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In this work, we investigate the application of Transmodal Ordered Network Analysis (TONA) to analyze and visualize geriatric caregiving attitudes, aiming to enhance caregiver perceptions through an immersive VR simulation. Specifically, my research focuses on three main objectives: (1) identifying disparities between real-life caregiving experiences and previous training, (2) improving our VR training by integrating findings from the initial phase and (3) conducting a detailed TONA within the VR simulation. The first two objectives have been almost addressed, setting a strong foundation for the most crucial part of my research. The third objective involves a detailed analysis using TONA, utilizing gaze data, facial expressions, conversational dialogues, and embodiment data to monitor changes in caregiver attitudes within the immersive simulation featuring a virtual geriatric patient. Merging these diverse data types into a unified analysis presents challenges due to the complexities of multimodal data integration. Therefore, a key aspect of my thesis is enhancing methodologies to incorporate multichannel data analysis in TONA. The findings of this thesis are expected to make a significant contribution to the fields of nursing education, quantitative ethnography, and human-computer interaction. 

An emergent challenge in geriatric care is improving the quality of care, which requires insight from stakeholders. Qualitative methods offer detailed insights, but they can be biased and have limited generalizability, while quantitative methods may miss nuances. To address these limitations, network-based approaches such as Epistemic Network Analysis (ENA) can bridge the methodological gap. By leveraging the strengths of both methods, ENA provides profound insights into healthcare expert interviews. In this paper, to better understand geriatric care attitudes, we interviewed ten nursing assistants, used ENA to analyze the data, and compared their real-life daily activities with training experiences. A two-sample t-test with a large effect size (Cohen’s d = 1.63) indicated a significant difference between real-life and training activities. The findings suggested incorporating more empathetic training scenarios into the future design of our geriatric care simulation. The results have implications for human-computer interaction and effective nursing training. This is illustrated by presenting an example of using quantitative ethnography to analyze expert interviews with nursing assistants as caregivers and inform subsequent simulation and design processes. 

An emergent challenge in geriatric care is improving the quality of care, which requires insight from stakeholders. Qualitative methods offer detailed insights, but they can be biased and have limited generalizability, while quantitative methods may miss nuances. To address these limitations, network-based approaches such as Epistemic Network Analysis (ENA) can bridge the methodological gap. By leveraging the strengths of both methods, ENA provides profound insights into healthcare expert interviews. In this paper, to better understand geriatric care attitudes, we interviewed ten nursing assistants, used ENA to analyze the data, and compared their real-life daily activities with training experiences. A two-sample t-test with a large effect size (Cohen’s d = 1.63) indicated a significant difference between real-life and training activities. The findings suggested incorporating more empathetic training scenarios into the future design of our geriatric care simulation. The results have implications for human-computer interaction and effective nursing training. This is illustrated by presenting an example of using quantitative ethnography to analyze expert interviews with nursing assistants as caregivers and inform subsequent simulation and design processes. 

Virtual reality (VR) and interactive 3D visualization systems have enhanced educational experiences and environments, particularly in complicated subjects such as anatomy education. VR-based systems surpass the potential limitations of traditional training approaches in facilitating interactive engagement among students. However, research on embodied virtual assistants that leverage generative artificial intelligence (AI) and verbal communication in the anatomy education context is underrepresented. In this work, we introduce a VR environment with a generative AI-embodied virtual assistant to support participants in responding to varying cognitive complexity anatomy questions and enable verbal communication. We assessed the technical efficacy and usability of the proposed environment in a pilot user study with 16 participants. We conducted a within-subject design for virtual assistant configuration (avatar- and screen-based), with two levels of cognitive complexity (knowledge- and analysis-based). The results reveal a significant difference in the scores obtained from knowledge- and analysis-based questions in relation to avatar configuration. Moreover, results provide insights into usability, cognitive task load, and the sense of presence in the proposed virtual assistant configurations. Our environment and results of the pilot study offer potential benefits and future research directions beyond medical education, using generative AI and embodied virtual agents as customized virtual conversational assistants.