Evaluation of a Virtual Reality Platform to Train Stress Management Skills for a Defense Workforce: Multisite, Mixed Methods Feasibility Study

Abstract

Background Psychological stress-related injuries within first-responder organizations have created a need for the implementation of effective stress management training. Most stress management training solutions have limitations associated with scaled adoption within the workforce. For instance, those that are effective in civilian populations often do not align with the human performance culture embedded within first-responder organizations. Programs involving expert-led instructions that are high in quality are often expensive. Objective This study sought to evaluate a tailored stress management training platform within the existing training schedule of the Australian Defense Force (ADF). The platform, known as Performance Edge (PE), is a novel virtual reality (VR) and biofeedback-enabled stress management skills training platform. Focusing on practical training of well-established skills and strategies, the platform was designed to take advantage of VR technology to generate an immersive and private training environment. This study aimed to assess the feasibility of delivering the VR platform within the existing group-based training context and intended training population. In this setting, the study further aimed to collect data on critical predictors of user acceptance and technology adoption in education, including perceived usability, usefulness, and engagement, while also assessing training impacts. Methods This study used a mixed methods, multisite approach to collect observational, self-reported, and biometric data from both training staff and trainers within a real-world “on-base” training context in the ADF. Validated scales include the Presence Questionnaire and User Engagement Scale for perceived usefulness, usability, and engagement, as well as the State Mindfulness Scale and Relaxation Inventory, to gain insights into immediate training impacts for specific training modules. Additional surveys were specifically developed to assess implementation feedback, intention to use skills, and perceived training impact and value. Results PE training was delivered to 189 ADF trainees over 372 training sessions. The platform was easy to use at an individual level and was feasible to deliver in a classroom setting. Trainee feedback consistently showed high levels of engagement and a sense of presence with the training content and environment. PE is overall perceived as an effective and useful training tool. Self-report and objective indices confirmed knowledge improvement, increased skill confidence, and increased competency after training. Specific training elements resulted in increased state mindfulness, increased physical relaxation, and reduced breathing rate. The ability to practice cognitive strategies in a diverse, private, and immersive training environment while in a group setting was highlighted as particularly valuable. Conclusions This study found the VR-based platform (PE) to be a feasible stress management training solution for group-based training delivery in a defense population. Furthermore, the intended end users, both trainers and trainees, perceive the platform to be usable, useful, engaging, and effective for training, suggesting end-user acceptance and potential for technology adoption.

TACTICS VR Stroke Telehealth Virtual Reality Training for Health Care Professionals Involved in Stroke Management at Telestroke Spoke Hospitals: Module Design and Implementation Study

“…Despite more limited infrastructure and support during implementation in this study, we noted very similar participant feedback on acceptability, feasibility, and utility, which was very encouraging. This study also builds on our previous work deploying VR training in workplaces outside of health care, which has highlighted the importance of considering broad institutional factors and developing frameworks that support training implementation, uptake, and ongoing sustainment [54][55][56][57]. Consistently across sectors (ie, in health, tertiary education [55,56], and defense [54]), these aspects must be considered and addressed at the organizational level to optimize training implementation and maximize effects.…”

Mendelian randomization reveals the causal association between gout and hearing impairment in older adults

“…[30] Issues such as social isolation and depression, prevalent among the senior demographic, [31] are intricately linked with hearing loss, underscoring the criticality of mental well-being in the context of ARHL. [32] However, traditional observational research is beleaguered by methodological hurdles, [33] including the ubiquity of confounding variables that obfuscate the exclusion of external perturbations. Statistical rectifications seldom neutralize their influence entirely, [34] thereby stymieing the elucidation of causative links.…”

Exploration of the application of augmented reality technology for teaching spinal tumor’s anatomy and surgical techniques

“…VR can efficiently train and enhance psychological skills by creating a safe, repeatable, and fully controllable training environment. In high-pressure and high-performance environments, the VR technology offers various innovative solutions for the training and learning of complex skills, which are often expensive or dangerous to practice in reality ( 18 , 19 ). Extended reality (XR) is an advanced version and expansion of VR technology, and the utilization of XR in orthopedics and medical education is gaining popularity.…”

“…Through the VR/AR technology, realistic operating environments can be simulated, enabling trainees to improve key skills in virtual contexts, such as attention, decision-making ability, situational awareness, adaptability, and stress management ( 18 ). Such signals can be monitored and evaluated by analyzing physiological parameters such as heart rate, respiratory rate, and electroencephalogram (EEG) ( 19 , 23 ).…”

“…Machine learning and artificial intelligence technology can be applied in psychological skill assessment and training, and the combination of the two is expected to further improve the quality of medical education ( 18 , 23 ). For example, using machine learning algorithms, patterns can be extracted from a large amount of physiological and behavioral data to evaluate individual performance and progress at different training stages ( 23 ).…”