The Cognitive Affective Model of Immersive Learning (CAMIL): a Theoretical Research-Based Model of Learning in Immersive Virtual Reality

A randomized controlled trial investigating experiential virtual reality communication on prudent antibiotic use

Antimicrobial resistance (AMR) is a global health threat. This randomized controlled trial evaluates the impact of experiential virtual reality (VR) versus information provision via VR or leaflet on prudent antibiotic use. A total of 249 (239 analyzed) participants were randomized into three conditions: VR Information + Experience, VR Information, or Leaflet Information. All participants received AMR information, while those in the VR Information + Experience condition additionally engaged in a game, making treatment decisions for their virtual avatar's infection. Participants in the VR Information + Experience condition showed a significant increase in prudent use intentions from baseline (d = 1.48). This increase was significantly larger compared to the VR Information (d = 0.50) and Leaflet Information (d = 0.79) conditions. The increase in intentions from baseline remained significant at follow-up in the VR Information + Experience condition (d = 1.25). Experiential VR communication shows promise for promoting prudent antibiotics use.

Examining the Mechanisms of Virtual Reality Tourism's Impact on the Mental Well-Being of Long-Term Care Facility Residents: Perspectives on Presence and Flow

This study investigates the mechanisms of virtual reality (VR) tourism's impact on the well-being of residents in long-term care facilities (LTCFs). It aims to understand how presence and flow during VR experiences can enhance well-being. This experimental study used a quantitative approach with structured questionnaires to investigate VR experiences among LTCF residents in Taiwan. After obtaining ethical approval, 145 eligible participants from four LTCFs completed a full five-week VR tourism experience. Data collection took place from June to November 2022. This study employed Partial Least Squares Structural Equation Modeling (PLS-SEM) with Smart PLS software to analyze the causal relationships between latent variables. The results confirm that the more vivid the virtual reality image (β = 0.240, p < 0.05), the more immersive the experience (β = 0.267, p < 0.05), the greater the ability to control the experience (β = 0.465, p < 0.001), and the greater the ability to stimulate curiosity during the experience (β = 0.290, p < 0.05), the greater the sense of presence. Increased presence leads to user engagement and a state of flow (β = 0.556, p < 0.001), which is essential for personal hedonia (β = 0.453, p < 0.001) and eudaimonia (β = 0.220, p < 0.001). This study elucidates the mechanisms through which VR tourism experiences enhance well-being among LTCF residents, emphasizing the critical roles of presence and flow in promoting both hedonic and eudaimonic dimensions of well-being.

Alone but not isolated: social presence and cognitive load in learning with 360 virtual reality videos

Introduction

This study aimed to identify any differences in social presence and cognitive load among three types of 360 virtual reality (VR)-based videos lectures. We hypothesized that social presence would be higher when interactions among peers are visible in a 360 VR video lectures while the cognitive load would be also increased.

Methods

A total of 48 college students were randomly assigned to one of the three study groups to view an assigned 360 VR video lecture. The three groups were: (1) an instructor-only video viewing group, (2) a classroom lecture video viewing group, and (3) a classroom lecture and activity video viewing group. The video lectures were differently designed depending on the levels of peer visibility and the interactions between the instructor and peers. The participants watched one of the three types of assigned video lecture and subsequently completed two sets of questionnaires regarding social presence and cognitive load. A multivariate analysis of variance (MANOVA) was conducted with a planned contrast analysis for the type of video lectures.

Results

We found that, contrary to the hypotheses, students in the group 1 (instructor-only video) showed higher social presence scores than students in the groups 2 and 3. However, no significant differences were found in the cognitive load scores.

Discussion

The results show that 360 VR video lectures with an instructor-only are more effective at enhancing users' social presence than 360 VR video lectures with both the instructor and class-peers. We suggest creating 360 VR video lectures with the presence of the course instructor to offer learners the sense of actually participating in a lecture.

Comparing desktop 3D virtual reality with web 2.0 interfaces: Identifying key factors behind enhanced user capabilities

The aim of this paper is to investigate how commonly used 2D digital layouts can be transformed into 3-dimensional dashboards with the effect of reducing cognitive load. To this end, we compared user performance metrics, pupil dilation data as well as subject-reported qualitative measures in a Web 2.0-based 2D scenario and two different versions of a desktop 3D virtual reality scenario. All three scenarios focused on a use case involving the most prevalent 2D digital formats and designs encountered in digital education, making use of e.g. textual information (PDF files, PPT files), images and videos. Based on the assumption that cognitive load differences can be validated based on pupillometry measurements, we showed that it is possible to develop 3D virtual reality scenarios where users experience less cognitive load while achieving the same performance metrics as in commonly used 2D environments. At the same time, our experiment also showed that such improvements do not come automatically; instead, 3D workflows that require less locomotion - even at the expense of increased camera rotations - seem to result in more effective cognitive load reduction.

The conceptualisation and measurement of engagement in digital health

Digital tools are an increasingly important component of healthcare, but their potential impact is commonly limited by a lack of user engagement. Digital health evaluations of engagement are often restricted to system usage metrics, which cannot capture a full understanding of how and why users engage with an intervention. This study aimed to examine how theory-based, multifaceted measures of engagement with digital health interventions capture different components of engagement (affective, cognitive, behavioural, micro, and macro) and to consider areas that are unclear or missing in their measurement. We identified and compared two recently developed measures that met these criteria (the Digital Behaviour Change Intervention Engagement Scale and the TWente Engagement with Ehealth Technologies Scale). Despite having similar theoretical bases and being relatively strongly correlated, there are key differences in how these scales aim to capture engagement. We discuss the implications of our analysis for how affective, cognitive, and behavioural components of engagement can be conceptualised and whether there is value in distinguishing between them. We conclude with recommendations for the circumstances in which each scale may be most useful and for how future measure development could supplement existing scales.

Virtual reality-based training may improve visual memory and some aspects of sustained attention among healthy older adults - preliminary results of a randomized controlled study

BACKGROUND/AIMS

Older age and cognitive inactivity have been associated with cognitive impairment, which in turn is linked to economic and societal burdens due to the high costs of care, especially for care homes and informal care. Emerging non-pharmacological interventions using new technologies, such as virtual reality (VR) delivered on a head-mounted display (HMD), might offer an alternative to maintain or improve cognition. The study aimed to evaluate the efficacy and safety of a VR-based Digital Therapeutics application for improving cognitive functions among healthy older adults.

METHODS

Seventy-two healthy seniors (experimental group N = 35, control group N = 37), aged 65-85 years, were recruited by the Medical University of Lodz (Poland). Participants were randomly allocated to the experimental group (a VR-based cognitive training which consists of a warm-up module and three tasks, including one-back and dual-N-back) or to the control group (a regular VR headset app only showing nature videos). The exercises are performed in different 360-degree natural environments while listening to a preferred music genre and delivered on a head-mounted display (HMD). The 12-week intervention of 12 min was delivered at least three times per week (36 sessions). Compliance and performance were followed through a web-based application. Primary outcomes included attention and working memory (CNS-Vital Signs computerized cognitive battery). Secondary outcomes comprised other cognitive domains. Mixed linear models were constructed to elucidate the difference in pre- and post-intervention measures between the experimental and control groups.

RESULTS

The users performed, on average, 39.8 sessions (range 1-100), and 60% performed more than 36 sessions. The experimental group achieved higher scores in the visual memory module (B = 7.767, p = 0.011) and in the one-back continuous performance test (in terms of correct responses: B = 2.057, p = 0.003 and omission errors: B = -1.950, p = 0.007) than the control group in the post-test assessment. The results were independent of participants' sex, age, and years of education. The differences in CNS Vital Signs' global score, working memory, executive function, reaction time, processing speed, simple and complex attention, verbal memory, cognitive flexibility, motor speed, and psychomotor speed were not statistically significant.

