Introduction:
Older adults are at risk of falls, which increases further in care home environments. Due to the complexity of care home residents’ conditions and an increasing ageing population, it is important for care staff to have knowledge and understanding in falls awareness, prevention, and management in order to support their residents. Literature searches identified that barriers to care staff implementing falls prevention strategies included the limited knowledge of staff and insufficient resources (including lack of staff training). There is scarce research regarding methods to deliver training to care staff, however emerging research in Virtual Reality (VR) as a general training method had promise due to increased knowledge retention, and application into practice. There is very limited research exploring VR training in care homes. Stakeholder patient and public involvement and engagement (PPIE) determined that VR as a training method had potential value.

Objectives:
To develop and test the feasibility of a proof-of-concept VR training programme for care home staff in falls awareness and prevention.

Methods:
A multi-phase project, including two research phases and one technology development phase. An initial exploratory qualitative research phase (Phase I) was undertaken to guide the design and content of the training. A development phase followed this to create the falls awareness experience (FAE) proof-of-concept, utilising user-centred design with iCASE collaborator Sentireal. Following the development phase, a second research study was conducted (Phase II) - a mixed methods study exploring the feasibility of the proof-of-concept, obtaining additional feedback for further development of the VR training programme.

Results: Engagement, immersion and enjoyment were key factors for acceptability of a training method. The FAE suited the learning styles of care staff, and VR was accepted as a training method. Utilisation of a case study resident increased empathy to the resident experience. Feedback for development included additional locations, scenarios, and interactable items. Barriers and facilitators of acceptability and adoption were identified.

Conclusion:
Identifying a potentially effective method of training for a complex intervention may influence the creation of future training programmes for care homes: to assist in increasing care staff knowledge, retention of information, and application of knowledge into practice. This in turn may improve the quality of care delivered and resident outcomes. Additional research is required to develop the proof-of-concept into a minimum viable prototype, and feasibility tested further. Keywords: Falls, older adults, care homes, training, immersion, Virtual Reality, feasibility, mixed methods, development

Dr. Emma Stanmore Dr. Helen Hawley-Hague Dr. Lis Boulton