Background:
Ensuring medication safety in non-pharmacy storage areas (NPSAs), such as wards and clinics, is like navigating uncharted waters where hidden medication errors/hazards can pose significant risks to patient safety, particularly with high-alert and look-alike-sound-alike medications. Traditional training methods lack standardization and situational awareness training in recognizing potential safety hazards. Moreover, physical environmental setups presented limitations, especially during COVID-19. Just like the famous Netflix series “One Piece”, our in-house developed Virtual Medication Horror Room (VMHR) re-imagines medication safety training as an interactive “treasure hunt” for medication errors/hazards, so that healthcare learners can gain the knowledge and skills in hazard identification and risk management in NPSAs.

Methodology:
The VMHR leverages De Freita’s 4D framework and the Rapid eLearning Model to create interactive 360-degree video environments simulating NPSAs with embedded medication errors. Learners navigate two scenarios in a first-person perspective, identifying medication hazards through interactive elements (e.g. quizzes, images/videos, in-game feedback). A pilot study involving 33 participants was conducted, which included a 25 multiple-choice based pre- and post-program quiz to assess knowledge improvements, and a self-administered survey evaluating user-friendliness, engagement and perceived usefulness, based on the Technology Acceptance Model (TAM).

Results:
Majority of participants were females (69.7%) and between 21-30 years old (78.8%). They comprised mainly of pre-registration pharmacists (48.5%), pharmacy technicians (30.3%) and pharmacists (15.2%). One-third had less than one year (30.3%) and between 1-4 years (33.3%) of practice experience. There was a significant increase in quiz scores after going through the VMHR program (pre-scores 15.67±2.37 versus post-scores 18.42±2.61, p=0.013). The top TAM parameters rated by participants were perceived knowledge of 360-video technologies (5.67±1.14), perceived trust of the technology platform (5.56±0.81) and perceived usefulness of VMHR (5.56±0.81). Exploratory factor analyses indicated that perceived usefulness (0.858), perceived playfulness (0.866), perceived enjoyment (0.871) and perceived compatibility with learning styles (0.903) were important drivers of behavioral intention to use VMHR for learning.

Conclusion:
VMHR is an engaging educational tool for enhancing medication safety awareness among healthcare learners. The program not only aligns well with participants’ learning styles, but also fosters a safety culture through critical thinking and situational awareness of medication hazards in a safe, yet authentic environment. Through a standardized approach of tech-enhanced learning, VMHR can potentially enhance patient safety practices in the workplace setting. We would like to acknowledge the support of the Academic Medicine Education Institute (AMEI) grant awarded by SingHealth Duke-NUS, Singapore, for the development of this program.

Keywords: Medication Safety, Medication Errors, Non-pharmacy Storage Areas, Virtual Medication Horror Room, Hazard Identification, Interactive Learning, 360-Degree Video.