Effects of virtual environment platforms on emotional responses

User experience and interface assessment for metaverse platforms on nurses and nursing students: A cross-sectional study

BACKGROUND

The metaverse, a rapidly evolving virtual environment, offers new opportunities for healthcare education. The effectiveness of the metaverse as a learning tool depends on user readiness and platform characteristics.

AIM

This study aimed to examine the current use of metaverse platforms among nurses and nursing students in South Korea and explore the relationship between user characteristics and their metaverse experience, focusing on presence, usability, and user experience.

DESIGN

This was a cross-sectional descriptive study.

SETTINGS

Registered nurses and nursing students from various healthcare settings and educational institutions in South Korea participated in this study.

PARTICIPANTS

This study included 428 participants, comprising 188 nurses and 240 nursing students.

METHODS

Between September and November 2022, participants provided voluntary informed consent. The participants engaged with one of the following two metaverse platforms: ZEPETO (mobile-based) or Gather (screen-based). After four structured exploration phases, the participants completed online questionnaires. These surveys assessed general characteristics, metaverse self-efficacy, sense of presence, usability, and user experience.

RESULTS

Most participants had previous experience with the metaverse and rated their metaverse self-efficacy at 3.60. Nurses scored higher than nursing students in terms of presence, usability, and user experience in the metaverse. Higher work self-efficacy in nurses and academic self-efficacy in nursing students were associated with more positive experiences in the metaverse. Nurses consistently rated higher across all subdomains of presence, usability, and user experience than nursing students. The type of metaverse platform also significantly influenced user experience.

CONCLUSIONS

A significant proportion of Korean nurses and nursing students are familiar with the metaverse, reflecting a global trend towards virtual environments in education and healthcare. Although the metaverse holds promise for healthcare education, its effectiveness depends on user readiness, platform characteristics, and the development of a reliable, structured, and user-friendly educational programme.

How different text display patterns affect cybersickness in augmented reality

Cybersickness remains a pivotal factor that impacts user experience in Augmented Reality (AR). Research probing into the relationship between AR reading tasks and cybersickness, particularly focusing on text display patterns and user characteristics, has been scant. Moreover, the influence of cybersickness on searching ability and the broader spectrum of user experience has not been rigorously tested. Recent investigations have aimed to pinpoint the variables that contribute to cybersickness during AR reading sessions. In one such study, 40 participants underwent a series of controlled experiments with randomized text display patterns, including variations in text speed and text movement modes. Post-experiment, participants completed a questionnaire that helped quantify their experiences and the degree of cybersickness encountered. The data highlighted that satiety, text speed, and text movement mode are significant contributors to cybersickness. When participants experienced higher levels of cybersickness, font color stood out as a particularly influential factor, whereas gender differences seemed to affect the onset of cybersickness more noticeably at lower levels. This study also drew attention to the impact of cybersickness on search ability within AR environments. It was noted that as cybersickness intensity increased, search ability was markedly compromised. In sum, the research underscores the importance of text display patterns and user characteristics, such as past AR experience, in understanding cybersickness and its detrimental effects on user experience and search ability, particularly under conditions of intense cybersickness.

Learning Middle-Latitude Cyclone Formation up in the Air: Student Learning Experience, Outcomes, and Perceptions in a CAVE-Enabled Meteorology Class

Cave Automatic Virtual Environment (CAVE) is a virtual reality (VR) environment that has not been fully studied due to its high cost and complexity in system integration. Previous CAVE-related studies mainly focused on comparing its effectiveness with other learning media, such as textbooks, desktop VR, or head-mounted display (HMD) VR. In this study, through the utilization of CAVE in a meteorology class, we concentrated on CAVE itself, measured how CAVE impacted learners' learning outcomes before and after using CAVE in an actual ongoing undergraduate-level class, and investigated how learners perceived their learning experiences. Quantitative data were collected to examine the students' knowledge acquisition and learning experience. We also triangulated the quantitative results with qualitative data from the interviews regarding learners' perceptions of the CAVE-enabled class and their knowledge mastery. The results indicated that their learning outcomes increased through learning with CAVE and that their perceptions of immersion, presence, and engagement significantly correlated with each other. The interview results showed a great fondness of and satisfaction with the learning experience, group collaboration, and effectiveness of the CAVE-enabled class from the learners. We also learned that the learners' learning experiences in CAVE could be further improved if we provided them with more learner-environment interaction, offered them a better sense of immersion, and reduced cybersickness. Implications of these findings are discussed.

