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| Context and implementation considerations |
| Learners | (i) Well, when you get people coming in that’s never worked in a care home or in care work at all you ask somebody if they know how to wash their hands and they say, “yes.” And they just do a quick wash and that’s it, you know, it’s more involved than that. (P18) |
| (ii) I do think with the residents, it might be a really good idea, because a lot of them, you know, I don’t want to sound rude, but they end up with faeces on them, and it is quite hard to get it from under the fingernails. So, it might be quite fun for them. (P4) |
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| Care homes | (i) We don’t have work phones, so then staff would be expected to do it on their own phone, whereas they’re not expected to do their training on their own phones, they’re supposed to use our computers. We pay them for their time and things like that. (P13) |
| (ii) It’s (VR) taking someone off the floor, whereas this one (AR) can be done on the floor with the service users as well. You wouldn’t have to leave. (P12) |
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| Technology | (i) Probably the cost of it with the headset and things for a small business like ourselves we wouldn’t be able to go down that route… some virtual reality things you’re looking more like £100,000 but, no, for less than £100 if you can get it in-situ then that’s fine. (P1) |
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| Mechanisms |
| Perceptions of realism | (i) In a hospital you’ve got all definite wipeable floors and everything in there is very clinical, whereas in a care home it’s a homely environment, it’s not necessarily like that. So you’d need to be transported into that environment for it to be effective. (P1) |
| (ii) I don’t think we’re different to a hospital setting…. We do nine out of ten things the nurse staff do at the hospital, and we’ve got our own nursing ward upstairs…. If it’s okay for a hospital setting, I think it’s okay for a care home setting at the same time. (P9) |
| (iii) I think it’s got to be realistic because otherwise, they don’t relate it to their work. (P1) |
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| Visualisation of personal anatomy | (i) I think seeing what mistakes could happen if you didn’t do things right would also make people take a step back and think more about what they were doing. (P5) |
| (ii) I think the top one (AR) is better than the bottom one (VR) because you can actually see your hands doing it. (P12) |
| (iii) I think would be more relevant to hospitals especially if you’re dealing with wounds and injuries and blood and things like that than to a care home. (P22) |
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| Interactive learning experience | (i) People zone out. It can be really boring to sit there for an hour while someone talks at you, whereas this is more interactive and you’re more likely to pay attention. (P13) |
| (ii) You’re talking about what you’re doing, so I think you’re learning more as you’re talking…. We’d probably have a bit of banter and say, “Don’t forget to do your thumbs.” And I just think it makes you more relaxed. And I think the more you relax, the more you pay attention. |
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| Deep immersion in VR | (i) I think when you’re transported to a different world, it makes you see things differently, and you might learn differently. (P4) |
| (ii) I really agree with the idea that when you’re immersed in it when you don’t have the distractions of everything else going on, you’re paying attention. So if you’re just sitting on your phone and you’re looking at an app I don’t think you get the same sort of focus as you would do if you were, you know, had the headset on and you’re physically there….I’m not sure how high they would rate it on the scale of importance but I think if the ultimate goal was to get people to learn better. I think they’d be learning better if they were in there. (P25) |
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| Practice in a safe environment | (i) It is more like you’re being hands-on without actually being hands-on. There’s no danger, rather than going in and like I said, spreading things around. There’s no danger with it and you’re learning before that happens. (P13) |
| (ii) If you’ve learnt in like a safe environment where everything is calm and quiet and easy enough and there’s enough time, once you’re out there’s not always enough time- how are you going to make sure you’re still efficient? (P22) |
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| Repeated practice | (i) You can get lackadaisical in anything, so yes, I do think repeated practice is needed for nearly all skills to be fair, not just hand hygiene. (P9) |
| (ii) Obviously muscle memory - the more you’re doing it the more you’re sort of remembering that’s what I need to be doing….The more you do it the more you remember that’s what you are supposed to do and so naturally the more you’re going to do it. (P25) |
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| Feedback and reminding | (i) You know, it’s just that reminder, like I say, even though I automatically do it, I do look at the boards that are in the toilets and that, just to double check myself, to say I am doing it correctly. So, having something, an app like that would be great on the phone, that I could do it myself. (P17) |
| (ii) It’s quite easy for somebody to be watching you and miss it out themselves because humans are a bit more vulnerable to making mistakes than computers aren’t they? (P25) |
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| Outcomes | (i) I think it would give a lot of carers a lot more, you know, understanding, make them a lot more aware of how and when they sanitise and wash their hands. (P6) |
| (ii) I would expect that the staff wash their hands more and do it correctly every time. (P12) |
| (iii) It is the learning and passing on the learning, but at the end of the day it’s best practice for the protection of residents, and for each other, so I think that would be the main thing for me. (P17) |
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