A comparison of virtual reality and active video game usage, attitudes and learning needs among therapists in Canada and the US

Differences in health care funding and policies between the United States and Canada may influence uptake of and attitudes towards virtual reality (VR) and active video gaming (AVG) systems by physical (PTs) and occupational therapists (OTs) in each country. The purpose of this study was to undertake a cross-country comparison of VR/AVG uptake to inform the content of educational interventions designed to promote implementation of these technologies into practice. A cross-sectional online survey that included the Assessing Determinants of Prospective Take-up of Virtual Reality (version 2; ADOPT-VR2) Instrument was conducted in 2014-2015 (Canada) and replicated in 2017-2018 (US). Recruitment took place via convenience and snowball sampling, using email, social media and newsletter postings. Therapists in the US reported greater past experience with, current use of, and intention to use VR/AVGs than did those in Canada. They also rated facilitators more positively and barriers less negatively. Use of customized VR systems was low, with specific system prevalence differing between countries. The most frequently used AVG systems, populations and settings of use, functional goals, predictors of use, learning needs and preferred forms of support were similar between countries. These similarities support the generalizability of educational interventions for both countries. Materials to be developed will focus on non-customized AVG systems. Subsequent work will examine how uptake relates to country-specific health care funding and policies, probe differences in learning needs between therapists with experience using customized versus non-customized VR/AVG systems, and extend the survey to other countries where VR/AVG use is prevalent.