfunctions, regardless of their origin, have significant psychosocial effects. Depending on the existing disorder and bladder functionality, behavioural therapy and supporting tools are the first choice of therapy but the need for medication, intervention and surgery is significant. OBJECTIVE: The DFree ultrasonic sensor enables sonographic measurement of bladder filling and feeds this back to the sensor wearer via an app. The primary outcome of the study was the influence of the DFree on the quality of life of the patients. Secondary endpoints were usefulness and user-friendliness of the DFree device as well as the self-reported degree of autonomy. METHODS: In the present pilot study, 18 urological patients with various bladder dysfunctions were equipped with the DFree ultrasonic sensor for at least 12 hours daily over a period of three months. The parameters were collected at baseline (T1) and at end of the study (T2) using the Kings Health Questionnaire (KHQ) and the German version of the Client Satisfaction Questionnaire (ZUF-8) (quantitative data) as well as guided interviews (qualitative data). RESULTS: Improvement in bladder dysfunction based on the KHQ could not be statistically confirmed. However, the average value based on the ZUF-8 showed satisfaction with the DFree. In the interviews at T2, the participants gave a positive feedback with specific suggestions for improving user-friendliness. The device was described as helpful and easy to use. CONCLUSIONS: The DFree ultrasonic sensor is a new technical tool in the treatment of bladder dysfunctions. Improving specific technical details could increase the user-friendliness as well as the usefulness of the device.

Educational Concepts of Digital Competence Development for Older Adults-A Scoping Review.

The digital transformation of healthcare and nursing is becoming increasingly important due to demographic change and the growing shortage of skilled workers. In order to ensure the participation of senior citizens in digital assistive technologies, educational concepts and support services are needed to promote digital skills in older adults. Therefore, the specific needs and prerequisites of this target group have to be taken into consideration. This paper asks how educational programs for the support of digital competences of older adults are designed and implemented. A scoping review was conducted to systematically extract existing findings from the literature. Four databases (Cinahl, PubMed, Web of Science Social Sciences Citation Index (SSCI), ERIC) were searched using an exploratory strategy to identify studies that address educational concepts promoting digital competences for older adults. A total of 47 publications were included in the qualitative analysis and show a variety of strategies to deal with the promotion of digital competences for elderly people. In conclusion, programs dealing with the promotion of digital competences for elderly people should be flexibly adapted to the target group with its specific needs and challenges such as fears, lack of previous experience, or physical limitations. For successful implementation, social support is of outstanding importance.

"Of course, drones delivering urgent medicines are necessary. But I would not use them until " Insights from a qualitative study on users' needs and requirements regarding the use of medical drones.

BACKGROUND: The current COVID-19 pandemic, demographic trends, and the increasing shortage of skilled workers pose major challenges for the care of people with and without care needs. The potential of drones as unmanned aerial vehicles in health care is being discussed as an effective innovative way of delivering much-needed medicines, especially in rural areas. Although the advantages are well known, the needs of the users have not yet been taken into account. METHODS: Online-based focus groups (via WebEx) were conducted with participants from different disciplines: nursing, pharmacy, physicians. Focus groups with COVID-19 patients were conducted face-to-face. The focus was primarily on potential problems and requirements of the users regarding the use of drones. Structured and contrastive snowball sampling has been deployed. The focus groups were audio recorded, transcribed by a transcription-company, and coded with the help of the program "f4analyse 2" for content (Elo et al. 2008). RESULTS: Especially during the pandemic situation, delays, and restrictions in the delivery of medicines have been noticed. All interview partners (patients, pharmacists, physicians, and nurses; n = 36 participants) see drones as useful in cases of limited mobility, time-critical medicines (rapid availability), emergencies, and disasters (e.g., floods), but also for the delivery of regular medicines in rural areas (e.g., for the treatment of chronic diseases). Moreover, only 16.7% of the participants have experiences with drones. DISCUSSION: Drone deliveries do not play a role in the health system yet despite their great importance, which is perceived as particularly evident in the pandemic situation. The results lead to the conclusion that this is mainly due to knowledge and application deficits, so that educational and advisory work is absolutely necessary. There is also a need for further studies that go beyond the scope of acceptance research to describing and evaluating concrete scenarios of drone delivery on the basis of a user-centered approach.

