Usability study of using interactive 360° video-based virtual reality for teaching adult basic life support

To the Editor, Adult Basic Life Support (BLS) is one of the most widely taught emergency care skills for lay people. Despite this, the knowledge and skills of the adult BLS continue to be poorly retained. In recent years, the use of immersive technology such as 360° videos in healthcare education has increased.1Baysan A. Çonoğlu G. Özkütük N. Orgun F. Come and see through my eyes: A systematic review of 360-degree video technology in nursing education.Nurse Educ Today. 2023; 105886Crossref PubMed Scopus (1) Google Scholar, 2Blair C. Walsh C. Best P. Immersive 360 videos in health and social care education: a scoping review.BMC Med Educ. 2021; 21: 1-28Crossref PubMed Scopus (23) Google Scholar The aim of the study is to evaluate the usability of a newly developed interactive 360° video-based Virtual Reality (VR) as an adult BLS educational tool for lay people. In this study, conducted in July 2023, we evaluated the usability of interactive 360° video-based VR for teaching adult BLS. The aim was for participants to actively perform evidence-based adult BLS for an out-of-hospital cardiac arrest (OHCA) victim within an interactive 360° video-based VR. To develop the interactive 360° video-based VR, we used the Insta360 X3 camera (Arashi Vision Inc., Shenzhen, China) to capture 360° video and the Unity engine (San Francisco, CA, USA) to create the VR environment with interactive features (e.g., drag and drop questions) (Fig. 1 and Supplementary Video 1). Each participant experienced an interactive 360° video-based VR using Meta Quest 2 headset (Menlo Park, CA, USA), and quantitative feedback was provided through an open-source online survey platform called 1ka (Ljubljana, Slovenia). All participants signed an informed consent form before taking part in this study. A total of 21 participants with a mean age of 21 (SD ± 1.5) years participated in our study, the majority were female (14/21; 67%) and about half were in educational programs in the health sciences (10/21; 48%). Most participants (19/21; 90%) had attended an adult BLS course in the past, yet their self-assessment (on a scale from very poor (1) to very good (5)) of their BLS knowledge was 3.4 (SD ± 1.0). Interactive 360° video-based VR received an overall high score of 4.4 (SD ± 0.5). Participants gave a 4.2 (SD ± 0.9) rating of agreement that the interactive 360° video-based VR provided them with new information, such as the sound of agonal breathing. Learning adult BLS with interactive 360° video-based VR was considered more interesting than traditional instructor-based methods (4.6 (SD ± 0.5)). Usability of the VR headset with controllers was high at 4.5 (SD ± 0.6). Only one participant experienced cybersickness in the form of nausea/dizziness (1/21; 5%). All participants felt a sense of immersion in the OHCA VR simulation. Participants felt more confident in performing adult BLS (4.0 (SD ± 0.9)) and would be more likely to approach the victim of OHCA (4.0 (SD ± 0.7)) after the VR experience. In the next 12 months, 43% (9/21) would use interactive 360° video-based VR to teach adult BLS once or twice, 29% (6/21) three to ten times, and 24% (5/21) ten to twenty times. Compared to other similar VR solutions,1Baysan A. Çonoğlu G. Özkütük N. Orgun F. Come and see through my eyes: A systematic review of 360-degree video technology in nursing education.Nurse Educ Today. 2023; 105886Crossref PubMed Scopus (1) Google Scholar, 2Blair C. Walsh C. Best P. Immersive 360 videos in health and social care education: a scoping review.BMC Med Educ. 2021; 21: 1-28Crossref PubMed Scopus (23) Google Scholar, 3Curran V. Xu X. Simmons K. Fleet L. Coombs H. Porter R. White S. Bessell C. Deshpandey A. Shah A. Waheed S. A phenomenological study of the use of 360° Virtual Reality (VR) video in pediatric and neonatal resuscitation training.Heal Technol. 2022; : 1-9Google Scholar, 4Nicholson J. Gillespie R. Bickerdike S. Frith G. Hassan T. OP13 Immersive video for simulation debriefing: ‘record and review’ in 360-degrees using a virtual reality headset.BMJ Simulation & Technology Enhanced Learning. 2019; 5: A9Google Scholar, 5Herbert N. Axson S. Siegel L. Cassidy K. Hoyt-Brennan A.M. Whitney C. Herens A. Giordano N.A. Leveraging immersive technology to expand access to opioid overdose reversal training in community settings: Results from a randomized controlled equivalence trial.Drug Alcohol Depend. 2020; 214108160Crossref PubMed Scopus (4) Google Scholar we have developed a useful, immersive, interactive, repeatable, evidence-based, and low-risk cybersickness educational tool for teaching and re-learning lay people adult BLS. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors would like to thank all those who participated in this study. Prior to data collection, the objectives of the study were discussed with the participants and written consent was obtained. Data was collected anonymously, and confidentiality was maintained throughout the study. Nino Fijačko is supported by Slovenian development scheme funding 2021–2024 (RSF 2.0, O RC 1).