{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:06:49Z","timestamp":1790104009515,"version":"4.0.1"},"reference-count":37,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Dementia training requires innovative strategies to improve nursing students\u2019 attitudes, knowledge, and behavioral responses regarding ageism. Virtual reality (VR) offers immersive learning, but existing interventions often rely on passive 360\u00b0 viewing, which provides limited opportunities for practice communication.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to evaluate the effectiveness of a scenario-driven, AI-based VR awareness simulation adventure (ASA) in improving nursing students\u2019 attitudes toward people living with dementia, knowledge of dementia, ageism, and intention to help.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This protocol outlines a 4-arm quasi-experimental 2\u00d72 factorial design involving ASA VR and conventional lecture-based dementia training. Nursing students will complete preintervention and postintervention assessments measuring attitudes toward people living with dementia, dementia knowledge, ageism, and intention to help. The sample size justification is based on previous VR-based dementia education studies that reported large effects (Cohen\n d<\/jats:italic>\n =0.9). Data will be analyzed using a 2-tailed independent\n t<\/jats:italic>\n test, paired tests, analysis of covariance, and effect sizes. The intervention will be described in accordance with the TIDieR (Template for Intervention Description and Replication) guidelines. Data management, harm monitoring, and ethical approval procedures are specified.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Data collection began in December 2025 and was completed in June 2026, with 182 participants recruited. Data analysis is currently ongoing. Findings will report on the effectiveness of ASA VR in enhancing attitudes toward people living with dementia, dementia knowledge, ageism, and intention-to-help outcomes.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This protocol introduces Indonesia\u2019s first scenario-driven VR dementia simulation training. Findings may inform the development of culturally adapted VR-based dementia training.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/95684","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:52:41Z","timestamp":1790103161000},"page":"e95684-e95684","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Scenario-Driven Virtual Reality for Improving Nursing Students\u2019 Behavioral Responses Toward Older Adults With Dementia: Protocol for a 4-Arm Postintervention Study"],"prefix":"10.2196","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1661-7999","authenticated-orcid":false,"given":"Dianis Wulan","family":"Sari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2529-1962","authenticated-orcid":false,"given":"Hadziq","family":"Fabroyir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0109-2667","authenticated-orcid":false,"given":"Neisya Pratiwindya","family":"Sudarsiwi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9136-0164","authenticated-orcid":false,"given":"Manami","family":"Takaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1611-653X","authenticated-orcid":false,"given":"Nurul","family":"Hidayati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5431-3657","authenticated-orcid":false,"given":"Etty","family":"Rekawati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4928-3147","authenticated-orcid":false,"given":"Muhammad Rafi Insan","family":"Fillah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6121-5510","authenticated-orcid":false,"given":"Widian Sasi","family":"Disertasiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0165-2545","authenticated-orcid":false,"given":"Nauvila Fitrotul","family":"'Aini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7750-9734","authenticated-orcid":false,"given":"Nur Arifah","family":"Astri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9399-4322","authenticated-orcid":false,"given":"Gerry","family":"Sihaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0014-3533","authenticated-orcid":false,"given":"Harits Ar","family":"Rosyid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7003-7314","authenticated-orcid":false,"given":"Andika Bagus Nur Rahma","family":"Putra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5292-8893","authenticated-orcid":false,"given":"Ayumi","family":"Igarashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/S1474-4422(18)30403-4","article-title":"Global, regional, and national burden of Alzheimer\u2019s disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"GBD 2016 Dementia Collaborators","journal-title":"Lancet Neurol"},{"issue":"4","key":"R2","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2023.76","article-title":"Comprehensive measurement of the prevalence of dementia in low- and middle-income countries: STRiDE methodology and