The Effects of Immersive Virtual Reality-Assisted Experiential Learning on Enhancing Empathy in Undergraduate Health Care Students Toward Older Adults With Cognitive Impairment: Multiple-Methods Study.

BACKGROUND: Immersive virtual reality (IVR)-assisted experiential learning has the potential to foster empathy among undergraduate health care students toward older adults with cognitive impairment by facilitating a sense of embodiment. However, the extent of its effectiveness, including enhancing students' learning experiences and achieving intended learning outcomes, remains underexplored. OBJECTIVE: This study aims to evaluate the impacts of IVR-assisted experiential learning on the empathy of undergraduate health care students toward older people with cognitive impairment as the primary outcome (objective 1) and on their learning experience (objective 2) and their attainment of learning outcomes as the secondary outcomes (objective 3). METHODS: A multiple-methods design was used, which included surveys, focus groups, and a review of the students' group assignments. Survey data were summarized using descriptive statistics, whereas paired 2-tailed t tests were used to evaluate differences in empathy scores before and after the 2-hour IVR tutorial (objective 1). Focus groups were conducted to evaluate the impacts of IVR-assisted experiential learning on the empathy of undergraduate health care students toward older people with cognitive impairment (objective 1). Descriptive statistics obtained from surveys and thematic analyses of focus groups were used to explore the students' learning experiences (objective 2). Thematic analysis of group assignments was conducted to identify learning outcomes (objective 3). RESULTS: A total of 367 undergraduate nursing and occupational therapy students were recruited via convenience sampling. There was a significant increase in the students' empathy scores, measured using the Kiersma-Chen Empathy Scale, from 78.06 (SD 7.72) before to 81.17 (SD 8.93) after (P<.001). Students expressed high satisfaction with the IVR learning innovation, with a high satisfaction mean score of 20.68 (SD 2.55) and a high self-confidence mean score of 32.04 (SD 3.52) on the Student Satisfaction and Self-Confidence scale. Students exhibited a good sense of presence in the IVR learning environment, as reflected in the scores for adaptation (41.30, SD 6.03), interface quality (11.36, SD 3.70), involvement (62.00, SD 9.47), and sensory fidelity (31.47, SD 5.23) on the Presence Questionnaire version 2.0. In total, 3 major themes were identified from the focus groups, which involved 23 nursing students: enhanced sympathy toward older adults with cognitive impairment, improved engagement in IVR learning, and confidence in understanding the key concepts through the learning process. These themes supplement and align with the survey results. The analysis of the written assignments revealed that students attained the learning outcomes of understanding the challenges faced by older adults with cognitive impairment, the importance of providing person-centered care, and the need for an age-friendly society. CONCLUSIONS: IVR-assisted experiential learning enhances students' knowledge and empathy in caring for older adults with cognitive impairment. These findings suggest that IVR can be a valuable tool in professional health care education.

Predictors of nursing students' intentions to participate in an internationalization-at-home program: The roles of expectancies for success and subjective task value.

BACKGROUND: Internationalization-at-home programs are a unique opportunity for those who had been planning to study abroad to learn global clinical practices and cultures at home. However, the factors influencing the motivation of students to join such programs remain unexplored. OBJECTIVE: To investigate the relationship among expectancies for success, subjective task value, and the intention to participate in an internationalization-at-home program, and to identify key factors predicting such an intention among undergraduate nursing students. DESIGN: A descriptive correlational design with a predictive approach was adopted. METHODS: A total of 522 undergraduate and postgraduate nursing students in a Hong Kong university participated in the study. Intention to participate in the program was assessed using the Comprehensive Relative Autonomy Index. Expectancies for success and subjective task value were assessed as potential predictors. A multiple linear regression analysis was adopted to examine the predictive effects. RESULTS: The participants were aged 17-31 years (mean = 20.95, SD = 2.39). Those who reported having previously participated in the program (ß = 0.10, p-value = .014), greater intercultural communication competence (ß = 0.14, p-value = .003), greater perceived social competence (ß = 0.11, p-value = .031), and a higher subjective value of the program (ß = 0.28, p-value<.001) expressed a greater intention to join the program. Collectively, the three variables accounted for 14.7 % of the variances in intention to participate in the program. CONCLUSIONS: Cultural self-efficacy, intercultural communication competence, perceived social competence, individual interest, foreign language learning motivation, and subjective value of the program were found to be key factors predicting the intention of nursing students to participate in internationalization-at-home. Future studies can provide interventions to address these factors and enhance the benefits of internationalization-at-home programs.