CONCLUSIONS

VR-based cognitive training may prove to be a valuable, efficacious, and well-received tool in terms of improving visual memory and some aspect of sustainability of attention among healthy older adults. This is a preliminary analysis based on part of the obtained results to that point. Final conclusions will be drawn after the analysis of the target sample size.

TRIAL REGISTRATION

Clinicaltrials.gov ID NCT05369897.

The role of attention in immersion: The two-competitor model

Currently, we face an exponentially increasing interest in immersion, especially sensory-driven immersion, mainly due to the rapid development of ideas and business models centered around a digital virtual universe as well as the increasing availability of affordable immersive technologies for education, communication, and entertainment. However, a clear definition of 'immersion', in terms of established neurocognitive concepts and measurable properties, remains elusive, slowing research on the human side of immersive interfaces. To address this problem, we propose a conceptual, taxonomic model of attention in immersion. We argue (a) modeling immersion theoretically as well as studying immersion experimentally requires a detailed characterization of the role of attention in immersion, even though (b) attention, while necessary, cannot be a sufficient condition for defining immersion. Our broader goal is to characterize immersion in terms that will be compatible with established psychophysiolgical measures that could then in principle be used for the assessment and eventually the optimization of an immersive experience. We start from the perspective that immersion requires the projection of attention to an induced reality, and build on accepted taxonomies of different modes of attention for the development of our two-competitor model. The two-competitor model allows for a quantitative implementation and has an easy graphical interpretation. It helps to highlight the important link between different modes of attention and affect in studying immersion.

Investigating Whether the Mass of a Tool Replica Influences Virtual Training Learning Outcomes

Virtual Reality (VR) has emerged as a promising solution to address the pressing concern of transferring know-how in the manufacturing industry. Making an immersive training experience often involves designing an instrumented replica of a tool whose use is to be learned through virtual training. The process of making a replica can alter its mass, making it different from that of the original tool. As far as we know, the influence of this difference on learning outcomes has never been evaluated. To investigate this subject, an immersive training experience was designed with pre and post-training phases under real conditions, dedicated to learning the use of a rotary tool. 80 participants took part in this study, split into three groups: a control group performing the virtual training using a replica with the same mass as the original tool ($\mathrm{m}=100\%$), a second group that used a replica with a lighter mass than the original tool ($\mathrm{m}= 50\%$) and a third group using a replica heavier than the original tool ($\mathrm{m}=150\%$). Despite variations in the mass of the replica used for training, this study revealed that the learning outcomes remained comparable across all groups, while also demonstrating significant enhancements in certain performance measures, including task completion time. Overall, these findings provide useful insights regarding the design of tool replicas for immersive training.

Immersive virtual reality for learning about ecosystems: effect of two signaling levels and feedback on action decisions

Introduction

The goal of the present study was to test the effect of signaling associated with feed-back in learning forest ecosystems in the context of realistic living forest simulator, in IVR conditions for students in agriculture. Two signaling modalities, corresponding to two signaling levels, were investigated: visual flashing of forest elements (tree species, plants, flowers, fungi, wet-areas etc.) and marker-stones, both with text in pop-up windows, in a 2x2 experimental plan.

Methods

Ninety-three pupils of an agricultural technological high school had to explore (including physically), interrogate (search for) and select (using the joysticks) relevant elements of the forest in three living forest areas (visually delimited inside of a broader forest area) in order to choose (and justify) the best area, among the three, in which an equipped public-tourist reception site (picnic, resting, reception site) could be built. The chosen site must have the least possible negative impact on the ecosystem of the forest and its development over time. After their decision (and justification) they were provided a feed-back with a series of VR desktop multimedia slides showing the effect of this choice on the ecosystem of the chosen area. After the feed-back they had to decide and justify again whether they would change or maintain their first decision. Finally, subjective scales were also used in order to investigate presence, cognitive complexity, sickness and overall enjoyment.

Results and discussion

Results showed significant positive effects of both signaling levels, and of the feed-back on the correct decision answers. Further, the combination, and interaction, between signaling and feedback seemed to enhance, the activation and retrieval from memory, of the task-relevant concepts. In addition, the results indicated a significant positive effect (medium size) of presence on decision performances, a finding which is consistent with the immersion principle.

Factors affecting metaverse adoption in education: A systematic review, adoption framework, and future research agenda

The Metaverse, underpinned by its technical infrastructure, heavily relies on user engagement and behavior for successful integration into educational settings. Understanding its driving factors is essential for such a platform to transition from theory to practice, especially in educational settings. However, these factors remain elusive due to inconsistencies in infrastructure and environments. Therefore, this systematic review aims to fill this void by presenting an integrative view on Metaverse adoption in education. This is achieved via three primary dimensions: establishing a taxonomy of the factors influencing Metaverse adoption in education, proposing a framework for Metaverse adoption, and suggesting future research trajectories in this domain. The review systematically classifies the influential factors into four distinct categories: psychological and motivational factors, quality factors, social factors, and inhibiting factors. The proposed framework provides a structured approach for future studies investigating the Metaverse adoption in educational settings. The proposed framework also emphasizes that educational institutions should not only consider the technical prerequisites but also the social, psychological, and motivational aspects of the Metaverse. The study also pinpoints several critical research agendas to enhance our understanding of Metaverse adoption in education. The insights from this review are invaluable for educational institutions, policymakers, developers, and researchers, significantly enriching the emerging field of Metaverse adoption.

The impact of virtual reality on student engagement in the classroom-a critical review of the literature

Objective

The purpose of this review is to identify the impact of virtual reality (VR) technology on student engagement, specifically cognitive engagement, behavioral engagement, and affective engagement.

Methods

A comprehensive search of databases such as Google, Scopus, and Elsevier was conducted to identify English-language articles related to VR and classroom engagement for the period from 2014 to 2023. After systematic screening, 33 articles were finally reviewed.

Results

The use of VR in the classroom is expected to improve student engagement and learning outcomes, and is particularly effective for students with learning disabilities. However, introducing VR into middle school education poses several challenges, including difficulties in the education system to keep up with VR developments, increased demands on students' digital literacy, and insufficient proficiency of teachers in using VR.

Conclusion

To effectively utilize VR to increase student engagement, we advocate for educational policymakers to provide training and technical support to teachers to ensure that they can fully master and integrate VR to increase student engagement and instructional effectiveness.

Haptic Feedback, Performance and Arousal: A Comparison Study in an Immersive VR Motor Skill Training Task

This article investigates the relationship between fine motor skill training in VR, haptic feedback, and physiological arousal. To do so, we present the design and development of a motor skill task (buzzwire), along with a custom vibrotactile feedback attachment for the Geomagic Touch haptic device. A controlled experiment following a between-subjects design was conducted with 73 participants, studying the role of three feedback conditions - visual/kinesthetic, visual/vibrotactile and visual only - on the learning and performance of the considered task and the arousal levels of the participants. Results indicate that performance improved in all three feedback conditions after the considered training session. However, participants reported no change in self-efficacy and in terms of presence and task load (NASA-TLX). All three feedback conditions also showed similar arousal levels. Further analysis revealed that positive changes in performance were linked to higher arousal levels. These results suggest the potential of haptic feedback to affect arousal levels and encourage further research into using this relationship to improve motor skill training in VR.

