Occupational therapists’ views of using a virtual reality interior design application within the pre-discharge home visit process

This article has been made available through the Brunel Open Access Publishing Fund.Background: A key role of Occupational Therapists (OTs) is to carry out pre-discharge home visits (PHV) and propose appropriate adaptations to the home environment, to enable patients to function independently after hospital-home discharge. However, research shows that more than 50% of specialist equipment installed as part of home adaptations is not used by patients. A key reason for this is that decisions about home adaptations are often made without adequate collaboration and consultation with the patient. Consequently, there is an urgent need to seek out new and innovative uses of technology to facilitate patient/practitioner collaboration, engagement and shared decision making in the PHV process. Virtual reality interior design applications (VRIDAs) primarily allow users to simulate the home environment and visualise changes prior to implementing them. Customised VRIDAs, which also model specialist occupational therapy equipment, could become a valuable tool to facilitate improved patient/practitioner collaboration if developed effectively and integrated into the PHV process. Objective: To explore the perceptions of occupational therapists with regards to using VRIDAs as an assistive tool within the PHV process. Methods: Task-oriented interactive usability sessions, utilising the think-aloud protocol and subsequent semi-structured interviews were carried out with seven Occupational Therapists who possessed significant experience across a range of clinical settings. Template analysis was carried out on the think-aloud and interview data. Analysis was both inductive and driven by theory, centring around the parameters that impact upon the acceptance, adoption and use of this technology in practice as indicated by the Technology Acceptance Model (TAM). Results: OTs’ perceptions were identified relating to three core themes: (1) perceived usefulness (PU), (2) perceived ease of use (PEoU), and (3) actual use (AU). Regarding PU, OTs believed VRIDAs had promising potential to increase understanding, enrich communications and patient involvement, and improved patient/practitioner shared understanding. However, it was unlikely that VRIDAs would be suitable for use with cognitively impaired patients. For PEoU, all OTs were able to use the software and complete the tasks successfully, however, participants noted numerous specialist equipment items that could be added to the furniture library. AU perceptions were positive regarding use of the application across a range of clinical settings including children/young adults, long-term conditions, neurology, older adults, and social services. However, some “fine tuning” may be necessary if the application is to be optimally used in practice. Conclusions: Participants perceived the use of VRIDAs in practice would enhance levels of patient/practitioner collaboration and provide a much needed mechanism via which patients are empowered to become more equal partners in decisions made about their care. Further research is needed to explore patient perceptions of VRIDAs, to make necessary customisations accordingly, and to explore deployment of the application in a collaborative patient/practitioner-based context

Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

Examining the moderating effect of individual-level cultural values on users’ acceptance of E-learning in developing countries: a structural equation modeling of an extended technology acceptance model

In this study, we examine the effects of individual-level culture on the adoption and acceptance of e-learning tools by students in Lebanon using a theoretical framework based on the Technology Acceptance Model (TAM). To overcome possible limitations of using TAM in developing countries, we extend TAM to include subjective norms (SN) and quality of work life constructs as additional constructs and a number of cultural variables as moderators. The four cultural dimensions of masculinity/femininity (MF), individualism/collectivism, power distance and uncertainty avoidance were measured at the individual level to enable them to be integrated into the extended TAM as moderators and a research model was developed based on previous literature. To test the hypothesised model, data were collected from 569 undergraduate and postgraduate students using e-learning tools in Lebanon via questionnaire. The collected data were analysed using the structural equation modelling technique in conjunction with multi-group analysis. As hypothesised, the results of the study revealed perceived usefulness (PU), perceived ease of use (PEOU), SN and quality of work life to be significant determinants of students’ behavioural intention (BI) towards e-learning. The empirical results also demonstrated that the relationship between SN and BI was particularly sensitive to differences in individual-cultural values, with significant moderating effects observed for all four of the cultural dimensions studied. Some moderating effects of culture were also found for both PU and PEOU, however, contrary to expectations the effect of quality of work life was not found to be moderated by MF as some previous authors have predicted. The implications of these results to both theory and practice are explored in the paper

E-Voting in an ubicomp world: trust, privacy, and social implications

The advances made in technology have unchained the user from the desktop into interactions where access is anywhere, anytime. In addition, the introduction of ubiquitous computing (ubicomp) will see further changes in how we interact with technology and also socially. Ubicomp evokes a near future in which humans will be surrounded by “always-on,” unobtrusive, interconnected intelligent objects where information is exchanged seamlessly. This seamless exchange of information has vast social implications, in particular the protection and management of personal information. This research project investigates the concepts of trust and privacy issues specifically related to the exchange of e-voting information when using a ubicomp type system

