title: Usability of a virtual reality environment simulating an automated teller machine for assessing and training persons with acquired brain injury.
abstract: OBJECTIVE
  This study aimed to examine the usability of a newly designed virtual reality (VR) environment simulating the operation of an automated teller machine (ATM) for assessment and training.
  
  
  METHODS
  Part I involved evaluation of the sensitivity and specificity of a non-immersive VR program simulating an ATM (VR-ATM). Part II consisted of a clinical trial providing baseline and post-intervention outcome assessments.
  
  
  METHODS
  A rehabilitation hospital and university-based teaching facilities were used as the setting.
  
  
  METHODS
  A total of 24 persons in the community with acquired brain injury (ABI)--14 in Part I and 10 in Part II--made up the participants in the study.
  
  
  METHODS
  In Part I, participants were randomized to receive instruction in either an "early" or a "late" VR-ATM program and were assessed using both the VR program and a real ATM. In Part II, participants were assigned in matched pairs to either VR training or computer-assisted instruction (CAI) teaching programs for six 1-hour sessions over a three-week period.
  
  
  METHODS
  Two behavioral checklists based on activity analysis of cash withdrawals and money transfers using a real ATM were used to measure average reaction time, percentage of incorrect responses, level of cues required, and time spent as generated by the VR system; also used was the Neurobehavioral Cognitive Status Examination.
  
  
  RESULTS
  The sensitivity of the VR-ATM was 100% for cash withdrawals and 83.3% for money transfers, and the specificity was 83% and 75%, respectively. For cash withdrawals, the average reaction time of the VR group was significantly shorter than that of the CAI group (p = 0.021). We found no significant differences in average reaction time or accuracy between groups for money transfers, although we did note positive improvement for the VR-ATM group.
  
  
  CONCLUSIONS
  We found the VR-ATM to be usable as a valid assessment and training tool for relearning the use of ATMs prior to real-life practice in persons with ABI.
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong. rsnkfong@polyu.edu.hk
authors.forename: Kenneth N K
authors.initials: KN
authors.lastname: Fong
authors.forename: Kathy Y Y
authors.initials: KY
authors.lastname: Chow
authors.forename: Bianca C H
authors.initials: BC
authors.lastname: Chan
authors.forename: Kino C K
authors.initials: KC
authors.lastname: Lam
authors.forename: Jeff C K
authors.initials: JC
authors.lastname: Lee
authors.forename: Teresa H Y
authors.initials: TH
authors.lastname: Li
authors.forename: Elaine W H
authors.initials: EW
authors.lastname: Yan
authors.forename: Asta T Y
authors.initials: AT
authors.lastname: Wong
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011930:Reaction Time; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D014584:User-Computer Interface