The Effects of Immersive Virtual Reality-Assisted Experiential Learning on Enhancing Empathy in Undergraduate Health Care Students Toward Older Adults With Cognitive Impairment: Multiple-Methods Study

BACKGROUND

Immersive virtual reality (IVR)-assisted experiential learning has the potential to foster empathy among undergraduate health care students toward older adults with cognitive impairment by facilitating a sense of embodiment. However, the extent of its effectiveness, including enhancing students' learning experiences and achieving intended learning outcomes, remains underexplored.

OBJECTIVE

This study aims to evaluate the impacts of IVR-assisted experiential learning on the empathy of undergraduate health care students toward older people with cognitive impairment as the primary outcome (objective 1) and on their learning experience (objective 2) and their attainment of learning outcomes as the secondary outcomes (objective 3).

METHODS

A multiple-methods design was used, which included surveys, focus groups, and a review of the students' group assignments. Survey data were summarized using descriptive statistics, whereas paired 2-tailed t tests were used to evaluate differences in empathy scores before and after the 2-hour IVR tutorial (objective 1). Focus groups were conducted to evaluate the impacts of IVR-assisted experiential learning on the empathy of undergraduate health care students toward older people with cognitive impairment (objective 1). Descriptive statistics obtained from surveys and thematic analyses of focus groups were used to explore the students' learning experiences (objective 2). Thematic analysis of group assignments was conducted to identify learning outcomes (objective 3).

RESULTS

A total of 367 undergraduate nursing and occupational therapy students were recruited via convenience sampling. There was a significant increase in the students' empathy scores, measured using the Kiersma-Chen Empathy Scale, from 78.06 (SD 7.72) before to 81.17 (SD 8.93) after (P<.001). Students expressed high satisfaction with the IVR learning innovation, with a high satisfaction mean score of 20.68 (SD 2.55) and a high self-confidence mean score of 32.04 (SD 3.52) on the Student Satisfaction and Self-Confidence scale. Students exhibited a good sense of presence in the IVR learning environment, as reflected in the scores for adaptation (41.30, SD 6.03), interface quality (11.36, SD 3.70), involvement (62.00, SD 9.47), and sensory fidelity (31.47, SD 5.23) on the Presence Questionnaire version 2.0. In total, 3 major themes were identified from the focus groups, which involved 23 nursing students: enhanced sympathy toward older adults with cognitive impairment, improved engagement in IVR learning, and confidence in understanding the key concepts through the learning process. These themes supplement and align with the survey results. The analysis of the written assignments revealed that students attained the learning outcomes of understanding the challenges faced by older adults with cognitive impairment, the importance of providing person-centered care, and the need for an age-friendly society.

CONCLUSIONS

IVR-assisted experiential learning enhances students' knowledge and empathy in caring for older adults with cognitive impairment. These findings suggest that IVR can be a valuable tool in professional health care education.

Reducing Stigma Toward People with Serious Mental Illness Through a Virtual Reality Intervention: A Randomized Controlled Trial

Background: Stigma toward people with serious mental illnesses (SMI), like schizophrenia, is a serious global public health challenge that limits the quality of life of those affected and poses a major barrier that keeps people from seeking professional help. There is an urgent need for novel, effective, and scalable interventions to decrease stigmatized perceptions of chronic psychotic disorders and to reduce the health burden imposed by them. Method: We conducted a randomized controlled trial to assess the impact of a new immersive virtual reality game (Inclúyete-VR) on the level of stigma toward people with SMI, measured by the Attribution questionnaire (AQ-27). Participants in the experimental group were exposed in an immersive way to hallucinations common in schizophrenia, then shown different psychosocial resources available for their recovery and social inclusion; those in the control group used VR software unrelated to mental health. VR sessions were delivered through Oculus headgear and lasted 25 minutes. Results: We randomly assigned 124 university students (55% female) to experimental or control conditions (n = 62 each). We used mixed ANOVA to compare outcomes before and after the intervention between the two groups. We found a significant intervention-by-time interaction (P < 0.001), with a reduction in the experimental group of overall stigma levels on the AQ-27 scale and its three subscales: dangerousness-fear, avoidance, and lack of solidarity (P < 0.001 for all). Conclusions: The Inclúyete-VR software proved effective in the short term in reducing stigma toward people with severe mental illness. The program's longer-term efficacy, scalability, and dissemination remain to be studied. ClinicalTrials.gov Identifier: NCT05393596.

Effect of immersive virtual reality-based cognitive remediation in patients with mood or psychosis spectrum disorders: study protocol for a randomized, controlled, double-blinded trial

BACKGROUND

Cognitive impairments are prevalent across mood disorders and psychosis spectrum disorders, but there is a lack of real-life-like cognitive training programmes. Fully immersive virtual reality has the potential to ensure motivating and engaging cognitive training directly relevant to patients' daily lives. We will examine the effect of a 4-week, intensive virtual reality-based cognitive remediation programme involving daily life challenges on cognition and daily life functioning in patients with mood disorders or psychosis spectrum disorders and explore the neuronal underpinnings of potential treatment efficacy.

METHODS

The trial has a randomized, controlled, double-blinded, parallel-group design. We will include 66 symptomatically stable outpatients with mood disorders or psychosis spectrum disorders aged 18-55 years with objective and subjective cognitive impairment. Assessments encompassing a virtual reality test of daily life cognitive skills, neuropsychological testing, measures of daily life functioning, symptom ratings, questionnaires on subjective cognitive complaints, and quality of life are carried out at baseline, after the end of 4 weeks of treatment and at a 3-month follow-up after treatment completion. Functional magnetic resonance imaging scans are performed at baseline and at the end of treatment. The primary outcome is a broad cognitive composite score comprising five subtasks on a novel ecologically valid virtual reality test of daily life cognitive functions. Two complete data sets for 54 patients will provide a power of 80% to detect a clinically relevant between-group difference in the primary outcome. Behavioural data will be analysed using linear mixed models in SPSS, while MRI data will be analysed with the FMRIB Expert Analysis Tool (FEAT). Treatment-related changes in neural activity from baseline to end of treatment will be investigated for the dorsal prefrontal cortex and hippocampus as the regions of interest.

DISCUSSION

The results will provide insight into whether virtual reality-based cognitive remediation has beneficial effects on cognition and functioning in symptomatically stable patients with mood disorders or psychosis spectrum disorders, which can aid future treatment development.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06038955. Registered on September 15, 2023.

Intrinsic motivation in a virtual reality mock crime affects participants' willingness to invest more effort in deceptive interviews

In studies of investigative interviewing, it is not well understood how participant experience of mock-crime activities might affect participants' desire to perform (well) in subsequent interviews. In this study, we utilized two immersive virtual reality mock-crimes to examine if participants' intrinsic motivation (i.e., competence, autonomy, relatedness) while committing the virtual mock-crime affects their desire to perform well in interviews. We also examined if the self-reported feeling of presence during the virtual reality mock-crime is associated with participants' intrinsic motivation. We found significant positive associations between presence and all intrinsic motivation variables in both truth and lie conditions. We also found that competence and relatedness significantly predicted the self-reported effort to perform well in interviews. We discuss these results in the context of prior literature and provide recommendations for researchers on the design of mock-crime experiences.

Effectiveness of digital games promoting young people's mental health: A review of reviews

Objectives

Digital games are a popular form of entertainment for youth. They are often used as a therapy for psychological problems, a mental health promotion intervention, and a preventative measure. Systematic reviews and meta-analyses have been conducted to assess the effectiveness of mental health-related digital games. However, a synthesis considering all evaluation results to inform their development is missing.

