Violence against nurses and other healthcare workers is a significant and escalating concern, impeding the provision of safe and effective healthcare services. A majority of nurses experience some kind of violence, including physical and nonphysical assaults during their careers. The consequences of workplace violence extend beyond individual trauma, leading to increased burnout, turnover, and significant financial costs for healthcare systems. Training programs focused on workplace violence prevention (WVP) have become ubiquitous, with elements like situational threat assessment, de-escalation techniques, and physical skills. Studies show that experiential components, such as role play, enhance the effectiveness of these trainings. Virtual Reality (VR) offers a promising solution by providing immersive, interactive training environments that enhance decision-making, physical coordination, and team dynamics. In this article we discuss how VR simulations can replicate real-world settings, allowing healthcare workers to practice and master violence prevention and management skills in a controlled, safe environment. We also describe how VR is scalable and cost-effective, enabling widespread adoption within and across organizations with minimal logistical challenges. Integrating VR into WVP training programs could significantly improve training outcomes, reduce the need for physical and chemical restraints, and ultimately enhance the overall safety and quality of healthcare services.

The gateway in-street sign configuration has been demonstrated to be a low-cost method for increasing motorist yielding the right of way to pedestrians at crosswalks. It has previously been hypothesized that the gateway is effective because it visually narrows a travel lane. In the present study, gateway widths (i.e., distance between signs) were compared to determine whether there was a differential effect on motorist yielding. Experiment 1 was a parametric analysis of distance between the signs, varying in 2-ft intervals from 12 to 18 ft. The results showed that the percentage of motorists yielding increased as the distance between the signs decreased. Experiment 2 examined curb-top and gutter-pan placements of the edge signs at three different sites. Both placements produced substantial increases in yielding compared with baseline, though the difference between gutter-pan and curb-top placement was not significant at two of the three sites. Based on the distance between signs in these two configurations, the results at two of the sites aligned with those in Experiment 1, and one site demonstrated much higher yielding than would have been predicted. This suggests that small increases in the distance between signs may result in a minor decrease in yielding but may improve the survivability of the signs and reduce maintenance costs over time. The potential to combine this sign effect with other engineering treatments (e.g., curb extensions and bicycle lanes) was additionally explored. The results are discussed in relation to a perceived narrowing hypothesis, sign survival, cost effectiveness, and equity. © National Academy of Sciences: Transportation Research Board 2023.