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NursesNCT06938997

The Effectiveness of Combining AR/VR Technology in Virtual Clinical Auditory Hallucinations on the Comprehensive Auditory Hallucination Nursing Competency of Psychiatric Nurses

A study testing Virtual clinical auditory hallucination solution combining AR/VR technology and Auditory Hallucination Care Video in people with Nurses and Schizophenia Disorder, run by National Yang Ming Chiao Tung University at 4 sites in Taiwan.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study aims to develop and evaluate a Virtual Reality (VR) Auditory Hallucination Program to enhance psychiatric nurses' comprehensive care competence in managing auditory hallucinations among patients with schizophrenia. Read more about this study

Who is it for?
Ages 20 to 65 yearsHealthy volunteers can take part
What is being tested?
Virtual clinical auditory hallucination solution combining AR/VR technology and Auditory Hallucination Care Video
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
200 participants
Where
4 sitesTaiwan
Study dates
1 May 2025to 1 May 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • A psychiatric nurse who has been engaged in nursing work in a psychiatric unit for at least three months;
  • Those who were willing to participate in the study and filled out the consent form;
  • Willing to use smartphones to watch VR360 videos;
  • Willing to cooperate with the study and use 3D glasses.

Who cannot join

  • Nurses who are about to leave or be transferred out of the psychiatric ward within six months
  • Part-time nurses
  • Part-time supervisors
  • Specialist nurses.

Trial locations and contacts

4 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Chiu-Yueh Yang, PhD contact

886228267388

Cyyang530904@nycu.edu.tw

Taiwan4 sites
  • Yuli Hospital, Ministry of Health and Welfare

    Hualien City, 981

    Shiou-Rung LIN, MSN, 88638886141, mountain115@gmail.com

  • Tsaotun Psychiatric Center, Ministry of Health and Welfare

    Nantou County, 542

    I-Ling LI, MSN, 886492550800, cadenceiling@gmail.com

  • Bali Psychiatric Center, Ministry of Health and Welfare

    New Taipei City, 249

    Jia-Min Li, MSN, 886226101660, louislee0720@gmail.com

  • Tri-Service General Hospital Beitou Branch

    Taipei, 112

    LI-RU WANG, MSN, 886228959808, louislee0720@gmail.com

    louislee0720@gmail.com

Other trials in Taiwan

About this study

This study aims to develop and evaluate a Virtual Reality (VR) Auditory Hallucination Program to enhance psychiatric nurses' comprehensive care competence in managing auditory hallucinations among patients with schizophrenia. Given that 60-80% of patients on the schizophrenia spectrum experience auditory hallucinations, and many continue to do so despite medication, improving nurses' professional skills in this area is critical.

The research is conducted in two phases across four psychiatric institutions. Phase one involves the development and validation of the VR program and an OSCE (Objective Structured Clinical Examination), piloted with five participants and evaluated by psychiatric nursing experts. Phase two is a formal interventional study with 200 psychiatric nurses, using block randomization and three data collection time points.

Assessment tools include five instruments measuring nurses' confidence, knowledge, attitude, empathy, immersion, and care performance related to auditory hallucinations. The study expects to strengthen nurses' ability to assess and manage auditory hallucinations effectively, and proposes the VR program as a potential tool for nursing in-service education.

Read the detailed description

Background: The lifetime prevalence of auditory hallucinations among patients on the schizophrenia spectrum is 60-80%. More than half of these patients continue to experience auditory hallucinations even with regular medication adherence. The professional competence of nurses in managing auditory hallucinations affects the stability of patients' symptoms and their recovery process, highlighting the importance of nurses' capabilities in caring for patients with auditory hallucinations.

Purpose: To develop and test the effectiveness of a virtual reality auditory hallucination program on the comprehensive care competence of psychiatric nurses in managing auditory hallucinations.

