Virtual reality for preoperative patient education: Impact on satisfaction, usability, and burnout from the perspective of new nurses

Table 1 Demographics of participating nurses

Characteristics of participating nurses
Sex	Male	0	(0/20)
	Female	20	(20/20)
Mean age, years		24.4
Mean years of experience		2.3

Table 2 Demographics of the patients

Characteristics of the patients		Control group (n = 40), n of mean ± SD		VR Group(n = 40), n of mean ± SD		t	P value
Sex	Male	25	(25/40)	27	(27/40)		0.815
	Female	15	(15/40)	13	(13/40)
Mean age, years		42.75 ± 13.23		40.75 ± 15.60		0.62	0.538
Type of operation	Facial trauma	26	(26/40)	25	(25/40)		0.717
	Limb or trunk reconstruction	3	(3/40)	3	(3/40)
	Corrective rhinoplasty	2	(2/40)	1	(1/40)
	Benign tumor excision	7	(7/40)	10	(10/40)
	Breast augmentation	0	(0/40)	1	(1/40)
	etc. (Skin cancer, burn)	2	(2/40)	0	(0/40)

VR: virtual reality.

Table 3 Questionnaire items

	Strongly disagree (1)	Disagree (2)	Neutral (3)	Agree (4)	Strongly disagree (5)
1 Does the amount of time needed for preoperative education make sense?
2 Is a preoperative education making your job more difficult?
3 Does a preoperative education make you more physically stressed?
4 Does a preoperative education make you more mentally stressed?
5 After explaining the procedure to the patient, do you feel satisfied?
6 Do you believe that by giving the patient precise information, your preoperative education satisfied them?
7 Do you employ effective communication skills or tools in your preoperative education?

Table 4 System usability scale

System usability scale
	Strongly disagree (1)	Disagree (2)	Neutral (3)	Agree (4)	Strongly agree (5)
I think that I would like to use this system frequently (SUS1)
I found the system unnecessarily complex (SUS2)
I thought the system was easy to use (SUS3)
I think that I would need the support of a technical person to be able to use this system (SUS4)
I found the various functions in this system were well integrated (SUS5)
I thought there was too much inconsistency in this system (SUS6)
I would imagine that most people would learn to use this system very quickly (SUS7)
I found the system very cumbersome to use (SUS8)
I felt very confident using the system (SUS9)
I needed to learn a lot of things before I could get going with this system (SUS10)

Table 5 After-Scenario Questionnaire

After-Scenario Questionnaire
	Strongly disagree (1)	(2)	(3)	(4)	(5)	(6)	Strongly agree (7)
I am satisfied with the ease of completing the task in this scenario (ASQ1)
I am satisfied with the amount of time it took to complete the task in this scenario (ASQ2)
I am satisfied with the support information (on-line help, messages, documentation) when completing the task (ASQ3)

Table 6 Maslach Burnout Inventory

Questions	Never	Rarely	Sometimes	Frequently	Always
I Emotional Exhaustion
I feel emotionally drained from my work	1	2	3	4	5
I feel used up at the end of the workday	1	2	3	4	5
I feel fatigued when I get up in the morning and have to face another day on the job	1	2	3	4	5
Working with people all day is really a strain for me	1	2	3	4	5
I feel burned out from my work	1	2	3	4	5
I feel frustrated by my job	1	2	3	4	5
I feel I’m working too hard on my job	1	2	3	4	5
Working with people directly puts too much stress on me	1	2	3	4	5
I feel like I’m at the end of my rope	1	2	3	4	5
II Personal Accomplishment
I can easily understand how my recipients feel about things	1	2	3	4	5
I deal very effectively with the problems of my recipients	1	2	3	4	5
I feel I’m positively influencing other people’s lives through my work	1	2	3	4	5
I feel very energetic	1	2	3	4	5
I can easily create a relaxed atmosphere with my recipients	1	2	3	4	5
I feel exhilarated after working closely with my recipients	1	2	3	4	5
I have accomplished many worthwhile things in this job	1	2	3	4	5
In my work, I deal with emotional problems very calmly	1	2	3	4	5
III Depersonalization
I feel I treat some recipients as if they were impersonal ‘objects’	1	2	3	4	5
I’ve become more callous toward people since I took this job	1	2	3	4	5
I worry that this job is hardening me emotionally	1	2	3	4	5
I don’t really care what happens to some recipients	1	2	3	4	5
I feel recipients blame me for some of their problems	1	2	3	4	5

Table 7 Comparison of satisfaction survey results of healthcare providers in VR and Control Group