Recreational cycling provides greater satisfaction and flow in an immersive virtual environment than in real life

BACKGROUND

As the state of satisfaction and flow involved in the physical activity (PA) determines future training commitment, it is undoubtedly very important to study the factors influencing the attractiveness of PA. One of such factors is the usage of virtual reality (VR) technology which creates opportunities for its users to practice various forms of PA in a altered way. It is interesting whether PA practiced in a virtual environment can offer higher levels of satisfaction and flow comparing with PA practiced in the real world. Positive answer to this question support the statement that the use of such technology could contribute to the future commitment in PA. Therefore, in order to find out whether PA in VR can be an attractive alternative towards the PA in a real world, the research should be undertaken to verify if the state of satisfaction and flow involved in the practising certain PA in the VR environment could be higher comparing to the levels of pleasure and flow connected with the same PA carried out in the real world.

OBJECTIVE

The main objective of the study was to assess the level of satisfaction and flow experienced by healthy adults during various cycling conditions: real life (RL), non-immersive and immersive virtual reality (nIVR and IVR). Additionally, questionnaires for assessing satisfaction with PA and flow in RL and VR were also validated in terms of their measurement reliability. The correlation of the results obtained during tests using both measurement tools was also assessed.

METHODS

Forty students were studied, including 20 women (age 22.35 ± 2.32 years) and 20 men (age 22.95 ± 2.19 years). The Physical Activity Enjoyment Scale (PACES) was used to evaluate the enjoyment of cycling. Flow state was assessed using The Flow State Scale (FSS).

RESULTS

Based on Friedman's analysis of variance regarding the results obtained for all the respondents, it can be concluded that the conditions of cycling significantly affect their level of satisfaction (χ2 = 85.61(40;3); p < 0.001) and flow (χ2 = 40.52(40;3); p < 0.001). The research participants rated cycling the highest in IVR. Based on the calculated Cronbach's alpha coefficients, high measurement reliability of the questionnaires used in nIVR (PACES, α = 0.94; FFS-2, α = 0.86) and IVR (PACES, α = 0.89; FFS-2, α = 0.91). There was also a significant positive moderate correlation between PA satisfaction and user flow.

CONCLUSIONS

The research is the first attempt to directly compare the sense of satisfaction and flow when practicing cycling in RL and in nIVR and IVR. The greater attractiveness and higher level of flow during PA in IVR compared to a similar traditional form of PA in RL, found on the basis of the conducted research, should prompt reflection by both those involved in planning and promoting PA, as well as the creators of active video games (AVGs). Due to the great attractiveness of PA in IVR and the constant, dynamic development of immersive information technologies, virtual training may, in the near future, become not only an important supplement to conventional forms of exercise, but perhaps even an alternative solution.

The underwood project: A virtual environment for eliciting ambiguous threat

Threatening environments can be unpredictable in many different ways. The nature of threats, their timing, and their locations in a scene can all be uncertain, even when one is acutely aware of being at risk. Prior research demonstrates that both temporal unpredictability and spatial uncertainty of threats elicit a distinctly anxious psychological response. In the paradigm presented here, we further explore other facets of ambiguous threat via an environment in which there are no concrete threats, predictable or otherwise, but which nevertheless elicits a building sense of danger. By incorporating both psychological research and principles of emotional game design, we constructed this world and then tested its effects in three studies. In line with our goals, participants experienced the environment as creepy and unpredictable. Their subjective and physiological response to the world rose and fell in line with the presentation of ambiguously threatening ambient cues. Exploratory analyses further suggest that this ambiguously threatening experience influenced memory for the virtual world and its underlying narrative. Together the data demonstrate that naturalistic virtual worlds can effectively elicit a multifaceted experience of ambiguous threat with subjective and cognitive consequences.

The effect of immersion on sense of presence and affect when experiencing an educational scenario in virtual reality: A randomized controlled study

Virtual reality (VR) technology has been used to learn skills for decades. While no standardized measure exists for learning outcomes in VR training, commonly explored outcomes are immersion, sense of presence and emotions.

Methods

In this paper, the objective was to investigate these outcomes in two VR conditions, immersive and desktop in a randomized controlled trial with a parallel design. The sample consisted of 134 university students (70 women, mean age 23 years, SD = 2.99). These were randomized using a covariate-adaptive randomization procedure based on stratification by gender into two interventions; play out a VR scenario in either desktop (control group) or immersive VR (intervention group). The setting was a university lab.