Methods: This is a two-phase study conducted in four psychiatric medical institutions. The study includes a development phase, a testing phase, and a formal research phase. In the pilot phase, five participants are expected to be recruited. The first phase involves the development and testing of the virtual reality auditory hallucination program and the Objective Structured Clinical Examination (OSCE), which includes components such as auditory hallucination assessment, communication with individuals experiencing auditory hallucinations, and management of auditory hallucinations. Upon completion, content validation will be conducted by psychiatric experts. Five psychiatric nursing master's students will be invited as simulated candidates to examine the applicability of the "VR-based Auditory Hallucination Nursing OSCE" for psychiatric nurses. The second phase is the formal interventional study, which will recruit 200 psychiatric nurses through convenience sampling. Participants will be grouped by institution using block randomization software. Data will be collected at three time points using the HTC virtual human system in conjunction with Google online questionnaires. The research instruments include:

  • Self-rated Confidence Questionnaire on Auditory Hallucination Assessment and Management,② Auditory Hallucination Knowledge, Attitude, and Empathy Self-awareness Scale,③ Auditory Hallucination Immersion and Empathy Scale, ④ Comprehensive Auditory Hallucination Nursing OSCE Evaluation Form, and ⑤ Nurse Auditory Hallucination Literacy Scale. Expected Results: This study is expected to enhance psychiatric nurses' capabilities in assessing and managing auditory hallucinations. The program may be routinely used in in-service education for nursing staff and may serve as a reference to assist nurses in helping patients improve their insight into auditory hallucinations.

Keywords: Auditory hallucination care competence, interventional study, virtual reality, schizophrenia, Objective Structured Clinical Examination (OSCE)

Being tested
Virtual clinical auditory hallucination solution combining AR/VR technology, Auditory Hallucination Care Video
Keywords
Auditory hallucination care competence, virtual reality, schizophrenia, Objective Structured Clinical Examination
Medical subject headings
Hallucinations, Schizophrenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Virtual clinical auditory hallucination solution combining AR/VR technologyOther

    This study, titled "Effectiveness of AR/VR-integrated OSCE on Psychiatric Nurses' Comprehensive Auditory Hallucination Care Ability: A Randomized Controlled Trial," involves both experimental and control groups watching videos. The control group views standard educational videos, while the experimental group uses AR/VR technology, virtual patient interaction platforms, and educational videos in a simulated clinical environment. Four scripts were developed: two for training and two for pre/post-testing. All scripts and OSCE checklists are researcher-developed, reviewed by experts, and pilot tested.

  • Auditory Hallucination Care VideoOther

    The videos include professional knowledge and skills related to auditory hallucinations.

Study groups in NCT06938997
Study groupRoleWhat they receive
50-minute Auditory Hallucination Care instructional videoPlacebo comparatorControl Group * Pre-test: No intervention * Intervention 1: Auditory Hallucination Care Video only * Post-test: Conduct measurement (no new intervention) * Intervention 2: 50-minute Auditory Hallucination Care instructional video only * Follow-up: Conduct measurements (no new intervention)
Receives: Other: Auditory Hallucination Care Video
Virtual clinical auditory hallucination solution and Auditory Hallucination Care instructional videExperimentalExperimental Group * Pre-test: No intervention * Intervention 1: Accept intervention A+B * A: Virtual clinical auditory hallucination solution combining AR/VR technology and virtual human interactive platform * B: 50-minute Auditory Hallucination Care instructional video * Post-test: Conduct measurement (no new intervention) * Intervention 2: Re-intervention of A+B * Follow-up: Conduct measurements (no new intervention)
Receives: Other: Virtual clinical auditory hallucination solution combining AR/VR technology; Other: Auditory Hallucination Care Video

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Auditory Hallucination Immersion and Empathy Scale

    To assess the impact of the intervention on empathy, this study uses the Situational Scale of Empathetic Responses (Schutte \& Stilinović, 2017), consisting of 15 items-7 on empathic perspective taking and 8 on empathic concern. Participants imagine interacting with a person hearing voices and rate items on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree); higher scores indicate greater empathy in auditory hallucination scenarios. The scale was translated and validated for content. Additionally, we will adopt the Jefferson Scale of Empathy (JSE-HP version), translated and adapted by Cheng et al. (2011), with a KMO of 0.93 and Cronbach's α = .73-.89.

    Measured: At baseline (pre-intervention), 6 weeks after the first intervention, and 6 weeks after the second intervention.