[Teaching digital competences in nursing education-a comparative analysis of the federal and state framework curricula]. / Vermittlung digitaler Kompetenzen in der Pflegeausbildung ­ eine Vergleichsanalyse der Rahmenpläne von Bund und Ländern.

BACKGROUND AND OBJECTIVE: The digital transformation of healthcare requires changed competences in the nursing professions. The reform of nursing education opens up the opportunity to anchor the requisite content in vocational education. The framework curricula of the expert commission ("Rahmenpläne der Fachkommission nach § 53 Pflegeberufegesetz") form the basis for the federal states to create their own framework curricula. This paper examines to what extent and in what form the framework curricula take up digitalisation. MATERIAL AND METHODS: The framework curricula were investigated in an explicative-qualitative content analysis between August and October 2021. First, the frequency of previously defined keywords was determined. This was followed by a systematic context analysis. RESULTS: Merely six federal states had created their own framework curriculum; the others used the federal framework curriculum, which only addresses the acquisition of competences in the field of digitalisation to a small extent. Digitalisation was addressed to varying degrees in the federal state's own framework plans but only selectively overall. Recommendations for practical exercise formats were hardly given. DISCUSSION: The acquisition of competences in the area of digitalisation forms the foundation for later professional life and is an important component of the digital transformation. In the context of the possibility of modifying nursing education until 2024, the topic should be taken into focus more strongly. Improvements can also be made directly at technical and vocational schools as well as universities since the framework curricula are sometimes only of a recommendatory nature.

[Identification of measures conducive to learning for the introduction of digital and assistive technologies (DAT) in processes of nursing care: a qualitative study]. / Identifikation von lernfördernden Maßnahmen zur Einführung von digitalen und assistiven Technologien (DAT) in Prozesse der pflegerischen Versorgung: eine qualitative Studie.

Background: Digital, assistive technologies (DAT) are finding their way into care processes. There are no concepts for introducing nursing professionals DAT in a structured manner. A structured concept makes sense for a sustainable implementation of DAT. This paper suggests a guideline to train nurses in dealing with DAT. Aim: The work addresses the question of how nursing professionals experience and evaluate a structured approach of sensitization, qualification and testing with respect to DAT. This is also intended to assess the extent to which a transformative learning approach changes the willingness of nurses to use DAT. Method: In a long-term inpatient facility, nurses have been made aware of DAT and instructed in its use. The nurses were trained in using two robotic systems and a passive exoskeleton. The experience and perception of the structural design of the educational approach were surveyed through interviews. Evaluation took place by qualitative content analysis according to Kuckartz. Results: All 5 nurses surveyed had completed 3 years of training in nursing care. 2 of the interviewees perform tasks in the management of the care unit. All interviewee rated the structured approach positively. The approach increases the interest to think about an integration of DAT. It turns out that the accuracy of fit of DAT to care-related problems as well as the necessity to make DAT available by employers are crucial prerequisites for DAT integration into practice. Conclusion: A structured concept can sustainably increase the willingness of nurses to use DAT. Poor implementation of DAT is based on a lack of knowledge and concepts for education and training. The reflection that has been initiated enables DAT to be checked for specific care problems.

Human drone interaction in delivery of medical supplies: A scoping review of experimental studies.

BACKGROUND: The COVID-19 pandemic, ageing populations and the increasing shortage of skilled workers pose great challenges for the delivery of supplies for people with and without care needs. The potential of drones, as unmanned air vehicles, in healthcare are huge and are discussed as an effective new way to delivery urgent medicines and medical devices, especially in rural areas. Although the advantages are obvious, perspectives of users are important particularly in the development process. Investigating human drone interaction could potentially increase usefulness and usability. The present study aims to perform a systematic scoping review on experimental studies examining the human drone interaction in deliveries of drugs and defibrillators. METHODS: Two databases (MEDLINE and CINAHL) and references of identified publications were searched without narrowing the year of publication or language. Studies that investigated the human drone interaction or medical delivery with drones in an experimental manner were included (research articles). All studies that only simulated the delivery process were excluded. RESULTS: The search revealed 83 publications with four studies being included. These studies investigated the user experience of drone delivered defibrillators, but no study was identified that investigated the human drone interaction in the delivery of drugs. Three categories of human drone interaction were identified: landing, handover, and communications. Regarding landing and handover, the most important issue was the direct physical contact with the drone while regarding communications users need clearer instructions about drone´s direction, sound and look like. DISCUSSION: The identified studies used technology-driven approaches by investigating human drone interaction in already existing technologies. Users must become integral part of the whole development process of medical drone services to reduce concerns, and to improve security, usability and usefulness of the system. Human drone interaction should be developed according to the identified categories of human drone interaction by using demand- and technology-driven approaches.

