Immersive Virtual Reality Simulation to Promote Empathy in Delirium Care: A Pilot Evaluation
Journal
Delirium
ISSN
2958-9134
Type
journal article
Date Issued
2025-12-19
Author(s)
Schlögl, Mathias
;
Fontanesi, Laura
;
Coltekin, Arzu
;
Thomas Kunz
;
Steven Bourke
;
Jeremy Howick
;
Vinay, Rasita
;
;
Leo Kronberger
;
Giuseppe Bellelli
;
Virginia Boccardi
;
Paolo Piaggi
;
Vincenza Frisardi
;
Yuliya Yoncheva
;
Alasdair MacLullich
Abstract
Background
Despite affecting one in four hospitalised older adults, delirium remains under-recognised and undertreated. One reason for this is that health professionals are unaware of patients’ lived experience of terror and disorientation. Immersive virtual reality (VR) provides an innovative medium for experiential education, supporting engagement, reflection, and understanding of complex real-world situations.
Objective
Building on earlier pilot study on VR-based empathy education, this study evaluated a VR delirium simulation created in partnership with delirium survivors and caregivers, focusing on its feasibility, safety, and educational impact.
Methods
Over two years, four Patient and Public Involvement (PPI) partners (one delirium survivor, two family caregivers, one advocacy expert) co-designed scenario language, safety protocols, and reflection prompts alongside researchers and clinicians. We evaluated a 10-minute VR simulation reproducing delirium phenomenology paired with 25-minute structured reflection. Fifteen clinicians and educators (physicians, nurses, researchers) participated in an international empathy-in-healthcare symposium. Quantitative outcomes (perceived realism, empathy, communication, behavioural intentions) were analyzed descriptively; qualitative reflections were thematically analyzed to explore educational mechanisms and ethical implications.
Results
Participants rated VR realism and emotional salience highly (means 4.1–4.5, 80-100% agreement). All participants reported stronger perspective-taking, with intended changes including slower speech, environmental control, and caregiver inclusion. Thematic analysis identified affective immersion and cognitive reframing as key mechanisms, alongside risks of emotional overload and oversimplification. PPI-informed safety protocols (pre-briefing, opt-out, quiet space) prevented adverse effects; no withdrawals occurred.
Conclusion
The VR simulation was a realistic, emotionally engaging, and educationally meaningful medium for delirium training. This approach may foster greater empathy and intentional changes in communication and care practices In delirium care. Future controlled studies should examine behavioural retention, patient outcomes, and equitable access across diverse learner populations.
Despite affecting one in four hospitalised older adults, delirium remains under-recognised and undertreated. One reason for this is that health professionals are unaware of patients’ lived experience of terror and disorientation. Immersive virtual reality (VR) provides an innovative medium for experiential education, supporting engagement, reflection, and understanding of complex real-world situations.
Objective
Building on earlier pilot study on VR-based empathy education, this study evaluated a VR delirium simulation created in partnership with delirium survivors and caregivers, focusing on its feasibility, safety, and educational impact.
Methods
Over two years, four Patient and Public Involvement (PPI) partners (one delirium survivor, two family caregivers, one advocacy expert) co-designed scenario language, safety protocols, and reflection prompts alongside researchers and clinicians. We evaluated a 10-minute VR simulation reproducing delirium phenomenology paired with 25-minute structured reflection. Fifteen clinicians and educators (physicians, nurses, researchers) participated in an international empathy-in-healthcare symposium. Quantitative outcomes (perceived realism, empathy, communication, behavioural intentions) were analyzed descriptively; qualitative reflections were thematically analyzed to explore educational mechanisms and ethical implications.
Results
Participants rated VR realism and emotional salience highly (means 4.1–4.5, 80-100% agreement). All participants reported stronger perspective-taking, with intended changes including slower speech, environmental control, and caregiver inclusion. Thematic analysis identified affective immersion and cognitive reframing as key mechanisms, alongside risks of emotional overload and oversimplification. PPI-informed safety protocols (pre-briefing, opt-out, quiet space) prevented adverse effects; no withdrawals occurred.
Conclusion
The VR simulation was a realistic, emotionally engaging, and educationally meaningful medium for delirium training. This approach may foster greater empathy and intentional changes in communication and care practices In delirium care. Future controlled studies should examine behavioural retention, patient outcomes, and equitable access across diverse learner populations.
Refereed
Yes
Publisher
European Delirium Association