Methods

We performed a review of reviews to synthetize results of previous research to describe the impact of digital games on the mental health of young people aged <30 years old. We considered systematic reviews and meta-analyses published between 2012 and 2022. Searches were conducted in Scopus, Google Scholar, Pubmed, and Cochrane library systematic reviews (CENTRAL) during October 2023.

Results

Our final selection included 10 systematic reviews and meta-analyses on interventions targeting youth of both sexes aged 2-29 years old across the world. In total, 218 interventions were identified. Selected articles reported different types of games, e.g., active and non-active video games, virtual reality games, serious games. Not all digital games were conscientiously evaluated, but, in general, their impact on mental health was positive. Regarding the quality, 5 studies were of high quality, 3 of moderate quality and 2 of low quality.

Conclusions

Overall, elements of gamification were well-accepted, but they lacked assessment through rigorous experimental conditions. Digital games for mental health are promising, but in order to be consistently effective in promoting young people's mental health and prevent psychological diseases, they should present specific features.

Learning Experience Design and Unpacking Sociocultural, Technological, and Pedagogical Design Considerations of Spherical Video-Based Virtual Reality Systems for Autistic Learners: A Systematic Literature Review

This systematic literature review discusses the use of spherical video-based virtual reality (SVVR) as a training and therapy intervention for autistic individuals. The authors emphasize the need for an evidence-based framework with guidelines and design considerations to help developers and educators tailor SVVR to the diverse needs of autistic learners. The paper highlights the unique benefits of SVVR, such as being relatively easier to develop compared to other VR technologies and high compatibility with various devices, making it more affordable for educational settings. The authors also discuss the importance of the STP (Sociotechnical-Pedagogical) framework for evaluating and designing social aspects of SVVR interventions for autistic individuals.

Medical Extended Reality Trials: Building Robust Comparators, Controls, and Sham

The explosive pace of development and research in medical extended reality (MXR) is a testament to its promise for health care and medicine. In comparison with this growth, there is a relative sparsity of rigorous clinical trials that establish the efficacy and effectiveness of these interventions. Explicating mechanisms of action across clinical areas and MXR applications is another major area of need. A primary impediment to these goals is a lack of frameworks for trial design, more specifically, the selection of appropriate controls that effectively address unique elements of MXR. This paper delineates a framework for designing controls, sham conditions, and comparators, as well as proposed considerations for MXR trial designs. Special consideration is given to the design of sham conditions. Improved designs would enable more robust findings and the development of generalizable knowledge that could be adopted across MXR interventions.

Using Virtual Reality in the Care of Older Adults With Dementia: A Randomized Controlled Trial

There is a shortage of personnel to provide care for older adults with dementia, and traditional teaching methods could be improved. The teaching method used in the Care for Older Adults With Dementia course is mainly theoretical, lacking real-life care scenarios and practical procedural training. In the current study, we developed a virtual reality (VR) teaching system and designed a randomized controlled trial aimed at testing the availability of the VR-assisted teaching system, filling the gap in teaching through care scenarios, enabling students majoring in intelligent health and oldage care service management to have a more positive attitude toward learning, and improving students' knowledge and course satisfaction. This study showed that the developed VR system can meet the initial needs of daily teaching, help students have a more positive attitude toward learning, and improve their academic performance and course satisfaction. [Journal of Gerontological Nursing, 49(11), 25-32.].

Design and Evaluation of Using Head-Mounted Virtual Reality for Learning Clinical Procedures: Mixed Methods Study

BACKGROUND

The capacity of health care professionals to perform clinical procedures safely and competently is crucial as it will directly impact patients' outcomes. Given the ability of head-mounted virtual reality to simulate the authentic clinical environment, this platform should be suitable for nurses to refine their clinical skills for knowledge and skills acquisition. However, research on head-mounted virtual reality in learning clinical procedures is limited.

OBJECTIVE

The objectives of this study were (1) to describe the design of a head-mounted virtual reality system and evaluate it for education on clinical procedures for nursing students and (2) to explore the experience of nursing students using head-mounted virtual reality for learning clinical procedures and the usability of the system.

METHODS

This usability study used a mixed method approach. The stages included developing 3D models of the necessary instruments and materials used in intravenous therapy and subcutaneous injection procedures performed by nurses, followed by developing the procedures using the Unreal Engine (Epic Games). Questionnaires on the perception of continuance intention and the System Usability Scale were used along with open-ended questions.

RESULTS

Twenty-nine nursing students took part in this questionnaire study after experiencing the immersive virtual reality (IVR) intervention. Participants reported largely favorable game perception and learning experience. Mean perception scores ranged from 3.21 to 4.38 of a maximum score of 5, while the mean system usability score was 53.53 of 100. The majority found that the IVR experience was engaging, and they were immersed in the game. The challenges encountered included unfamiliarity with the new learning format; technological constraints, such as using hand controllers; and physical discomfort.

CONCLUSIONS

The conception of IVR for learning clinical procedures through deliberate practice to enhance nurses' knowledge and skills is promising. However, refinement of the prototypes is required to improve user experience and learning. Future research can explore other ways to use IVR for better education and health care purposes.

Exploring the effects of 3D-360°VR and 2D viewing modes on gaze behavior, head excursion, and workload during a boxing specific anticipation task

Introduction

Recent evidence has started to demonstrate that 360°VR, a type of VR that immerses a user within a 360° video, has advantages over two-dimensional (2D) video displays in the context of perceptual-cognitive evaluation and training. However, there is currently a lack of empirical evidence to explain how perceptual-cognitive strategies differ between these two paradigms when performing sports-related tasks. Thus, the objective of this study was to examine and compare the impact of different viewing conditions (e.g., 3D-360°VR and 2D video displays), on gaze behavior and head excursions in a boxing-specific anticipatory task. A secondary objective was to assess the workload associated with each viewing mode, including the level of presence experienced. Thirdly, an exploratory analysis was conducted to evaluate any potential sex differences.

Methods

Thirty-two novice participants (16 females) were recruited for this study. A total of 24 single-punch sequences were randomly presented using a standalone VR headset (Pico Neo 3 Pro Eye), with two different viewing modes: 3D-360°VR and 2D. Participants were instructed to respond to the punches with appropriate motor actions, aiming to avoid punches. Gaze behavior was recorded using a Tobii eyetracker embedded in the VR headset. Workload and presence were measured with the SIM-TLX questionnaire. Fixation duration, number of fixations, saccades, search rate and head excursions (roll, pitch, yaw) were analyzed using linear mixed models.

Results

The results revealed significant shorter fixation durations and more head excursions (roll, pitch) in 3D-360°VR, compared to the 2D viewing mode (ps < 0.05). The sense of presence was found to be much higher in the 3D-360°VR viewing mode (p < 0.05). No sex differences were observed. These results demonstrate that 360°VR elicited shorter fixation durations but mostly greater head excursions and immersion compared to a 2D projection in the context of a boxing-specific task.

Discussion

These findings contribute to the understanding of previous evidence supporting the possible advantages of using 360°VR over 2D for perceptual-cognitive evaluation and training purposes. Further validation studies that compare behaviors and performance in 360°VR with those in the real-world will be needed.

My hands are running away - learning a complex nursing skill via virtual reality simulation: a randomised mixed methods study

BACKGROUND

Clinical skills training is an essential component of nursing education. However, sometimes education does not sufficiently prepare nurses for the real world. Virtual reality (VR) is an innovative method to complement existing learning strategies, yet few studies investigate its effectiveness. This study compared educational outcomes achieved by three groups learning with either of two different VR simulation variants, with varying technological features, or a video training on the endotracheal suctioning skill.

