JMIR Publications

ABSTRACT

Background:

The Domestic Abuse Plan1 and Strategic Direction for Sexual Assault and Abuse Services2 set out a stronger system, prioritising the improvement of healthcare staffs’ ability to identify and refer domestic abuse victims/survivors, as key areas for supporting workforce development. Healthcare staff are often the first professional contact of victims/survivors of domestic abuse (3), and insufficient staff training is a key barrier to victims/survivors being identified and directed to support (4, 5, 6). The Microsoft HoloLens2 (7) is a mixed-reality headset, that allows virtual objects (holograms), to be integrated into the real world (8). Mixed-reality headsets are being increasingly used within medical education (9, 10, 11) and have the advantage of independent operation, reducing the staffing requirements for teaching.

Objective:

The HoloLens2 can be used to project HoloPatients (HP), which resemble clinical unwell patients, into the classroom.Two of these Holopatients have been specifically designed to portray victims/survivors of domestic abuse (DA) and sexual violence (SV). This study explored potential uses of the HP in DA/SV training, as a potential survivor-centered educational initiative that could be used as an adjunct to existing training for healthcare professionals (HCPs) and community sector workers. 

Methods:

Frontline staff and community stakeholders from the national health service, DA and law enforcement sectors were invited on three separate occasions (n=14, 12, 22) to a HoloLens2 demonstration which displayed nine HoloPatients. The patient voice was to be outlined by personalised scripts, co-created alongside sector charities ensuring victim/survivor engagement and participation. Participants were given the opportunity to wear the headset and familiarise themselves with the technology during the sessions. A post-intervention evaluation research model was used to explore the feasibility and functionality of the HoloPatient as an educational tool.

Results:

Thematic analysis described the HoloPatient as a ‘realistic’, 'adjustable’ tool which ‘creates a safe learning environment’. Participants suggested it could be useful in ‘pre-exposure preparation’ by ‘improving communication’ and allowing different approaches to be trialed in a safe environment. The use of victim/survivor scripts was described as a useful tool to ‘bring the victim/survivor into the learning space’ in a safe way. Participants identified the HoloPatient as a suitable tool for workers inside and outside healthcare, including social sectors such as law enforcement (32%).

Conclusions:

The HP acts as a low risk, adaptable tool for trainees to develop skills in a safe environment. This study demonstrates that professionals perceived the HoloLens as an innovative means to amplify the lived experience voice.  Further research will evaluate this additional impact on trainees’ confidence and responses to victim/survivors disclosing DA and SV, within different disciplines, to drive improved outcomes.