  2. Auditory Hallucination Knowledge, Attitude, and Empathic Self-Awareness Scale; Auditory Hallucination Literacy Scale.

    This tool, developed by Mawson (2014), includes 11 items assessing knowledge, attitudes, and empathy toward auditory hallucinations. Participants respond using a 5-point Likert scale ranging from "strongly agree" (5) to "strongly disagree" (1). As it has not been used in Taiwan, we have completed forward and backward translation and content validity testing. Reliability and validity testing of the Chinese version will be completed before the intervention study.

    Measured: At baseline (pre-intervention), 6 weeks after the first intervention, and 6 weeks after the second intervention.

Secondary outcomes (1)
  1. Demographic variables

    Includes age, educational level, gender, marital status, total years of nursing experience, years of psychiatric nursing experience, advanced certifications (nurse practitioner, psychiatric mental health nurse, community psychiatric mental health nurse), level of competency advancement, workplace setting, and type of employment.

    Measured: Before intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Apr 2025
  2. Study start1 May 2025 (estimated)
  3. Primary completion1 May 2027 (estimated)
  4. Study completion1 May 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Crossover
Masking
Single blind
Who is masked
Participant
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06938997
Sponsor's protocol ID
NYCU113052AE
Status last verified
Mar 2025
First submitted
14 Apr 2025
Last updated
8 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Dutta TK, Veeresh A, Mathur C, Phani V, Mandal A, Sagar D, Nebapure SM. The induced knockdown of GmCAD receptor protein encoding gene in Galleria mellonella decreased the insect susceptibility to a Photorhabdus akhurstii oral toxin. Virulence. 2021 Dec;12(1):2957-2971. doi: 10.1080/21505594.2021.2006996.

    PubMed 34882066
  • Lee JH, An CH, Yoo NJ, Lee SH. Mutational intratumoral heterogeneity of a putative tumor suppressor gene RARRES3 in colorectal cancers. Pathol Res Pract. 2018 Apr;214(4):601-602. doi: 10.1016/j.prp.2017.12.011. Epub 2017 Dec 21. No abstract available.

    PubMed 29496306
  • Della Libera C, Goosse M, Laroi F, Willems S. Examining the impact of experiencing auditory verbal hallucinations from a first-person perspective on the degree of empathy and stigmatization in a group of psychology students: A study using 360 degrees immersive videos. Compr Psychiatry. 2023 May;123:152379. doi: 10.1016/j.comppsych.2023.152379. Epub 2023 Feb 26.

    PubMed 36870090
  • de Leede-Smith S, Barkus E. A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals. Front Hum Neurosci. 2013 Jul 16;7:367. doi: 10.3389/fnhum.2013.00367. eCollection 2013.

    PubMed 23882203
  • Craig TK, Rus-Calafell M, Ward T, Leff JP, Huckvale M, Howarth E, Emsley R, Garety PA. AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial. Lancet Psychiatry. 2018 Jan;5(1):31-40. doi: 10.1016/S2215-0366(17)30427-3. Epub 2017 Nov 23.

    PubMed 29175276
  • Carlson CG. Virtual and Augmented Simulations in Mental Health. Curr Psychiatry Rep. 2023 Sep;25(9):365-371. doi: 10.1007/s11920-023-01438-4. Epub 2023 Aug 25.

    PubMed 37624512
  • Browne C, Wall P, Walters J. Exploring Nursing Students' Experiences With Different Teaching Pedagogies: A Mixed-Methods Study. J Nurs Educ. 2022 Mar;61(3):147-152. doi: 10.3928/01484834-20220109-04. Epub 2022 Mar 1.

    PubMed 35254159
  • Abdolrahimi M, Ghiyasvandian S, Zakerimoghadam M, Ebadi A. Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electron Physician. 2017 Aug 25;9(8):4968-4977. doi: 10.19082/4968. eCollection 2017 Aug.

    PubMed 28979730

Questions about this trial

What is this clinical trial studying?

A study testing Virtual clinical auditory hallucination solution combining AR/VR technology and Auditory Hallucination Care Video in people with Nurses and Schizophenia Disorder, run by National Yang Ming Chiao Tung University at 4 sites in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 8 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Chiu-Yueh Yang, PhD (886228267388, Cyyang530904@nycu.edu.tw), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Auditory Hallucination Immersion and Empathy Scale (time frame: At baseline (pre-intervention), 6 weeks after the first intervention, and 6 weeks after the second intervention.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06938997, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2025.

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