Barriers and facilitators of integrating the miWe immersive wheelchair simulator as a clinical tool for training powered wheelchair-driving skills

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Training is an essential aspect of power wheelchair (PWC) service delivery, but is often insufficient and inadequate, which can lead to sub-optimal wheelchair driving skills and decreased confidence in one's abilities. Training using a validated and portable virtual reality platform could increase access, efficiency and safety in PWC skills training. The McGill Immersive Wheelchair Simulator (miWe) was developed for this purpose and has already been validated for PWC training. Before integrating miWe into clinical practice we need input from stakeholders to optimize uptake. Therefore, the objective of this project is to investigate clinical stakeholders’ acceptance of miWe as a potential PWC skills training tool in a rehabilitation setting. A series of focus groups were used to obtain perspectives from clinical program directors and rehabilitation therapists experienced in PWC skills training from four sites in two Canadian provinces. An online survey was also conducted to obtain perspectives from therapists who were not able to attend the focus groups. Thirteen occupational therapists, seven clinical program directors, two seating clinical specialists and one orthotic/prosthetic mechanic ( n = 23) participated in the focus groups, and seven occupational therapists completed the survey. Participants generally expressed that use of miWe would be complementary to training in a real PWC, and that miWe could be useful for challenging situations in rehabilitation centres (e.g., clients who are anxious; when there is uncertainty around their potential to drive a PWC; tasks that cannot be assessed in a real-life environment). They also provided suggestions to improve miWe (e.g., more feedback during tasks; possibility of adjusting the parameters and adding varied control interfaces). MiWe has the potential to provide a robust platform for the assessment and training of complex PWC driving skills in a realistic and immersive training context. The results of this project will inform its potential distribution in rehabilitation centres.