[Database indexing of health science journals from the German-speaking area: A journal analysis]. / Datenbankindexierung von gesundheitswissenschaftlichen Fachzeitschriften aus dem deutschsprachigen Raum: eine Zeitschriftenanalyse.

BACKGROUND: Journal hand searching offers the possibility to complement a literature search as part of systematic reviews and other evidence syntheses. Hand searching is indicated in cases where scientific journals with potentially relevant publications addressing the research question are not indexed in a literature database. However, it is often unclear whether these journals are actually indexed, and when they are, in which literature databases. In many cases, it is also unknown which journals should be searched by hand in addition to systematic literature search after databases to be searched have been specified. Therefore, the project aimed to investigate the indexation of selected scientific health science journals and to provide an overview of indexation in order to facilitate the hand search planning process. METHODS: Journals from German-speaking countries covering eight professional fields (medical laboratory assistance, occupational therapy, midwifery, logopedics, nursing, physiotherapy, public health and rehabilitation) were considered that publish original research papers or systematic reviews or other review types in German and/or English. Two researchers per field identified relevant journals and independently analyzed the indexing locations using the journal websites. In case of missing information, we contacted the editors. RESULTS: A total of 70 journals were included: from 1 to 17 journals per field. These journals are indexed in 1 to 29 databases. Twelve journals are not indexed or do not offer information concerning indexation. Indexation is distributed across n=74 different literature databases. Most journals are indexed in LIVIVO (n=55) and bibnet.org (n=33). Other common indexing databases are Scopus (n=18), Web of Science Core Collection (n=16), PSYNDEX (n=13), and Embase (n=10). CONCLUSIONS: The results indicate a heterogeneous indexation of the included journals. Only a small number is indexed in common international literature databases such as MEDLINE or CINAHL. On the other hand, only a few journals are not indexed in any database. The results can be used as a basis to define databases for literature searches as part of systematic reviews. In addition, the findings might guide the selection of journals for hand searching after literature databases have been defined.

Wie Pflegekräfte im ambulanten Bereich den Einsatz von Telepräsenzsystemen einschätzen - Eine qualitative Studie.

How nurses assess telepresence systems in outpatient care. A qualitative study Abstract. Background: Robotic assistance devices are reviewed as being promising technological developments in healthcare to assist elderly patients and to foster autonomy in their home environment as long as possible. Also, telepresence systems (tps) currently in use to facilitate several nursing tasks are reviewed under the same perspective. AIM: The study aims to describe how nurses estimate the use of a tps in outpatient care. METHOD: After a presentation of a tps, focus groups of nurses (n = 4) in Saxony-Anhalt discussed freely on possible applications, concerns and potential of the system in outpatient care. The analysis followed the documentary method developed by Bohnsack, Nentwig-Gesemann & Nohl (2007). RESULTS: The tps presented was considered rather unsuitable for practical application in outpatient care. As main reasons nurses voiced theirs and patients' lack of technical competence; limited mobility functions of the device; ethical and financial concerns. The opportunity to intensify contact between patients and relatives was considered very positive. Faster contact in case of emergency as well as nurse supervised intake of medication were considered as important further practical applications of the device. CONCLUSIONS: Tps are not suitable yet for practical implementation in outpatient care. Acquiring appropriate technical knowledge during nursing education programs can help nurses to participate in the engineering development process this way increasing the potential of such devices and more in general can help nurses to handle more easily further technical innovations in healthcare.

Receptiveness Of GPs In The South Of Saxony-Anhalt, Germany To Obtaining Training On Technical Assistance Systems For Caregiving: A Cross-Sectional Study.

