Beyond outcomes: A rubric-based characterization of older adults’ learning evidence following a virtual reality dementia prevention program

This study examined post-intervention learning evidence among older adults following a virtual reality (VR)–based dementia prevention program. Using the preliminary Annotation, Questioning, Summarization, and Reflection (AQSR) rubric, we characterized response patterns across four dimensions. A convergent mixed-methods design included 47 older adults (mean age = 78.19 years). Immediately after the VR-based dementia prevention program, participants completed AQSR-guided interviews. Two raters scored the transcripts, and framework-guided qualitative analysis contextualized the scores. Inter-rater reliability was evaluated using Cohen’s kappa and intraclass correlation coefficients (ICC). Participants were classified into four descriptive score strata based on total rubric scores to compare response patterns within the sample. The AQSR rubric demonstrated excellent reliability (Cohen’s kappa = 0.755–0.818; ICC = 0.950). Descriptive differences across the four score strata indicated heterogeneity in post-intervention learning-related responses. Higher-scoring strata contained a greater proportion of participants with higher educational attainment. Questioning scores remained low across strata, indicating limited production of content-related questions under the present assessment conditions. This exploratory mixed-methods study illustrates how the preliminary AQSR rubric can make multidimensional, post-intervention learning-related verbal responses visible and instructionally interpretable among older adults following a guided VR-based dementia-prevention session. The findings also highlight the potential value of structured instructional support, particularly question scaffolding, in future VR-based health education.