Co-creating virtual reality for pain education: A qualitative study to explore factors influencing participation

Background Students have challenges in assessing pain. Virtual Reality applications (VR-app) can help visualization, thus helping students better understand a patient's pain experiences. Inviting teachers and students to co-creating a VR app will improve innovation. Nevertheless, previous studies reported that the power dynamic between teachers and students influenced co-creations. In developing VR, students have an additional advantage over teachers, as they are digital natives. Yet, it is less explored if students’ technology superiority influenced the co-creation dynamic. This study aimed to investigate the influencing factors for participation experienced by the teachers and students in co-creating a VR app for pain education. Summary of Work Ten medical students and twelve teachers participated in the co-creation to develop a VR app for pain education. We provided an orientation session to introduce the co-creation approach and VR technology. We conducted two parallel online co-creation sessions, where students and teachers discussed together, and the research team served as facilitators. Afterwards, we interviewed students and teachers in separate Focus Group Discussions (FGDs) to explore influencing factors for participation. We recorded the co-creation sessions and the FGDs and transcribed the recordings. We used a thematic analysis approach to analyze the data. Summary of Results Three factors influenced participation in co-creation: participants’ experience in using VR, organization of co-creation, and participants’ attitudes toward co-creation. Experience in using VR enabled participants to share more active contributions. The organization of the cocreation included time availability and the facilitators’ strategy to manage interaction. Teachers with a positive attitude toward co-creation were more open to students’ participation and appreciation of students’ expertise in technology. Meanwhile, teachers noticed students’ hesitance to discuss with teachers, which students confirmed. Discussion and Conclusion In co-creating a new technology like VR, participants' prior experience is beneficial. For students, this experience also enhances participation. Attitude toward co-creation and adequate time for discussion also influenced participation, primarily to support student-teacher interaction. Take home messages Preparation of co-creation in developing VR apps should focus on introducing the technology and promoting a positive attitude toward co-creation. The facilitator's role is essential to create a supportive environment, such as inviting participants to contribute ideas and managing student-teacher interactions.