METHODS

The investigated outcomes were knowledge and skill acquisition, learner satisfaction, and technology acceptance. 131 undergraduate nursing students were randomised into three groups, based on the interventions they received. Knowledge was assessed through a pre-post-test design, skill through a post-intervention objective structured clinical examination on a manikin, learning satisfaction and technology acceptance through standardised questionnaires, and qualitative feedback through focus groups.

RESULTS

All interventions led to a significant knowledge acquisition, with no significant difference between the groups. The video intervention group performed significantly better than the VR groups in skill demonstration. One of the two VR intervention groups had a significantly higher learner satisfaction than the video group. Technology acceptance was high for both VR groups, with the simpler VR simulation resulting in higher technology acceptance than the one with more experimental features. Students described the VR experience as realistic, interactive, and immersive, and saw the opportunity to practise skills in a safe environment, learn from mistakes, and increase knowledge and confidence.

CONCLUSIONS

For the development of VR trainings, we recommend keeping them simple and targeting a specific educational outcome since trying to optimise for multiple outcomes is resource intensive and hard to achieve. Psychomotor skills were easier for participants to learn by watching a video on the procedure rather than practically learning it with the VR hardware, which is a more abstract representation of reality. We therefore recommend using VR as a complementing resource to skills labs, rather than replacing existing learning strategies. Perhaps VR is not ideal for practising practical psychomotor skills at the moment, but it can increase knowledge, satisfaction, motivation, confidence and prepare for further practical training.

TRIAL REGISTRATION

Not applicable.

Improvement of short-term outcomes with VR-based safety training for work at heights

Serious games and virtual reality offer engaging learning opportunities and a cost-effective solution within an immersive and safe environment for safety training in construction. However, there have been few examples of safety training for work at heights developed using these technologies, especially commercial training. To fill this literature gap, a new VR-based safety training was developed and compared with lecture-based training across time. We conducted a quasi-experiment with a non-equivalent group design with 102 workers from six construction sites in Colombia. Learning objectives, observations from training centers, and national regulations were considered during the design of the training methods. Training outcomes were assessed using Kirkpatrick's model. We found that both training approaches were effective in improving knowledge test results and self-reported attitudes in the short-term; and risk-perception, self-reported behavior and safety climate in the long-term. In particular, participants of the VR-based training got significantly higher results in knowledge and reported higher attitudes (commitment and motivation) than participants of the lecture-based training. We suggest that safety managers and practitioners should invest in VR using serious games as an alternative to training programs based on short-term outcomes. Future work is needed to test VR for long-term outcomes.

Using Immersive Virtual Reality in an Online Biology Course

Interest in virtual reality (VR) for teaching and learning in higher education is growing, given its many potential applications. VR offers a socially interactive environment with novel ways to engage students with materials, objects, and activities and provide students with experiences such as "field trips" that would be otherwise very difficult. Preliminary work indicates overall positive gains in student learning across disciplines compared to other technology and traditional techniques, although more studies are needed to better our understanding of this tool. We employed an "immersive" VR (with a head-mounted display) in an online course which provided students with the opportunity to interact with peers and engage in activities. We asked about perceptions of the learning experience with the technology and how using VR impacts students' performance. We also noted the benefits and challenges of VR in an online course. Students perceived VR as a helpful component of the course, although performance on the cardiovascular unit assessment did not differ compared to the previous semester without VR.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41979-023-00095-9.

Learning about Victims of Holocaust in Virtual Reality: The Main, Mediating and Moderating Effects of Technology, Instructional Method, Flow, Presence, and Prior Knowledge

The goal of the current study was to investigate the effects of a virtual reality (VR) simulation of Anne Frank’s hiding place on learning. In a 2 × 2 experiment, 132 middle school students learned about the living conditions of Anne Frank, a girl of Jewish heritage during the Second World War, through desktop VR (DVR) and head-mounted display VR (HMD-VR) (media conditions). Approximately half of each group engaged in an explorative vs. an expository learning approach (method condition). The exposition group received instructions on how to explore the hiding place stepwise, whereas the exploration group experienced it autonomously. Next to the main effects of media and methods, the mediating effects of the learning process variables of presence and flow and the moderating effects of contextual variables (e.g., prior technical knowledge) have been analyzed. The results revealed that the HMD-VR led to significantly improved evaluation, and—even if not statistically significant—perspective-taking in Anne, but less knowledge gain compared to DVR. Further results showed that adding instructions and segmentation within the exposition group led to significantly increased knowledge gain compared to the exploration group. For perspective-taking and evaluation, no differences were detected. A significant interaction between media and methods was not found. No moderating effects by contextual variables but mediating effects were observed: For example, the feeling of presence within VR can fully explain the relationships between media and learning. These results support the view that learning processes are crucial for learning in VR and that studies neglecting these learning processes may be confounded. Hence, the results pointed out that media comparison studies are limited because they do not consider the complex interaction structures of media, instructional methods, learning processes, and contextual variables.

Effects of a Computer-Based Community Health Nursing Virtual Reality Simulation on Postlicensure Nursing Students

BACKGROUND

Virtual reality simulation in postlicensure nursing education, including community health, is an emerging instructional approach, and more research is needed on its effectiveness. The goal of this study was to evaluate the effectiveness of an innovative, computer-based community health nursing virtual reality simulation among postlicensure nursing students.

METHOD

This mixed methods study consisted of 67 postlicensure community health nursing students who completed a pretest, computer-based virtual reality simulation, and a posttest and evaluation.

RESULTS

The majority of participant scores increased from pretest to posttest, and most participants agreed that the computer-based virtual reality simulation was effective; new knowledge and skills learned, the material that was found to be most helpful, and benefits to nursing practice were identified.

CONCLUSION

This community health nursing computer-based virtual reality simulation was effective at increasing participants' knowledge and confidence with learning. [J Contin Educ Nurs. 2023;54(3):109-116.].

How to Maximise Spatial Presence: Design Guidelines for a Virtual Learning Environment for School Use

Research on learning with and in immersive virtual reality (VR) continues to grow, yielding more insights into how immersive learning works. However, the actual use of VR learning environments in schools is still in its infancy. A major hurdle that hinders the use of immersive digital media in schools is the lack of guidelines for designing VR learning environments for practical use in schools. Such guidelines need to consider how students interact and learn in VR learning environments and how teachers can use such environments on a day-to-day basis. Using a design-based research approach, we explored the guidelines for creating VR learning content for tenth-grade students in a German secondary school and recreated a real-world, out-of-school VR learning space which can be used for hands-on instruction. This paper investigated how to maximise the experience of spatial presence by creating a VR learning environment in several microcycles. Furthermore, it took a closer look at the influence of the spatial situation model and cognitive involvement on this process. The results were evaluated with ANOVAs and path analyses, showing, for example, that involvement does not influence spatial presence in highly immersive and realistic VR learning environments.

Creating a Successful Virtual Reality-Based Medical Simulation Environment: Tutorial

Innovation in medical education is not only inevitable but a requirement. Manikin-based simulation is currently the gold standard for supplemental clinical training; however, this modality requires significant equipment and personnel to operate. Virtual reality (VR) is emerging as a new method of delivering medical simulation sessions that requires less infrastructure but also allows for greater accessibility and flexibility. VR has slowly been integrated into the medical curriculum in some hospitals; however, more widespread adoption would transform the delivery of medical education for future clinicians. This tutorial introduces educators to the BUILD REALITY (begin, use, identify, leverage, define, recreate, educate, adapt, look, identify, test, amplify) framework, a series of practical tips for designing and implementing a VR-based medical simulation environment in their curriculum. The suggestions are based on the relevant literature and the authors' personal experience in creating and implementing VR environments for medical trainees. Altogether, this paper provides guidance on conducting a needs assessment, setting objectives, designing a VR environment, and incorporating the session into the broader medical curriculum.