Results

There was a significant within subject effect for positive affect and a significant between-group effect for the immersive compared to desktop VR groups. Positive affect was reduced after interacting with the VR scenario in both the immersive and desktop versions, however, positive affect was overall higher in the immersive, compared to the desktop version. The results show higher scores for sense of presence (d = 0.90, p < 0.001) and positive affect pre- and post-scenario in the immersive VR condition (d = 0.42, p = 0.017 and d = 0.54, p = 0.002) compared to the desktop condition.

Conclusion

Immersive VR may be beneficial in higher education as it promotes high levels of sense of presence as well as positive emotions. When it comes to changing the immediate emotions of the students, type of VR does not seem to matter. The project was funded by the Norwegian Directorate for Higher Education and Skills.

Differences in virtual and physical head orientation predict sickness during active head-mounted display-based virtual reality

During head-mounted display (HMD)-based virtual reality (VR), head movements and motion-to-photon-based display lag generate differences in our virtual and physical head pose (referred to as DVP). We propose that large-amplitude, time-varying patterns of DVP serve as the primary trigger for cybersickness under such conditions. We test this hypothesis by measuring the sickness and estimating the DVP experienced under different levels of experimentally imposed display lag (ranging from 0 to 222 ms on top of the VR system's ~ 4 ms baseline lag). On each trial, seated participants made continuous, oscillatory head rotations in yaw, pitch or roll while viewing a large virtual room with an Oculus Rift CV1 HMD (head movements were timed to a computer-generated metronome set at either 1.0 or 0.5 Hz). After the experiment, their head-tracking data were used to objectively estimate the DVP during each trial. The mean, peak, and standard deviation of these DVP data were then compared to the participant's cybersickness ratings for that trial. Irrespective of the axis, or the speed, of the participant's head movements, the severity of their cybersickness was found to increase with each of these three DVP summary measures. In line with our DVP hypothesis, cybersickness consistently increased with the amplitude and the variability of our participants' DVP. DVP similarly predicted their conscious experiences during HMD VR-such as the strength of their feelings of spatial presence and their perception of the virtual scene's stability.

Multimodal Assessment of Changes in Physiological Indicators when Presenting a Video Fragment on Screen (2D) versus a VR (3D) Environment

The increasing role of virtual environments in society, especially in the context of the pandemic and evolving metaverse technologies, requires a closer study of the physiological state of humans using virtual reality (VR) for entertainment, work, or learning. Despite the fact that many physiological reactions to the content presented in various modalities under VR conditions have already been described, often these studies do not reflect the full range of changes in the physiological reactions that occur to a person during their immersion in the virtual world. This study was designed to find and compare the most sensitive physiological indicators that change when viewing an emotionally intense video fragment in standard format on screen and in virtual reality conditions (in a VR helmet). The research methodology involved randomly presenting a group of subjects with visual content-a short video clip-first on screen (2D) and then in a virtual reality helmet (3D). A special feature of this study is the use of multimodal physiological state assessment throughout the content presentation, in conjunction with psychological testing of the study participants before and after the start of the study. It has been discovered that the most informative physiological indicators reflecting the subjects' condition under virtual reality conditions were changes in theta rhythm amplitude, skin conductance, standard deviation of normal RR-intervals (SDRR), and changes in photoplethysmogram (PPG). The study results suggest that in the process of immersion in a virtual environment, the participants develop a complex functional state, different from the state when watching on screen, which is characterised by the restructuring of autonomic regulation and activation of emotion structures of the brain.

A review on ergonomics evaluations of virtual reality

BACKGROUND: Virtual reality (VR) is a combination of technologies that allow the user to interact with a computer-simulated environment with the experience of immersion, interactivity, and imagination. However, ergonomic problems related to virtual reality have adverse effects on the health and experience of users, which restrict the application of virtual reality technology. OBJECTIVE: The paper aims to provide an overview of the ergonomics evaluation of VR for further development of software and hardware of VR. METHODS: This paper describes and discusses the ergonomics issues involved in the software and hardware of VR from three aspects: visual, physiological, and cognitive. The paper also summarizes the research methods and evaluation metrics. RESULTS: Many attempts have been made to study ergonomics issues of VR, mainly including pressure, muscle fatigue, thermal comfort, visual fatigue, and motion sickness. Ergonomics studies are very valuable for research related to virtual reality. There is a summary table that lists the main evaluation metrics and methods. CONCLUSIONS: According to current research, this review gives three recommendations for further research on VR, which will be helpful for further human-centered research and design work within the VR industry.

