Formative Evaluation of Virtual Reality Materials for Inducing Cultural Awareness

As Japan moves toward a multiculturally convivial society, nurses are required to have intercultural competence to recognize the diverse characteristics of their patients and to practice nursing. In order to acquire intercultural competence, it is important to take an attitudinal approach that encourages cultural awareness, which is to recognize and acknowledge differences between oneself and others. Therefore, we developed a VR teaching material that allows Japanese people to experience first-person the anxiety and difficulty that foreigners feel when they visit a Japanese hospital. As the first step from the experience, we extracted gaps between foreign patients and Japanese medical staffs by reviewing the literature; the gaps were due to lack of communication, preconceptions, and bitterness. As a second step, we set four learning objectives and created an ICE rubric. The learning objectives were as follows: 1) to try to get involved actively without feeling uncomfortable, 2) to accept others as they are, 3) to think about the reasons for their words and actions by considering their culture and customs, and 4) to be able to recognize one's own prejudices, discrimination, and assumptions. As the third step, we created a prototype of the content. We shot a 360° video of three scenes in a hospital. We embedded a video of a French actors playing a medical staff and talking to the patient. In this way, we recreated the situation of a Japanese patient visiting a hospital in a foreign country. The fourth step was to conduct alpha testing among the developers to complete the content. Four developers watched the prototype and evaluated the usability and the learning outcomes using the ICE rubric. As a result, it was pointed out that although they could experience the sense of difficulty and anxiety of not understanding the language, they could not understand the situation of what was happening, nor could they think about the other person's culture or their own preconceptions. Therefore, we completed the contents by adding guidance, explaining the situation, presenting a summary of what was said, and setting up a quiz for reflection.