	Item	Score					mean ± SD	t	P value (n = 20)
		1	2	3	4	5
After verbal education	1		9 (45.0)	9 (45.0)	1 (5.0)	1 (5.0)	20.50 ± 1.76	14.44	< 0.001
	2		7 (35.0)	11 (55.0)	1 (5.0)	1 (5.0)
	3		3 (15.0)	9 (45.0)	4 (20.0)	4 (20.0)
	4		7 (35.0)	8 (40.0)	5 (25.0)
	5		6 (30.0)	7 (35.0)	4 (20.0)	3 (15.0)
	6		9 (45.0)	9 (45.0)	1 (5.0)	1 (5.0)
	7		6 (30.0)	13 (65.0)	1 (5.0)
After VR education	1			2 (10.0)	8 (40.0)	10 (50.0)	30.60 ± 2.37
	2			2 (10.0)	9 (45.0)	9 (45.0)
	3			3 (15.0)	10 (50.0)	7 (35.0)
	4			2 (10.0)	11 (55.0)	7 (35.0)
	5			2 (10.0)	7 (35.0)	11 (55.0)
	6			3 (15.0)	3 (15.0)	14 (70.0)
	7			3 (15.0)	6 (30.0)	11 (55.0)

VR: Virtual reality.

Table 8 Comparison of satisfaction results of each item

		Number	mean ± SD	t	P value
Item 1	Verbal education	20	2.70 ± 0.80	8.23	< 0.001
	VR education	20	4.40 ± 0.68
Item 2	Verbal education	20	2.80 ± 0.77	6.31	< 0.001
	VR education	20	4.35 ± 0.67
Item 3	Verbal education	20	3.45 ± 1.00	3.00	0.003
	VR education	20	4.20 ± 0.70
Item 4	Verbal education	20	2.90 ± 0.79	5.81	< 0.001
	VR education	20	4.25 ± 0.64
Item 5	Verbal education	20	3.20 ± 1.06	4.19	< 0.001
	VR education	20	4.45 ± 0.69
Item 6	Verbal education	20	2.70 ± 0.80	7.59	< 0.001
	VR education	20	4.55 ± 0.76
Item 7	Verbal education	20	2.75 ± 0.55	7.47	< 0.001
	VR education	20	4.40 ± 0.75

VR: Virtual reality.

Table 9 Comparison of traditional paper-based verbal method and virtual reality method using System Usability Scale

Variables	Verbal education, mean ± SD	VR education, mean ± SD	t	P value
SUS1	2.35 ± 1.04	4.10 ± 0.72	-7.68	< 0.001
SUS2	3.90 ± 0.79	2.65 ± 0.81	4.80	< 0.001
SUS3	2.25 ± 0.72	4.10 ± 0.79	-7.00	< 0.001
SUS4	4.00 ± 0.79	2.75 ± 0.79	4.63	< 0.001
SUS5	2.10 ± 0.91	4.30 ± 0.73	-7.03	< 0.001
SUS6	4.00 ± 0.79	2.75 ± 0.91	5.22	< 0.001
SUS7	2.05 ± 0.89	4.30 ± 0.66	-8.64	< 0.001
SUS8	4.10 ± 0.72	2.90 ± 0.85	4.33	< 0.001
SUS9	2.05 ± 0.83	4.00 ± 0.73	-7.06	< 0.001
SUS10	3.95 ± 0.76	2.55 ± 0.83	5.98	< 0.001
Score of SUS	27.13 ± 8.82	68.00 ± 5.42	-16.79	< 0.001

SUS: System Usability Scale; VR: Virtual reality.

Table 10 Comparison of traditional paper-based verbal method and virtual reality method using After-Scenario Questionnaire

Variables	Verbal education, mean ± SD	VR education, mean ± SD	t	P value
ASQ1	4.05 ± 1.19	5.75 ± 0.97	-5.23	< 0.001
ASQ2	2.75 ± 1.12	5.55 ± 1.00	-11.33	< 0.001
ASQ3	2.95 ± 1.10	3.85 ± 0.99	-4.72	< 0.001
Average of ASQ	3.25 ± 0.59	5.05 ± 0.61	-10.59	< 0.001

ASQ: After-Scenario Questionnaire; VR: Virtual reality.

Table 11 Comparison of traditional paper-based verbal method and virtual reality method using Maslach Burnout Inventory

Variables	Verbal education, mean ± SD	VR education, mean ± SD	t	P value
Emotional exhaustion	2.53 ± 0.31	1.98 ± 0.17	6.77	< 0.001
Personal accomplishment	2.80 ± 0.20	2.54 ± 0.44	2.28	0.034
Depersonalization	1.97 ± 0.30	2.01 ± 0.27	-0.54	0.599

VR: Virtual reality.