Describing, Evaluating, and Exploring Barriers to Adoption of Virtual Reality: An International Modified Delphi Consensus Study Involving Clinicians, Educators, and Industry Professionals.

With the rising interest in extended reality technology, the literature base is rapidly growing. With this growth, confusion within the descriptive terminology, and incoherence in the methodological approach to training tool evaluation exists. Additionally, the development expectations of the health care worker, educator, and academic are not clear. This study aimed to work toward consensus agreement around four key areas of interest: (1) descriptive terminology (2) evaluation methodology (3) research outcome measure selection, and (4) barriers and facilitators to adoption of VR into health care education. This study was an international, electronic, Modified Delphi Consensus study, which ran over two rounds. Systematic literature review, ratified by a multidisciplinary study advisory group, and combined with Delphi round, one participant responses generated a total of 133 propositions across all areas of interest. In two rounds of a Delphi process, consensus was reached for a total of 102 propositions of which 49 were included, and 53 excluded, with the remaining 31 propositions not reaching consensus. Fifteen terms were deemed important when describing VR technology with 'virtual environment', 'interactive', and 'simulation' achieving the highest levels of agreement. There was almost unanimous agreement that technology should be described by its interplay between the hardware and software involved in a system and that educational outcome retention should be measured when evaluating VR training. High-cost was the most important prohibitive barrier to VR uptake with easy access to content and low maintenance effort being most attractive factors. This study represents a first step toward international consensus around how to describe VR technology, how to approach VR educational evaluation including selection of appropriate research outcome measures, the most important barriers to technology adoption and design considerations that facilitate technology adoption into health care education.