Acceptance and feasibility of virtual reality for teaching adult basic life support in older populations.

Background
Virtual reality (VR) is emerging in adult Basic Life Support (BLS) training, but its acceptance among older adults has not been fully studied. This study aimed to develop expert-informed BLS content for both VR and laptop formats, and to evaluate the feasibility, usability, knowledge acquisition, satisfaction, and cybersickness of these platforms among older adult learners.Methods
A two-phase mixed-methods study was conducted. Five experts co-developed and validated a VR/laptop-compatible adult BLS scenario based on the 2021 European Resuscitation Council guidelines. This scenario was then tested by older adults who voluntarily participated in either VR- or laptop-based training at a public technology event in Spain. Post-training, we measured knowledge acquisition, usability, satisfaction, user experience, and cybersickness. Comparative statistics and regression analyses were performed to evaluate learning outcomes and predictors.Results
Five experts developed a consensus-based adult BLS decision tree with 10 scenes and six questions. A total of 583 adults (mean age 72.3 ± 4.8 years) took part in the BLS training evaluation. Those in the VR group (n = 415) outperformed those in the laptop group (n = 168) in key steps, including initiating CPR (58 % vs 41 %, p < 0.001) and using an AED (49 % vs 23 %, p < 0.001). VR participants rated usability of VR-training as excellent (73.8 ± 4.2), expressed high satisfaction and realism. Cybersickness was low (13.1 %). VR training predicted higher knowledge scores (β = 5.8, p < 0.001), and increased scores by 5.8 points over laptop training. VR participants were 2.3 times more likely to answer BLS questions correctly (OR = 2.3, 95 % CI: 1.6-3.2, p < 0.001).Conclusion
VR could improve adult BLS knowledge in older adults, with high levels of acceptance and positive user experience. Future work should enhance accessibility and reduce discomfort.