The simplicity project: easing the burden of using complex and heterogeneous ICT devices and services

As of today, to exploit the variety of different "services", users need to configure each of their devices by using different procedures and need to explicitly select among heterogeneous access technologies and protocols. In addition to that, users are authenticated and charged by different means. The lack of implicit human computer interaction, context-awareness and standardisation places an enormous burden of complexity on the shoulders of the final users. The IST-Simplicity project aims at leveraging such problems by: i) automatically creating and customizing a user communication space; ii) adapting services to user terminal characteristics and to users preferences; iii) orchestrating network capabilities. The aim of this paper is to present the technical framework of the IST-Simplicity project. This paper is a thorough analysis and qualitative evaluation of the different technologies, standards and works presented in the literature related to the Simplicity system to be developed

Developing sustainable business models for institutions’ provision of open educational resources: Learning from OpenLearn users’ motivations and experiences

Universities across the globe have, for some time, been exploring the possibilities for achieving public benefit and generating business and visibility through releasing and sharing open educational resources (OER). Many have written about the need to develop sustainable and profitable business models around the production and release of OER. Downes (2006), for example, has questioned the financial sustainability of OER production at scale. Many of the proposed business models focus on OER’s value in generating revenue and detractors of OER have questioned whether they are in competition with formal education. This paper reports on a study intended to broaden the conversation about OER business models to consider the motivations and experiences of OER users as the basis for making a better informed decision about whether OER and formal learning are competitive or complementary with each other. The study focused on OpenLearn - the Open University’s (OU) web-based platform for OER, which hosts hundreds of online courses and videos and is accessed by over 3,000,000 users a year. A large scale survey and follow-up interviews with OpenLearn users worldwide revealed that university provided OER can offer learners a bridge to formal education, allowing them to try out a subject before registering on a formal course and to build confidence in their abilities as learners. In addition, it was found that using OER during formal paid-for study can improve learners’ performance and self-reliance, leading to increased retention and satisfaction with the learning experience

Differences in intention to use educational RSS feeds between Lebanese and British students: A multi‑group analysis based on the technology acceptance model

Really Simple Syndication (RSS) offers a means for university students to receive timely updates from virtual learning environments. However, despite its utility, only 21% of home students surveyed at a university in Lebanon claim to have ever used the technology. To investigate whether national culture could be an influence on intention to use RSS, the survey was extended to British students in the UK. Using the Technology Adoption Model (TAM) as a research framework, 437 students responded to a questionnaire containing four constructs: behavioral intention to use; attitude towards benefit; perceived usefulness; and perceived ease of use. Principle components analysis and structural equation modelling were used to explore the psychometric qualities and utility of TAM in both contexts. The results show that adoption was significantly higher, but also modest, in the British context at 36%. Configural and metric invariance were fully supported, while scalar and factorial invariance were partially supported. Further analysis shows significant differences between perceived usefulness and perceived ease of use across the two contexts studied. Therefore, it is recommended that faculty demonstrate to students how educational RSS feeds can be used effectively to increase awareness and emphasize usefulness in both contexts

Open educational resources for all? Comparing user motivations and characteristics across The Open University’s iTunes U channel and OpenLearn platform.

With the rise in access to mobile multimedia devices, educational institutions have exploited the iTunes U platform as an additional channel to provide free educational resources with the aim of profile-raising and breaking down barriers to education. For those prepared to invest in content preparation, it is possible to produce interactive, portable material that can be made available globally. Commentators have questioned both the financial implications for platform-specific content production, and the availability of devices for learners to access it (Osborne, 2012). The Open University (OU) makes its free educational resources available on iTunes U and via its web-based open educational resources (OER) platform, OpenLearn. The OU’s OER on iTunes U reached the 60 million download mark in 2013; its OpenLearn platform boasts 27 million unique visitors since 2006. This paper reports the results of a large-scale study of users of the OU’s iTunes U channel and OpenLearn platform. A survey of several thousand users revealed key differences in demographics between those accessing OER via the web and via iTunes U. In addition, the data allowed comparison between three groups: formal learners, informal learners and educators. The study raises questions about whether university-provided OER meet the needs of users and makes recommendations for how content can be modified to suit their needs. As the publishing of OER becomes core to business, we reflect on reasons why understanding users’ motivations and demographics is vital, allowing for needs-led resource provision and content that is adapted to best achieve learner satisfaction, and to deliver institutions’ social mission