BACKGROUND: Challenges to general practitioners (GPs) as family doctors in Germany are growing because of the demographic situation. Technical assistance systems can improve the care for patients provided by GPs and care personnel to preserve autonomy. GPs are key persons in the health care team to recommend and facilitate access to technical solutions to influence their implementation into their patients' homes. AIM: Explore the general receptiveness of GPs in Germany regarding state-of-the-art and modern assistive technology, as well as their experiences, attitudes and expectations and their training demands. METHODS: A cross-sectional survey was conducted among GPs in Germany with a self-developed questionnaire sent by mail. RESULTS: Response rate was 34% (n=194). As expected computers and smartphones are widely used. Data glasses, digital pens and virtual reality and others are often "unknown". Experience with assistive technology was gained with emergency call systems, smart calendars and tablet dispensers. Self-reported receptiveness to use innovative technology is high but knowledge is low. The majority reported lack of access to training and support. The receptiveness for advanced education about technical solutions is high. In free-text response, some communicated their worries about the replacement of human interaction with technology. CONCLUSION: The survey showed an overall high receptiveness about assistance technology to GPs and strong demands for education and support. Education for GPs need greater efforts to master the process transforming the digital health care provision.

[Counselling approaches to assistive technologies in nursing care for people with dementia - A focus group study with informal carers]. / Beratungsansätze zu assistiven Technologien in der Pflege von Menschen mit Demenz.

Counselling approaches to assistive technologies in nursing care for people with dementia - A focus group study with informal carers Abstract. Background: Assistive technologies may support caregiving relatives of people with dementia. Presently, counselling and training courses are lacking as well as concrete considerations for didactic and methodical implementation. AIM: To convey the perspectives of caring relatives on the development of knowledge and competences in assistive technologies. METHODS: Six interview-guided focus groups with 46 caring relatives of people with dementia were conducted. For analysis the documentary method was applied. RESULTS: Assistive technologies currently do not seem to play a role in care-relevant information and counselling structures. The early development of competences as part of a guided support process is explicitly requested by caregiving relatives. The respondents favoured to try out assistive technologies, e. g. by moderated test possibilities. CONCLUSION: The interviewed caregiving relatives consider the existing approaches to get access to assistive technologies as inadequate. Access to knowledge and competence development of caregiving relatives must be more clearly integrated into the design of the care process. Counselling formats focusing on experience, reflection and usage of assistive technologies might be the didactic basis of structured competence achievement for sustainable integration of useful technologies in daily nursing care.

[Robotic systems for care at home: A scoping review]. / Robotische Systeme zur pflegerischen Versorgung im häuslichen Umfeld: ein Scoping Review.

BACKGROUND: In the future, modern technologies could make a significant contribution to a self-determined life in one's own environment when in need of care. Robots might alleviate everyday domestic life and promote participation. In the nursing science debate concerns have been raised over alienation through technology and loss of direct social and emotional contact. Robots are also being tested in nursing care, for example as social robots in the nursing home setting. The current state of knowledge regarding the domestic application of robotic systems has so far not been examined in systematic reviews. AIM: To examine the possibilities of the usage and application of robotic systems in the home healthcare setting. In addition to the functions of the systems, methodological issues and further research in this subject area are considered. METHODS: In this scoping review, an overview of the subject area and current research activities is produced. Five databases and the reference lists of the publications identified were searched. All study designs and publications since 2005 were eligible. We included studies investigating robotic interventions in the home care setting and their impact on outcomes relevant to patients or family members. The relevance of the robotic systems for nursing care was assessed according to the six dimensions of the new definition of care dependency in the Eleventh Book of the German Social Code (SGB XI). RESULTS: The search revealed 7,755 hits; 19 studies were included. Two studies used a control group. Further studies were feasibility studies and acceptance surveys. The majority of studies were conducted in EU countries. Three out of 13 robotic systems were commercially available. Nine studies did not report ethical approval, and seven studies did not mention whether informed consent was obtained. DISCUSSION: Robotic systems in home care have mainly been investigated in exploratory or pilot studies. Apart from technical aspects, the studies focussed on ease of use and, to this purpose, predominantly employed prototype robots. No reference was made to users' living environment, and there was no proof of effectiveness. The devices are far from being in the stage of broad practical application.