Acceptance and feasibility of virtual reality for teaching adult basic life support in older populations

Abstract

BACKGROUND: Virtual reality (VR) is emerging in adult Basic Life Support (BLS) training, but its acceptance among older adults has not been fully studied. This study aimed to develop expert-informed BLS content for both VR and laptop formats, and to evaluate the feasibility, usability, knowledge acquisition, satisfaction, and cybersickness of these platforms among older adult learners. METHODS: A two-phase mixed-methods study was conducted. Five experts co-developed and validated a VR/laptop-compatible adult BLS scenario based on the 2021 European Resuscitation Council guidelines. This scenario was then tested by older adults who voluntarily participated in either VR- or laptop-based training at a public technology event in Spain. Post-training, we measured knowledge acquisition, usability, satisfaction, user experience, and cybersickness. Comparative statistics and regression analyses were performed to evaluate learning outcomes and predictors. RESULTS: Five experts developed a consensus-based adult BLS decision tree with 10 scenes and six questions. A total of 583 adults (mean age 72.3 ± 4.8 years) took part in the BLS training evaluation. Those in the VR group (n = 415) outperformed those in the laptop group (n = 168) in key steps, including initiating CPR (58 % vs 41 %, p < 0.001) and using an AED (49 % vs 23 %, p < 0.001). VR participants rated usability of VR-training as excellent (73.8 ± 4.2), expressed high satisfaction and realism. Cybersickness was low (13.1 %). VR training predicted higher knowledge scores (? = 5.8, p < 0.001), and increased scores by 5.8 points over laptop training. VR participants were 2.3 times more likely to answer BLS questions correctly (OR = 2.3, 95 % CI: 1.6-3.2, p < 0.001). CONCLUSION: VR could improve adult BLS knowledge in older adults, with high levels of acceptance and positive user experience. Future work should enhance accessibility and reduce discomfort.