# Training social care staff in promoting self-determination and nutritional health for people with intellectual disabilities using 360o virtual reality videos and ethical reflection: a qualitative study

## TL;DR

This study explores how using 360° virtual reality videos and ethical reflection can help train social care staff to better support people with intellectual disabilities in making healthy food choices while respecting their autonomy.

## Contribution

The study introduces a novel training approach combining immersive virtual reality with ethical reflection to enhance staff competence in promoting self-determination and nutrition.

## Key findings

- The 360° videos provided an immersive and emotionally engaging experience for participants.
- The approach enhanced self-awareness, ethical sensitivity, and reflection among staff.
- Participants showed increased competence in supporting residents' autonomy and preventing unethical practices.

## Abstract

People with intellectual disabilities living in supported housing facilities are vulnerable to developing obesity and malnutrition. It is therefore essential to strengthen staff competence in providing nutrition and dietary support for people with intellectual disabilities, with particular attention to balancing the provision of appropriate health care with the promotion of residents’ autonomy and self-determination. The aim of this study was to explore social care service providers’ experiences with a teaching and learning approach that combines the use of 360° virtual reality videos with structured ethical reflection focusing on self-determination and preventive dietary work for people with intellectual disabilities.

This study employed an explorative qualitative design that tested a learning intervention consisting of watching a 360o video followed by participating in a structured group reflection. Data were collected through three focus group interviews with a total of 14 participants from two Norwegian municipality-based supported housing facilities for people with intellectual disabilities. The data were analysed using inductive reflexive thematic analysis.

Three main themes with associated subthemes were identified: (a) the opportunity to experience and immerse oneself in a challenging situation, (b) the opportunity to expand perspectives together, and (c) Satisfaction with the teaching and learning approach. The 360o videos demonstrated immersive qualities, such as authenticity, presence and emotional engagement. Our results also showed that the teaching and learning approach heightened self-awareness, ethical sensitivity, reflection and ethical judgement related to the facilitation of self-determination for people with intellectual disabilities.

Our results showed that the teaching and learning approach of combining 360° videos with structured ethical reflection provided an immersive experience and stimulated meaningful reflections, on which the experiential learning process depends. The participants in our study revealed rich perspectives and strong competence related to supporting residents, showing that staff members can be a potential source for increasing ethical awareness and preventing unethical practices in the support of people with intellectual disabilities regarding food and eating.

The online version contains supplementary material available at 10.1186/s12913-026-14308-5.