JMIR Publications

ABSTRACT

Background:

Relationship-centered care (RCC) emphasizes the importance of mutual respect, empathy, and shared humanity in care relationships, yet formal dementia training for direct care staff in long-term care settings remains limited. Immersive virtual reality (VR) offers a novel approach to fostering empathy and knowledge by allowing staff to experience dementia from the perspective of the person living with it.

Objective:

This pilot study examined the effects of integrating RCC training with immersive VR simulation on direct care staff’s empathy and dementia knowledge.

Methods:

Twenty-one certified nursing assistants from one U.S. nursing home participated in a mixed-methods intervention. The training included an RCC-based online module, in-person group discussions, and three VR scenarios delivered monthly. Empathy and knowledge were measured pre- and post-intervention; qualitative feedback was collected through open-ended surveys and in-group discussions.

Results:

Participants were predominantly female, Black care workers with an average of 16 years’ experience. Quantitative results showed small but positive changes in empathy (Cohen’s d = 0.47) and modest gains in knowledge (Cohen’s d = 0.27), though differences were not statistically significant. Qualitative findings revealed that VR training reduced stigma, encouraged compassionate perspectives, and fostered emotional connection: Most preferred immersive, interactive formats over online modules, and cultural differences in the VR scenarios were not seen as barriers.

Conclusions:

While preliminary, these findings suggest that combining RCC with immersive VR may enhance empathy and engagement among direct care staff, particularly when paired with facilitated discussion and plain-language explanations. Larger, multi-site studies with sustained follow-up are needed to determine long-term effects and optimize training for linguistically and culturally diverse workforces.