JMIR Publications

ABSTRACT

Background:

To address barriers to interactive technology adoption in pediatric rehabilitation (access, space, support, knowledge), we developed the Technotheque: a dedicated clinical space equipped with 10+ interactive technologies (XR as an umbrella term), over 150 games, and trained knowledge brokers to support clinical XR use.

Objective:

This study evaluated the Technotheque’s feasibility over a 4-month period and identified factors influencing feasibility at our pediatric rehabilitation centre.

Methods:

Convergent mixed-methods design. Feasibility was assessed using 3 criteria (Bowen et al., 2009): demand, acceptability and implementation. Participation was open to all clinicians at our centre; Technotheque use objectives and frequency were self-determined. Measures included descriptive use patterns, self-reported satisfaction, pre-post Assessing Determinants of Prospective Take-up of Virtual Reality (version 2; ADOPT-VR2) scores, and semi-structured individual interviews. Quantitative analyses included descriptive and exploratory inferential statistics, while qualitative analyses followed a deductive thematic approach guided by the 3 feasibility criteria. Results were integrated using a mixed methods expansion approach, with qualitative findings contextualizing quantitative results.

Results:

Demand: One hundred and forty sessions were conducted over the 4-month period: 120 (86.0%) were therapy sessions (involving a client) and 20 (14.0%) were education sessions. Twenty-four clinicians used the Technotheque for therapy a median of 2 times (range: 0-22) with 34 clients of diverse ages, diagnoses and mobility levels; adolescents were most represented age group (75/120, 62.5%). Clinicians working with in-patient clienteles were the most frequent users. Acceptability: Clinicians reported high satisfaction with the extent to which Technotheque sessions met clinical objectives (median = 6/7, ‘Very satisfied’). Implementation: Overall, 25.2% of the 135 eligible clinicians participated in the study. Most therapy sessions required assistance from a knowledge broker (93/120, 77.5%). Independent use was strongly correlated with a higher number of sessions per clinician (rho = 0.657, P=.001). A significant pre-post improvement was observed for the ADOPT-VR2 Client Influence construct (Z = -2.294, P=.022); no change was observed for the other two constructs. Mixed methods integration showed that Technotheque use was driven by caseload relevance, with clinicians considering factors beyond diagnosis or functional abilities – such as therapy dosage, cognitive abilities, demographic characteristics or therapeutic alliance – when determining client suitability. Knowledge brokering was essential for aligning XR use with clinical needs and was a key contributor to clinician satisfaction. While the variety of XR systems supported diverse clinical needs, it also limited clinicians’ ability to achieve independent use within the study period.

Conclusions:

The Technotheque appears to be a feasible model to support XR adoption in our pediatric rehabilitation centre. Results provide real-world insights into XR implementation, including facilitators and barriers that are generalizable to other sites. Findings inform ongoing refinements to the Technotheque model at our site and will guide future integration and evaluation efforts in other clinical settings with varying resources and needs.