its application in Indonesia and South Africa","volume":"9","author":"Farina","journal-title":"BJPsych Open"},{"issue":"6","key":"R3","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1177\/07334648251358542","article-title":"Effects of age-friendly education on helping intention and attitude for older adults of elementary students: a quasi-experimental study in Japan","volume":"45","author":"Igarashi","journal-title":"J Appl Gerontol"},{"issue":"2","key":"R4","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1080\/02701960.2021.1999938","article-title":"Dementia education and training for the general public: a scoping review","volume":"44","author":"Matsumoto","journal-title":"Gerontol Geriatr Educ"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"e352","DOI":"10.1111\/ajag.12797","article-title":"Virtual reality program to develop dementia-friendly communities in Japan","volume":"39","author":"Sari","journal-title":"Australas J Ageing"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/opn.12616","article-title":"Effects of a dementia educational programme using virtual reality on nurses in an acute care hospital: a pre-post comparative study","volume":"19","author":"Wu","journal-title":"Int J Older People Nurs"},{"issue":"11","key":"R7","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnae113","article-title":"A dementia-friendly educational program using virtual reality for the general public in Japan: a randomized controlled trial for DRIVE","volume":"64","author":"Suzuki","journal-title":"Gerontologist"},{"key":"R8","unstructured":"Sari DW . Enhancing healthcare students\u2019 attitudes toward dementia care through virtual reality education. ClinicalTrials.gov. URL: https:\/\/clinicaltrials.gov\/study\/NCT06629844 [Accessed 09-09-2026]"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/j.compedu.2019.103778","article-title":"A systematic review of immersive virtual reality applications for higher education: design elements, lessons learned, and research agenda","volume":"147","author":"Radianti","journal-title":"Comput Educ"},{"issue":"4","key":"R10","doi-asserted-by":"publisher","first-page":"348","DOI":"10.4103\/0974-2700.70743","article-title":"Simulation-based learning: just like the real thing","volume":"3","author":"Lateef","journal-title":"J Emerg Trauma Shock"},{"key":"R11","unstructured":"Kolb DA . Experiential Learning: Experience as the Source of Learning and Development. 2nd ed. Pearson Education; 2014. ISBN: 9780133892406"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1080\/01421590500046924","article-title":"Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review","volume":"27","author":"Issenberg","journal-title":"Med Teach"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1109\/ICCE56470.2023.10043560","article-title":"HMD in general public for training: case study of standardized dementia-friendly initiative in Japan","author":"Ito","journal-title":"IEEE Int Conf Consum Electron"},{"issue":"7","key":"R14","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1177\/0733464819871878","article-title":"Educational program for promoting collaboration between community care professionals and convenience stores","volume":"39","author":"Igarashi","journal-title":"J Appl Gerontol"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.2196\/62654","article-title":"Education program for enhancing health care students\u2019 attitudes toward people living with dementia: protocol for a single-arm pre-post study","volume":"13","author":"Sari","journal-title":"JMIR Res Protoc"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1177\/07334648261437960","article-title":"The effectiveness of an audiovisual and game-based dementia educational program on healthcare students\u2019 attitude: a pre-post comparative study","author":"Sari","journal-title":"J Appl Gerontol"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1353\/cpr.2023.0000","article-title":"Building relationships between community care professionals and convenience stores in Japan: community-based participatory research","volume":"17","author":"Igarashi","journal-title":"Prog Community Health Partnersh"},{"key":"R18","unstructured":"Ito K Suzuki H Kugai H et al. Use of VR learning material using HMD within the public community: application of dementia supporter training course. Presented at: The 27th Annual Conference of the Virtual Reality Society of Japan; Sep 12-14, 2022; Sapporo, Hokkaido, Japan. URL: https:\/\/www.conference.vrsj.org\/ac2022\/program\/doc\/2F1-4.pdf [Accessed 11-08-2026]"},{"issue":"2","key":"R19","first-page":"393","volume":"22","author":"Suzuki","journal-title":"Jpn J Dement Care"},{"issue":"3","key":"R20","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1017\/S1041610219000796","article-title":"Person-centered attitudes mediate the association between dementia knowledge and help-giving intentions in Singapore","volume":"32","author":"Lane","journal-title":"Int