Training For Retention in Senior Care

Posted by Todd Maddox & Tim Fitzpatrick on May 30, 2019 8:23:21 PM

Using Virtual Reality to “Train for Retention” in Senior Care

The “boomers” are aging.

This is leading to a growing need for in-home and staffed senior care professionals. The Bureau of Labor Statistics predicts that the home care workforce will grow 41% from 2016 to 2026 to 4 million jobs, and the direct care workforce is expected to grow 30% to 5.8 million jobs during the same time period. Exacerbating the problem, are the high turnover rates. Senior care staff turnover rates are consistently high and home care industry turnover reached an all-time high in 2018 reaching 82%.

One commonly noted cause of the turnover problem is a lack of high-quality, continuous education and training. When senior care professionals are provided with high-quality continuous training everyone wins. Senior care professionals win because they are confident, prepared, engaged, satisfied, and are less likely to leave. They enjoy the work, and are committed to the seniors under their care. Seniors under these professionals’ care are confident, satisfied and feel valued. It starts and ends with high-quality continuous education and training.

High-quality continuous education and training is central because the human brain is hardwired to forget. What this means is that you can train to perfection today, but you will immediately start to forget and ultimately will retain only a small portion of the information. This is a serious problem in any training setting, but is especially problematic in senior care. The last thing that you want is for your senior care professional to forget some critical piece of knowledge or skill.

This report examines the nature of continuous training in senior care and asks the question, “How can one address the problem of forgetting and enhance long-term retention?” We show that traditional approaches to training that rely predominantly on text, and some simulation or hands-on training are less effective than immersive technologies like virtual reality (VR) that are grounded in experiential learning and guard against forgetting. We show that the ability for endless study and practice enhances “Training for Retention”, and builds situational awareness in senior care professionals.


“Learning is an experience. Everything else is just information.”

-Albert Einstein

This is an insightful quote from Albert Einstein that is supported by the neuroscience of learning.

But why? What is it about experience that is so rich that it is fundamental to learning, and why is information so much less effective?

A detailed discussion of the neuroscience of learning can be found here. Briefly, the human brain is comprised of several distinct learning systems. We focus on three in this report: the experiential, cognitive and emotional learning systems in the brain.

As Einstein so eloquently stated, experience is at the heart of learning, and importantly is at the core of VR. The experiential learning system in the brain has evolved to represent the sensory aspects of an experience, whether visual, auditory, tactile or olfactory. Every experience is unique, adds rich context to the learning and is immersive. This is the true power of VR.

The cognitive learning system in the brain is the information system. It processes and stores knowledge and facts. Cognitive information comes in the form of text, graphics, or video and is processed using working memory and attention. Critically, these are limited resources and form a bottleneck that slows learning with more information coming in and available to the learner than can be processed.

The emotional learning system in the brain has evolved to facilitate the development of situational awareness -- the ability to read nuances in a situation and the uncanny ability to know what comes next – as well as empathy and an understanding of our and others’ behaviors. Whereas one can have all of the facts and figures available, in the end one has to extract the appropriate information and engage the appropriate behavior in each distinct situation. This is especially important in senior care.

The majority of senior care training comes in the form of textbooks, manuals or PowerPoint. In addition, this usually happens once, or across fairly long intervals. These training materials are all processed by the cognitive skills learning system in the brain and are thus strongly affected by the bottleneck of working memory and attention. This leads to poor initial learning and weak long-term retention. This may be supplemented with one-on-one training or senior care simulation, both of which are effective, but these two tend to be one-off, and are time-intensive, cost-intensive, and are difficult to scale.

Basic science research on learning is clear in showing that experiential learning is most effective, and is more effective than learning by reading text or PowerPoint. Experiential learning engages multiple learning and memory systems in the brain (e.g., experiential, cognitive and emotional) in synchrony whereas text and PowerPoint predominantly engage cognitive systems. When multiple learning and memory systems are engaged in synchrony, a highly interconnected, context-rich set of memory traces results that are slower to decay over time leading to better long-term retention.

VR provides senior care staff with a first-person immersive experience. When combined with interactive storytelling the lines between real and virtual immersive experience blur to the point that the senior care worker has a sense of “presence”. They feel like they are somewhere else. Because immersive training tools are available 24/7 the senior care professional can have unlimited practice, and can be exposed to adverse conditions. This approach trains for retention while also building situational awareness. Unlike one-on-one or simulation training, VR is time-effective, cost-effective, and scalable.

The training potential is limitless. A certified nursing assistant or home care therapist might be transported into a “A Day in the Life of Senior Caregiving” where they are given immersive experiences with the residents, staff, and living environments. This might be followed by interactive VR experiences focused on the disorientation and frustration associated with poor memory functioning, visual impairments, or sundowning. Safety procedures can also be experienced in VR such as learning how to “safety proof” a living quarter, walk a senior without the risk of a fall, or deescalate a tense situation. These VR experiences can take place third-person as a student learning, or could be first-person experiences. Imagine a first-person virtual experience of the senior’s frustration when a frontline worker states that they will “only be a minute”, but don’t return for ten to twenty minutes. These “walk a mile in my shoes” experiences build compassion and empathy that are so difficult to teach.

With VR, senior care professionals can start day one on the job with a broad-based and deep understanding of the senior care life. VR training can be repeated and new VR experiences can be added to increase the professional’s knowledge base. Because at the end of the day, a well-trained direct care workforce will be critical to keeping baby boomers safely in their homes as they age.

VR trains for retention and builds situational awareness that is critical in senior care – one experience at a time.

Topics: Training, Communication, Learning, Neuroscience, Staff Training, Home care, Workforce

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Now you will be.

At the end of the day, your healthcare journey begins and ends with you. Using virtual reality to improve education and training in healthcare has limitless potential to impact the lives of everyone you meet along the way.

Remember, evidence shows VR:

  • Improves satisfaction
  • Decreases anxiety
  • Improves learning
  • Improves retention
  • Increases actionable empathy
  • Outperforms classroom-based learning
  • Is the medium preferred by learners

The benefits of VR have never been more accessible.

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