Extended reality in language learning: A cognitive affective model of immersive learning perspective

A surge in the interest and implementation of extended reality (XR)-based lessons in language learning has resulted in many related studies. Recent reviews that summarized these studies and the previous studies focus on the technologies used in language-learning settings or the different ways of incorporating XR tools in language-learning activities. However, less work has been done to synthesize XR-based language-learning studies from a language-learning theory perspective. Thus, this study delineates the contour of scholarly literature on XR in language learning using the Cognitive Affective Model of Immersive Learning (CAMIL). The model contains six affective and cognitive factors that lead to XR-based learning: interest, motivation, self-efficacy, embodiment, cognitive load, and self-regulation. This model was adopted in the current study to systematically synthesize the findings from primary studies published between 2017 and 2022 to construct XR explanations on language learning from a cognitive theory perspective. Studies published in 12 indexed privileged journals in the language education and technology field on XR in language learning were reviewed. The results showed that the factors in the CAMIL led to factual, conceptual, and procedural knowledge acquisition and transfer. This study provides some insights into understanding the cognitive outcomes of XR-based language learning by analyzing the findings from previous studies. Suggestions for future studies are proposed in this study.

Experiencing herd immunity in virtual reality increases COVID-19 vaccination intention: Evidence from a large-scale field intervention study

This study investigates the impact of an immersive virtual reality (VR) simulation of herd immunity on vaccination intentions and its potential underlying mechanisms. In this preregistered field study, N = 654 participants were randomly assigned to one of the three VR conditions: (1) Gamified Herd Immunity; (2) Gamified Herd Immunity + Empathy (with additional narrative elements); (3) Control (gamified with no vaccination-related content). In the Gamified Herd Immunity simulation, participants embodied a vulnerable person and navigated a wedding venue trying to avoid getting infected. A total of 455 participants with below maximum intentions to take a novel vaccine and without severe cybersickness were analyzed. The Gamified Herd Immunity + Empathy and the Gamified Herd Immunity conditions increased vaccination intentions by 6.68 and 7.06 points on a 0-100 scale, respectively, compared to 1.91 for the Control condition. The Gamified Herd Immunity + Empathy condition enhanced empathy significantly more than the Gamified Herd Immunity condition but did not result in higher vaccination intentions. Experienced presence was related to the change in vaccination intentions. The results suggest that VR vaccination communication can effectively increase vaccination intentions; the effect is not solely due to the technological novelty and does not depend on empathy.

Toward immersive communications in 6G

The sixth generation (6G) networks are expected to enable immersive communications and bridge the physical and the virtual worlds. Integrating extended reality, holography, and haptics, immersive communications will revolutionize how people work, entertain, and communicate by enabling lifelike interactions. However, the unprecedented demand for data transmission rate and the stringent requirements on latency and reliability create challenges for 6G networks to support immersive communications. In this survey article, we present the prospect of immersive communications and investigate emerging solutions to the corresponding challenges for 6G. First, we introduce use cases of immersive communications, in the fields of entertainment, education, and healthcare. Second, we present the concepts of immersive communications, including extended reality, haptic communication, and holographic communication, their basic implementation procedures, and their requirements on networks in terms of transmission rate, latency, and reliability. Third, we summarize the potential solutions to addressing the challenges from the aspects of communication, computing, and networking. Finally, we discuss future research directions and conclude this study.

How does interactive virtual reality enhance learning outcomes via emotional experiences? A structural equation modeling approach

Introduction

Interest in interactive virtual reality (IVR) is increasing due to its potential for embodied learning and group-led teaching. However, few studies have investigated the internal mechanism by which IVR technology features and learning experiences affect learning outcomes in terms of psychological and emotional value. Based on media technology models and the control value theory of achievement emotions (CVTAE), this study uses structural equation modeling (SEM) to investigate the correlations among the internal elements of IVR technology features, learning experiences, and learning outcomes. It also emphasizes the role played by emotional experience in this context.

Methods

The sample referenced by this study consisted of 480 college students (193 males) who were simultaneously engaged in guided inquiry and learning in an IVR-based COVID-19 pandemic science museum in groups of 10.

Results

The findings suggest that presence and perceived enjoyment have a key mediating effect on the relationship between virtual reality (VR) features and perceived learning outcomes in an IVR-based learning simulation. In addition, the results indicate that presence is more strongly correlated with perceived learning effects, while enjoyment is more strongly correlated with learning satisfaction.

Discussion

These findings provide intellectual support and theoretical backing for VR-based instructional design and environmental development. Moreover, this study has practical value with regard to the future large-scale application of IVR to experiential teaching, group-led teaching, and the promotion of the digital transformation and intelligence upgrading in education.

Facilitating writing performance of EFL learners via virtual reality: Immersion, presence, embodiment

Immersive virtual reality (IVR) technology is being used to help EFL learners overcome their difficulties with their language skills, especially writing skills. Past studies showed that the instrument that provides immersion will positively affect learners' written performance. In line with that, this study aims to investigate the vocabulary usage and writing performance of learners who learn vocabulary via IVR versus those who learn from conventional classroom-based instruction. A total of 144 Chinese-speaking English learners, who were divided into experimental group (N = 69) and control group (N = 75), experienced the treatments related to the writing tasks. The results show that the learners in the experimental group wrote more informatively and presented more details. Comparative analysis revealed that learners using IVR performed significantly better on target word usage, lexical density, distribution richness, and completion of task than those in the conventional classroom. Based on the results, it would seem that the positive transfer of learning may be related to the experience of exploring in a virtual environment. The immersion of IVR and the sense of presence and embodiment enable learners to benefit from their immersive experience which aids the use of vocabulary in their writing. The implication of the study demonstrated the impact of the technological factors, whereby what causes the improvement in writing performance is due to the learners' virtual experience and their sense of embodiment.

New is not always better: Virtual reality does not necessarily enhance mnemonic processing

Integrating new technologies such as Virtual Reality (VR) can contribute to increasing efficiency in several areas relevant to society. VR can be applied in various contexts and has the potential to improve mnemonic processes and memory performance. However, the specific conditions under which VR is more beneficial than conventional learning methods remain unclear. To further investigate the value of VR for mnemonic processing, participants performed a memory task under three different conditions. For that task, they were presented with rules regarding the spatial arrangement of building blocks with a written text or a video in 2D on a screen or in 3D/360° with a head-mounted display. Following the learning session, memory performance was measured by a recognition test involving a multiple-choice questionnaire, in which participants had to mark the correct arrangement of building blocks, and a construction test, in which they had to arrange five different building blocks according to the rules learned. Additionally, participants had to arrange 38 building blocks according to the rules in a free recall test the following day. Surprisingly, results revealed no superiority effect for learning in VR. Instead, learning the rules with the text yielded the best memory performance results, indicating that prior experience with conventional learning methods facilitates declarative knowledge acquisition. Considering previous findings regarding cognitive processing in VR, our results suggest that in passive learning, processing the more salient and personally relevant virtual stimuli in the surrounding VR environment requires more attentional resources. Therefore, VR impairs focusing on the relevant declarative information and impedes the transfer of the learned knowledge to different contexts. When considering to implement VR, the value to the particular domain and specific learning task should be taken into consideration: For learning basic declarative information without actively involving the students, conventional learning methods seem sufficient and more efficient for mnemonic processing compared to new technologies.

