This article uses a practical example from our portfolio to illustrate how co-creation can amplify both academic impact and societal relevance. At the heart of this example is our collaboration with researcher and biomedical scientist Lise Beumeler. Together, we developed a VR game aimed at supporting recovery following an Intensive Care (IC) admission. This project formed part of Beumeler’s PhD research and, through follow-up studies using the prototype, recently resulted in a new publication. This milestone offers the perfect opportunity to reflect on the broader impact of a participatory approach.
Recovering from an ICU admission often requires months or even years. In her PhD research, Lise Beumeler collaborated with 8D to explore how gaming and technology could enhance this recovery process, making it both more effective and enjoyable. Through a co-creative design process, virtual reality was surprisingly well-received by both patients and professionals.
What societal impact has the participatory approach had, particularly through developing a prototype in collaboration with healthcare professionals and patients? During our collaboration with Beumeler and Medisch Centrum Leeuwarden, we identified several valuable ‘unexpected benefits’ of co-creation in research.
Increasing participant support and trust
At the outset of the research, we recommended exploring which hardware resonated most with the target groups by using existing serious games. ICU patients and healthcare professionals tested various games and hardware, including Kinect and VR headsets. This participatory approach not only ensured the hardware’s functionality but also built trust and garnered support among the target groups. Intensivist Carina Bethlehem noted: “If we had directly introduced a rehabilitation game with the Oculus Go 2 VR headset, there probably would have been resistance. However, the initial tests showed that virtual reality—with some guidance—was well-received by patients, even older ones. That first step was crucial for gaining support.”
Exchange with peers about the approach
During the process, there was significant interest in our design-oriented approach, which involves engaging target groups early and testing assumptions hands-on as soon as possible. Rather than striving for a perfect product upfront, we prioritized gathering participant input from the very beginning. Johan (8D), Lise, and student assistant Mirthe shared insights about this approach on the University of Groningen’s Global Cast podcast.
Successful dissemination to the general public
Our practice-oriented approach delivers results during the process that are both understandable and engaging for a broad audience, making it easier to communicate about the research. The study on VR therapy in the ICU received widespread media attention. On the recommendation of our communications department, an accessible article about the goals and approach was published in the alumni magazine of the University of Groningen. This opened new doors, including an interview with Beumeler in Focus, the premier science program on NPO Radio 1.
Co-creating and prototyping VR therapy for ICU rehabilitation has led to the following scientific publications and follow-up studies.
I see you: unravelling pathways of recovery after critical illness
Lise Beumeler’s dissertation, published in 2023, discusses the long-term physical and mental challenges many patients face after an ICU admission, the impact on quality of life, healthcare utilization, work participation, and the burden on loved ones. The publication concludes with an exploration of the feasibility and safety of virtual reality training during and after ICU admission, which was underpinned by the collaboration with 8D.
Follow-up research using our VR-prototype
After the PhD project, researcher Mirthe de Vries, under Beumeler’s guidance, carried out follow-up research into the effects and feasibility of VR therapy using the prototype. The therapy was offered three times a week for 20 minutes alongside standard care, and its effects on physical parameters such as balance and mobility were measured. In early 2025, the paper The Feasibility of Virtual Reality Therapy for Upper Extremity Mobilization During and After Intensive Care Unit Admission was published, with 8D designer Johan as co-author.
In response to the growing demand for tips and advice on integrating design, gaming, and research, we hosted a webinar in 2023 in collaboration with Campus Fryslân. Lise Beumeler and Johan van der Meulen shared their insights and answered questions on project design, as well as the testing and implementation of healthcare technology.
We regularly support researchers in strengthening and securing funding for their proposals. Every third Friday of the month, we host a free online Q&A session where you can ask all your questions. Sign up via johan@8d.nl to receive the time and call link. If you have specific questions or topics to discuss, like how to combine co-creation and research, feel free to include them in your registration email.
Design-driven research: what is the added value? Successful implementation of research results requires a perfect balance between user, the form of the intervention and the context in which it will be used. When all these elements are well aligned, research results end up where they really make a difference: in the middle of society.
Nienke Beerlage-de Jong is Assistant Professor at the University of Twente and a researcher in the field of infectious diseases and One Health, a field in which human, animal and planetary health are closely linked. She worked with 8D on a serious game about complex decision-making in zoonoses, diseases that can pass from humans to animals.
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