Evaluating change in virtual reality adoption for brain injury rehabilitation following knowledge translation.

PURPOSE: To evaluate the impact of knowledge translation (KT) on factors influencing virtual reality (VR) adoption and to identify support needs of therapists. HYPOTHESES: Intervention will be associated with improvements in therapists' perceived ease of use and self-efficacy, and an associated increase in intentions to use VR. METHOD: Single group mixed-methods pre-test-post-test evaluation of convenience sample of physical, occupational and rehabilitation therapists (n=37) from two brain injury rehabilitation centres. ADOPT-VR administered pre/post KT intervention, consisting of interactive education, clinical manual, technical and clinical support. RESULTS: Increases in perceived ease of use (p=0.000) and self-efficacy (p=0.001), but not behavioural intention to use VR (p=0.158) were found following KT, along with decreases in the frequency of perceived barriers. Post-test changes in the frequency and nature of perceived facilitators and barriers were evident, with increased emphasis on peer influence, organisational-level supports and client factors. Additional support needs were related to clinical reasoning, treatment programme development, technology selection and troubleshooting. CONCLUSIONS: KT strategies hold potential for targeting therapists' perceptions of low self-efficacy and ease of use of this technology. Changes in perceived barriers, facilitators and support needs at post-test demonstrated support for repeated evaluation and multi-phased training initiatives to address therapists' needs over time. Implications for Rehabilitation Therapists' learning and support needs in integrating virtual reality extend beyond technical proficiency to include clinical decision-making and application competencies spanning the entire rehabilitation process. Phased, multi-faceted strategies may be valuable in addressing therapists' changing needs as they progress from novice to experienced virtual reality users. The ADOPT-VR is a sensitive measure to re-evaluate the personal, social, environmental, technology-specific and system-level factors influencing virtual reality adoption over time.

Using virtual reality in clinical practice: A multi-site exploratory study.

BACKGROUND: Virtual reality (VR) is a relatively new treatment tool with emerging evidence supporting its use in neurorehabilitation, although no information exists about how therapists use VR clinically. OBJECTIVE: This study's purpose was to document current practice in GestureTek VR use for inpatient acquired brain injury (ABI) rehabilitation as a benchmark for clinicians integrating the approach into practice, and to inform future research to improve its clinical applicability. METHODS: As part of a larger study examining barriers and facilitators to VR use, participating therapists at two rehabilitation centres documented descriptive data about client demographics and VR treatment programme characteristics for 29 ABI clients on their caseloads over eight months. RESULTS: Differences between the clinical population and published research samples were apparent. Treatment characteristics and several outcomes of interest paralleled those in the literature; however, novel outcome areas were identified as research gaps. By study's end, more than half of clients' VR programmes had been discontinued, for reasons consistent with documented barriers to VR use. CONCLUSIONS: These findings can help bridge the knowledge-to-action gap by informing the design of research that has high clinical relevance, and by providing a point of reference for clinicians incorporating VR into their practices.

Canadian physical therapists' interest in web-based and computer-assisted continuing education.

BACKGROUND AND PURPOSE: Distance education via computer-assisted learning (CAL), including Web-based and CD-ROM learning, confers a number of advantages compared with traditional learning methods. The purposes of this study were (1) to determine the interest of Canadian physical therapists in participating in continuing education using CAL methods and (2) to determine whether interest in CAL was related to type of employment, area of practice, education, computer skill and access, and other demographic variables. SUBJECTS AND METHODS: A random sample of Canadian physical therapists and all members of cardiopulmonary interest groups were surveyed. RESULTS: Of 1,426 survey questionnaires mailed, 69 were returned (58 were unopened and 11 were duplicates). From the remaining 1,357 potential survey responses, 757 responses were received, for an overall response rate of 56%. Seventy-eight percent of the respondents indicated their interest in participating in CAL. Factors associated with interest in CAL included 2 or more hours of Internet access per week, Internet access at both home and work, computer skill, education level, practice area, and belonging to a cardiopulmonary interest group. DISCUSSION AND CONCLUSION: The findings indicate a large positive interest in CAL. Increasing CAL continuing education opportunities could increase options for physical therapists to meet professional expectations for continuing competency.