Use of theory to guide integration of virtual reality technology in nursing education: A scoping study

BACKGROUND

There is growing interest among academic nurse educators in using virtual reality (VR) environments as a pedagogical tool to enhance student learning.

PURPOSE

The aim of this scoping study was to identify the theories or conceptual models that informed the application of virtual reality technology in nursing education programs.

METHODS

A scoping study using the Arksey and O'Malley (2005) framework was conducted. A search strategy recommended and executed by a research librarian yielded 18 final articles for review.

FINDINGS

There is limited use of theory or a conceptual model, particularly of nursing origin, to guide the integration of VR technology for student learning.

DISCUSSION

More research is needed to define best practices for application of VR technology for specific curricular needs, and for theory development based on specific concepts and disciplinary perspectives of learning.

ADIDAS: An Examined Approach for Enhancing Cognitive Load and Attitudes towards Synchronous Digital Learning Amid and Post COVID-19 Pandemic

SARS-CoV-2 (COVID-19) has disrupted university education and turned it into distance learning for at least one semester in many countries, including the Kingdom of Saudi Arabia (KSA). However, there was an issue with university students' cognitive load at this critical time, because education totally stopped for about a month and then resumed remotely. This research draws on the cognitive load theory, particularly the extraneous load, to develop an instructional design model called ADIDAS. The model includes six stages, namely: analyse (A), design (D), improve (I), do (D), Assess (A), and Share (S). Thirty-four experts in instructional technology models have reviewed the ADIDAS model in Arab university contexts, producing a consensus about its suitability for use in distance learning amid the COVID-19 pandemic. Following the consensus of the experts, the model was applied to a sample of 527 students at King Faisal University, KSA. The results confirmed significant statistical differences with a very large effect size in relation to the attitude towards synchronous digital learning (SDL) and cognitive load pre and post ADIDAS. Students had a positive attitude towards SDL and a low cognitive load during the educational process pre adoption of the ADIDAS model, compared to post ADIDAS. The current research results have numerous implications for post the COVID-19 pandemic, especially in Arab countries and similar contexts.

Enhancing learning and retention with distinctive virtual reality environments and mental context reinstatement

Memory is inherently context-dependent: internal and environmental cues become bound to learnt information, and the later absence of these cues can impair recall. Here, we developed an approach to leverage context-dependence to optimise learning of challenging, interference-prone material. While navigating through desktop virtual reality (VR) contexts, participants learnt 80 foreign words in two phonetically similar languages. Those participants who learnt each language in its own unique context showed reduced interference and improved one-week retention (92%), relative to those who learnt the languages in the same context (76%)-however, this advantage was only apparent if participants subjectively experienced VR-based contexts as "real" environments. A follow-up fMRI experiment confirmed that reinstatement of brain activity patterns associated with the original encoding context during word retrieval was associated with improved recall performance. These findings establish that context-dependence can be harnessed with VR to optimise learning and showcase the important role of mental context reinstatement.

Effectiveness of immersive virtual reality training in nasogastric tube feeding education: A randomized controlled trial

BACKGROUND

Given rapidly aging societies worldwide, improving the quality of long-term care through the cultivation of immense nursing assistants is critical. Accordingly, developing a satisfactory learning model to improve the learning outcomes of nursing assistant students is imperative.

OBJECTIVE

This study tested the hypothesis that students in long-term care departments who underwent immersive virtual reality (IVR) training would have significantly (1) higher levels of knowledge about the skills of nasogastric tube feeding, (2) higher learning motivations (i.e., intrinsic and extrinsic motivations, task values, and self-efficacy), (3) lower cognitive load, and (4) higher satisfaction than a control group.

DESIGN

A randomized controlled trial with pretest and posttest design.

SETTINGS AND PARTICIPANTS

We randomly assigned 107 students from the long-term care departments of two universities in central Taiwan to the IVR group (n = 54) or the control group (n = 53).

METHODS

The IVR group learned the procedure of nasogastric tube feeding through IVR, whereas the control group watched a 15-min 2D video. The participants filled pretest and posttest questionnaires on nasogastric tube feeding knowledge. After the experiment was completed, the participants answered another questionnaire on their learning motivations, cognitive load, and learning satisfaction.

RESULTS

The nasogastric tube feeding knowledge improved significantly in the IVR and control groups after the intervention, with no significant between-group differences. The IVR group scored significantly higher than the control group on extrinsic goals, task value, and satisfaction; nevertheless, they also experienced a significantly higher cognitive load.

CONCLUSIONS

Both the IVR training and the traditional 2D video improved the learning outcomes of the nursing assistant students. The students were more satisfied with IVR than with the conventional learning model and indicated that IVR inspired their extrinsic learning motivations and perceived task value. However, IVR incurred a high cognitive load, which must be addressed in future course designs.

Investigating the effectiveness of immersive VR skill training and its link to physiological arousal

This paper details the motivations, design, and analysis of a study using a fine motor skill training task in both VR and physical conditions. The objective of this between-subjects study was to (a) investigate the effectiveness of immersive virtual reality for training participants in the 'buzz-wire' fine motor skill task compared to physical training and (b) investigate the link between participants' arousal with their improvements in task performance. Physiological arousal levels in the form of  electro-dermal activity (EDA) and ECG (Electrocardiogram) data were collected from 87 participants, randomly distributed across the two conditions. Results indicated that VR training is as good as, or even slightly better than, training in physical training in improving task performance. Moreover, the participants in the VR condition reported an increase in self-efficacy and immersion, while marginally significant differences were observed in the presence and the temporal demand (retrieved from NASA-TLX measurements). Participants in the VR condition showed on average less arousal than those in the physical condition. Though correlation analyses between performance metrics and arousal levels did not depict any statistically significant results, a closer examination of EDA values revealed that participants with lower arousal levels during training, across conditions, demonstrated better improvements in performance than those with higher arousal. These findings demonstrate the effectiveness of VR in training and the potential of using arousal and training performance data for designing adaptive VR training systems. This paper also discusses implications for researchers who consider using biosensors and VR for motor skill experiments.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10055-022-00699-3.

Comparing approaches for selection, development, and deployment of extended reality (XR) teaching applications: A case study at The University of Newcastle Australia

The use of extended reality (XR) technology in education offers many advantages for transferring knowledge and practical skills training at the higher education level. As a result, many Universities over the past 5 + years have undertaken pilot programs to both develop XR content and assess how to best implement it within existing teaching and learning systems. Unfortunately, very few of these efforts have included structured evaluation or documentation. As such, limited published evidence exists to inform processes and approaches that may assist or hinder broad scale implementation. This leads many Universities to unnecessarily commit significant time and resources to testing identical or similar approaches, resulting in repeated identification of the same or similar challenges. In response to this situation, The University of Newcastle, Australia decided to systematically document the approach for selection, development and implementation of four new virtual-reality (VR) teaching applications. The current paper contains a detailed intrinsic case study, outlining the process and critical elements that shaped the selection of suitable teaching content, software development, hardware solutions and implementation. Details are provided on how decisions were made, what components were considered helpful, challenges identified, and important lessons outlined. These findings will be useful to organisations and individuals as they look to develop pathways and processes to integrate XR technology, particularly within their existing training and educational frameworks.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10639-022-11364-2.