Psychogeriatr"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","first-page":"35","DOI":"10.14456\/nvts.2011.4","article-title":"A theoretical framework for back-translation as a quality assessment tool","volume":"7","author":"Tyupa","journal-title":"New Voices Transl Stud"},{"issue":"1","key":"R22","first-page":"43","volume":"28","author":"Kim","journal-title":"Bull Soc Med"},{"key":"R23","doi-asserted-by":"crossref","unstructured":"Malim T Birch A . Attitudes. In: Introductory Psychology. Macmillan Education UK; 1998:648-676. [doi: 10.1007\/978-1-349-14186-9_33]","DOI":"10.1007\/978-1-349-14186-9_33"},{"key":"R24","unstructured":"Falk EB Lieberman MD . The neural bases of attitudes, evaluation, and behavior change. In: Krueger F Grafman J , editors. The Neural Basis of Human Belief Systems. Psychology Press; 2013:71-94. URL: https:\/\/psycnet.apa.org\/record\/2012-21351-004 [Accessed 11-08-2026]"},{"issue":"4","key":"R25","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1017\/S0144686X2200040X","article-title":"Stigma and its implications for dementia in South Africa: a multi-stakeholder exploratory study","volume":"44","author":"Jacobs","journal-title":"Ageing Soc"},{"issue":"3","key":"R26","doi-asserted-by":"publisher","first-page":"187","DOI":"10.4067\/S0717-92272015000300006","article-title":"Stigma towards dementia: a review [Article in Spanish]","volume":"53","author":"Franco","journal-title":"Rev chil neuro-psiquiatr"},{"issue":"7","key":"R27","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1016\/j.jalz.2018.01.006","article-title":"What features of stigma do the public most commonly attribute to Alzheimer\u2019s disease dementia? Results of a survey of the U.S. general public","volume":"14","author":"Stites","journal-title":"Alzheimers Dement"},{"issue":"5","key":"R28","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1177\/14713012231165112","article-title":"Dementia-friendly communities: exploring terms used to describe dementia, attitudes and reactions towards people with dementia in Ilembe District, South Africa","volume":"22","author":"Mfene","journal-title":"Dementia (London)"},{"issue":"2","key":"R29","doi-asserted-by":"publisher","first-page":"867","DOI":"10.3233\/JAD-170982","article-title":"Impact of a virtual dementia experience on medical and pharmacy students\u2019 knowledge and attitudes toward people with dementia: a controlled study","volume":"62","author":"Gilmartin-Thomas","journal-title":"J Alzheimers Dis"},{"issue":"7-8","key":"R30","doi-asserted-by":"publisher","first-page":"2679","DOI":"10.1177\/1471301218754455","article-title":"Involvement of people with dementia in raising awareness and changing attitudes in a dementia friendly community pilot project","volume":"18","author":"Phillipson","journal-title":"Dementia (London)"},{"issue":"3","key":"R31","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igac023","article-title":"A two-step model for encouraging the general public to exhibit helping behaviors toward people living with dementia","volume":"6","author":"Matsumoto","journal-title":"Innov Aging"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1017\/S0714980800016093","article-title":"The Fraboni Scale of Ageism (FSA): an attempt at a more precise measure of ageism","volume":"9","author":"Fraboni","journal-title":"Can J Aging"},{"issue":"2","key":"R33","first-page":"35","volume":"34","author":"Mikami","journal-title":"Bull Soc Med"},{"issue":"1","key":"R34","doi-asserted-by":"publisher","first-page":"9","DOI":"10.29045\/14784726.2023.6.8.1.9","article-title":"The impact of dementia education on student paramedics\u2019 preparedness to care, knowledge, confidence and attitudes towards dementia: an analytic survey","volume":"8","author":"Jones","journal-title":"Br Paramed J"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2019.104207","article-title":"Use and impact of virtual reality simulation in dementia care education: a scoping review","volume":"84","author":"Hirt","journal-title":"Nurse Educ Today"},{"issue":"9","key":"R36","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1080\/13607863.2017.1348470","article-title":"A virtual reality intervention to improve the understanding and empathy for people with dementia in informal caregivers: results of a pilot study","volume":"22","author":"Wijma","journal-title":"Aging Ment Health"},{"issue":"7","key":"R37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s42979-025-04366-7","article-title":"Immersive simulation for caregiver empathy training: a Metaverse-AR educational framework addressing cognitive impairment care challenges","volume":"6","author":"Zhang","journal-title":"SN Comput Sci"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:52:44Z","timestamp":1790103164000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e95684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":37,"URL":"https:\/\/doi.org\/10.2196\/95684","relation":{},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"v15i1e95684"}}