The participatory process on co-designing a virtual reality program in long-term care: A Critical Reflection
L. Hung, J.O.Y. Wong, K.L.Y. Wong, A. Soni, M. Van, S. Kholmatov, K. Lee, J. Mann, A. Lim, W.B. Mortenson
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AbstractPURPOSE: Existing research studies in long-term care (LTC) adopting the participatory research (PR) approach show a positive impact on partners involved. However, limited evidence has examined the ethical challenges encountered during the participatory process. This presentation shares the critical reflection of our research team on the power dynamics and ethical challenges in our participatory technology project in LTC, in which we co-designed a virtual reality (VR) program with residents, staff, and family members. METHOD: Our research team comprised older adults with dementia, family partners, and multidisciplinary undergraduate and graduate students, guided by researchers in nursing, rehabilitation science, computer science, and system design engineering. The critical reflection focuses on three main activities in the PR, including co-design workshops and interviews, residents-led video co-creation, and staff-led VR implementation. Guided by Rolfe's model of reflection, our team reflected on the challenges faced regarding power dynamics and discussed methodological insights and lessons learned. RESULTS AND DISCUSSION: Three themes were identified: 1) the unintentional exclusion of voices, specifically on the recruitment strategy and the consideration of co-design workshops' group dynamics; 2) the perceived autonomy in the co-creation process and different levels of VR knowledge of staff and residents, impacting their engagement and contributions in the interactions during the research process; and 3) the unfamiliarity with the research team members and process, particularly the ethical dilemmas of consent and appreciation. We offer pragmatic implications and a PARTNER framework for future projects, adopting a participatory approach to the co-creation and implementation of technological interventions in LTC to ensure inclusive participation. The PARTNER framework involves: Plan thoroughly for group structures and observe dynamics; Adopt innovative forms of expression beyond verbal communication; Reflect on researchers' positionality and its influence on participation; Tailor consent processes to ensure accessibility and understanding; Nurture familiarity and comfort with the technology involved; Embrace inclusive recruitment strategies that reach residents with diverse abilities; Respect participants' preferences for tokens of appreciation. It is crucial for researchers in the field to continue to reflect on potential power dynamics and their own positionality in the collaborative process, consider diverse partners' capacities and assumptions, and be open and innovative in strategizing the participatory activities. Strengthening researchers' understanding of what collaboration truly means in PR in LTC is imperative.Keywords: Collaborative, Meaningful Engagement, Patient and Public Involvement, Nursing Homes, Technology
L. Hung, J.O.Y. Wong, K.L.Y. Wong, A. Soni, M. Van, S. Kholmatov, K. Lee, J. Mann, A. Lim, W.B. Mortenson (2026). The participatory process on co-designing a virtual reality program in long-term care: A Critical Reflection. Gerontechnology, 25(2), 1-10
https://doi.org/10.4017/gt.2026.25.2.1314.3