Collaborative and individual learning of geography in immersive virtual reality: An effectiveness study

Many university-taught courses moved to online form since the outbreak of the global pandemic of coronavirus disease (COVID-19). Distance learning has become broadly used as a result of the widely applied lockdowns, however, many students lack personal contact in the learning process. A classical web-based distance learning does not provide means for natural interpersonal interaction. The technology of immersive virtual reality (iVR) may mitigate this problem. Current research has been aimed mainly at specific instances of collaborative immersive virtual environment (CIVE) applications for learning. The fields utilizing iVR for knowledge construction and skills training with the use of spatial visualizations show promising results. The objective of this study was to assess the effectiveness of collaborative and individual use of iVR for learning geography, specifically training in hypsography. Furthermore, the study's goals were to determine whether collaborative learning would be more effective and to investigate the key elements in which collaborative and individual learning were expected to differ-motivation and use of cognitive resources. The CIVE application developed at Masaryk University was utilized to train 80 participants in inferring conclusions from cartographic visualizations. The collaborative and individual experimental group underwent a research procedure consisting of a pretest, training in iVR, posttest, and questionnaires. A statistical comparison between the geography pretest and posttest for the individual learning showed a significant increase in the score (p = 0.024, ES = 0.128) and speed (p = 0.027, ES = 0.123), while for the collaborative learning, there was a significant increase in the score (p<0.001, ES = 0.333) but not in speed (p = 1.000, ES = 0.000). Thus, iVR as a medium proved to be an effective tool for learning geography. However, comparing the collaborative and individual learning showed no significant difference in the learning gain (p = 0.303, ES = 0.115), speed gain (p = 0.098, ES = 0.185), or performance motivation (p = 0.368, ES = 0.101). Nevertheless, the collaborative learning group had significantly higher use of cognitive resources (p = 0.046, ES = 0.223) than the individual learning group. The results were discussed in relation to the cognitive load theories, and future research directions for iVR learning were proposed.

Comparing virtual reality, desktop-based 3D, and 2D versions of a category learning experiment

Virtual reality (VR) has seen increasing application in cognitive psychology in recent years. There is some debate about the impact of VR on both learning outcomes and on patterns of information access behaviors. In this study we compare performance on a category learning task between three groups: one presented with three-dimensional (3D) stimuli while immersed in the HTC Vive VR system (n = 26), another presented with the same 3D stimuli while using a flat-screen desktop computer (n = 26), and a third presented with a two-dimensional projection of the stimuli on a desktop computer while their eye movements were tracked (n = 8). In the VR and 3D conditions, features of the object to be categorized had to be revealed by rotating the object. In the eye tracking control condition (2D), all object features were visible, and participants' gaze was tracked as they examined each feature. Over 240 trials we measured accuracy, reaction times, attentional optimization, time spent on feedback, fixation durations, and fixation counts for each participant as they learned to correctly categorize the stimuli. In the VR condition, participants had increased fixation counts compared to the 3D and 2D conditions. Reaction times for the 2D condition were significantly faster and fixation durations were lower compared to the VR and 3D conditions. We found no significant differences in learning accuracy between the VR, 3D, and 2D conditions. We discuss implications for both researchers interested in using VR to study cognition, and VR developers hoping to use non-VR research to guide their designs and applications.

Exploring Immersive Learning Experiences: A Survey

Immersive technologies have been shown to significantly improve learning as they can simplify and simulate complicated concepts in various fields. However, there is a lack of studies that analyze the recent evidence-based immersive learning experiences applied in a classroom setting or offered to the public. This study presents a systematic review of 42 papers to understand, compare, and reflect on recent attempts to integrate immersive technologies in education using seven dimensions: application field, the technology used, educational role, interaction techniques, evaluation methods, and challenges. The results show that most studies covered STEM (science, technology, engineering, math) topics and mostly used head-mounted display (HMD) virtual reality in addition to marker-based augmented reality, while mixed reality was only represented in two studies. Further, the studies mostly used a form of active learning, and highlighted touch and hardware-based interactions enabling viewpoint and select tasks. Moreover, the studies utilized experiments, questionnaires, and evaluation studies for evaluating the immersive experiences. The evaluations show improved performance and engagement, but also point to various usability issues. Finally, we discuss implications and future research directions, and compare our findings with related review studies.

Personalization of the Learning Path within an Augmented Reality Spatial Ability Training Application Based on Fuzzy Weights

Adaptive systems and Augmented Reality are among the most promising technologies in teaching and learning processes, as they can be an effective tool for training engineering students' spatial skills. Prior work has investigated the integration of AR technology in engineering education, and more specifically, in spatial ability training. However, the modeling of user knowledge in order to personalize the training has been neither sufficiently explored nor exploited in this task. There is a lot of space for research in this area. In this work, we introduce a novel personalization of the learning path within an AR spatial ability training application. The aim of the research is the integration of Augmented Reality, specifically in engineering evaluation and fuzzy logic technology. During one academic semester, three engineering undergraduate courses related to the domain of spatial skills were supported by a developed adaptive training system named PARSAT. Using the technology of fuzzy weights in a rule-based decision-making module and the learning theory of the Structure of the Observed Learning Outcomes for the design of the learning material, PARSAT offers adaptive learning activities for the students' cognitive skills. Students' data were gathered at the end of the academic semester, and a thorough analysis was delivered. The findings demonstrated that the proposed training method outperformed the traditional method that lacked adaptability, in terms of domain expertise and learning theories, considerably enhancing student learning outcomes.

Experiencing an art education program through immersive virtual reality or iPad: Examining the mediating effects of sense of presence and extraneous cognitive load on enjoyment, attention, and retention

Sense of presence and extraneous cognitive load (ECL) are the two psychological effects widely employed to explain the cognitive outcomes caused by high-immersive media (e. g., virtual reality). This study identified the concepts of both technological affordance (i.e., immersion) and the psychological effects of VR learning. It investigated the mechanism by which immersion leads to better or worse communication in the context of art education. We operationalized the concept of immersion into two levels: a high-immersive VR system (HTC VIVE Cosmos) and a low-immersive tablet system (iPad). Through a between-subject experiment, we found that higher immersion not only led to a greater sense of presence but also lowered extraneous cognitive load. Enjoyment and attention increased as a sense of presence rose but were not necessarily predicted by extraneous cognitive load. This study found that sense of presence was a more robust explanatory variable than ECL and that cognitive load could be lower in a high-immersive environment with content specifically designed for VR.

Immersive virtual reality in STEM: is IVR an effective learning medium and does adding self-explanation after a lesson improve learning outcomes?

The goal of the current study was to investigate the effects of an immersive virtual reality (IVR) science simulation on learning in a higher educational setting, and to assess whether using self-explanation has benefits for knowledge gain. A sample of 79 undergraduate biology students (40 females, 37 males, 2 non-binary) learned about next-generation sequencing using an IVR simulation that lasted approximately 45 min. Students were randomly assigned to one of two instructional conditions: self-explanation (n = 41) or control (n = 38). The self-explanation group engaged in a 10 min written self-explanation task after the IVR biology lesson, while the control group rested. The results revealed that the IVR simulation led to a significant increase in knowledge from the pre- to post-test (ß _Posterior = 3.29). There were no differences between the self-explanation and control groups on knowledge gain, procedural, or conceptual transfer. Finally, the results indicate that the self-explanation group reported significantly higher intrinsic cognitive load (ß _Posterior = .35), and extraneous cognitive load (ß _Posterior = .37), and significantly lower germane load (ß _Posterior =  - .38) than the control group. The results suggest that the IVR lesson was effective for learning, but adding a written self-explanation task did not increase learning after a long IVR lesson.