Scientific Landscape of Embodied Experience in the Virtual Environment: A Bibliometric Analysis

The realm of architecture has been influenced by the expansion in virtual environments (VEs), along with Industry 4.0 technologies transforming human–VE interactions. Despite increasing scholarly interest in embodied experience-integrated VE, there have been few comprehensive literature reviews undertaken on VEs from a holistic experience perspective. Therefore, this article reviews the literature on the embodied experiential dimension of VEs that has become necessary to adapt theories and methodologies in a way that enhances the user experience in a VE. This study employs a bibliometric analysis to review research performance and undertake a science mapping of the literature. The 969 pieces of data retrieved from Web of Science were subjected to a performance analysis, and VOSviewer was used to visualize the intellectual structure and research themes. The results of this study emphasize the strength and growing interest in VEs from the embodied experience perspective. Another significant finding is that VE experience studies are mostly based on embodied technologies. In this paper, the results of analyses are discussed in terms of productivity, collaboration, and research themes for future. This study contributes to the literature by providing a significant theoretical reference for the potential of the embodied experience in VE research, which will mostly attract the interest of architectural design researchers.

An Immersive Virtual Reality Training Game for Power Substations Evaluated in Terms of Usability and Engagement

Safety-focused training is essential for the operation and maintenance concentrated on the reliability of critical infrastructures, such as power grids. This paper introduces and evaluates a system for power substation operational training by exploring and interacting with realistic models in virtual worlds using serious games. The virtual reality (VR) simulator used building information modelling (BIM) from a 115 kV substation to develop a scenario with high technical detail suitable for professional training. This system created interactive models that could be explored using a first-person-perspective serious game in a cave automatic virtual environment (CAVE). Different operational missions could be carried out in the serious game, allowing several skills to be coached. The suitability for vocational training carried out by utility companies was evaluated in terms of usability and engagement. The evaluation used a System Usability Scale (SUS) and a Game Engagement Questionnaire (GEQ) filled by 16 power substation operators demonstrating marginally acceptable usability, with improvement opportunities and high acceptance (by utility technicians) of this system for operation training focused on safety in such hazardous tasks.

Virtual Reality Erotica: Exploring General Presence, Sexual Presence, Sexual Arousal, and Sexual Desire in Women

Virtual reality (VR) media using a three-dimensional (3D) camera facilitates an immersive experience compared to traditional two-dimensional (2D) formats. In this novel study, we used high quality, women-centered erotica and examined whether stimulus modality (VR vs. 2D) and point of view (POV: first-person vs. third-person) impacted women's feelings of sexual presence (activation of sexual response induced by the perception of being present), sexual arousal, and sexual desire (dyadic and solitary). We also investigated the effects of stimulus modality on feelings of general presence (a sense of "being there"). Results from 38 women indicated that with medium to large effects, general presence, sexual presence, and sexual arousal were significantly higher for VR videos relative to 2D videos. Sexual presence was higher for first-person POV depending on the order of film exposure. A general trend toward increasing dyadic sexual desire over the course of the study was observed. No significant differences were observed for solitary sexual desire. These findings support the adaptability of VR media to sex research and show that it can induce feelings of sexual presence and presence more generally. That sexual arousal was positively impacted by VR erotica may have implications for addressing the limitations that accompany other stimulus modalities used to elicit sexual responses in women.

Reducing Cybersickness in 360-Degree Virtual Reality

Despite the technological advancements in Virtual Reality (VR), users are constantly combating feelings of nausea and disorientation, the so-called cybersickness. Cybersickness symptoms cause severe discomfort and hinder the immersive VR experience. Here we investigated cybersickness in 360-degree head-mounted display VR. In traditional 360-degree VR experiences, translational movement in the real world is not reflected in the virtual world, and therefore self-motion information is not corroborated by matching visual and vestibular cues, which may trigger symptoms of cybersickness. We evaluated whether a new Artificial Intelligence (AI) software designed to supplement the 360-degree VR experience with artificial six-degrees-of-freedom motion may reduce cybersickness. Explicit (simulator sickness questionnaire and Fast Motion Sickness (FMS) rating) and implicit (heart rate) measurements were used to evaluate cybersickness symptoms during and after 360-degree VR exposure. Simulator sickness scores showed a significant reduction in feelings of nausea during the AI-supplemented six-degrees-of-freedom motion VR compared to traditional 360-degree VR. However, six-degrees-of-freedom motion VR did not reduce oculomotor or disorientation measures of sickness. No changes were observed in FMS and heart rate measures. Improving the congruency between visual and vestibular cues in 360-degree VR, as provided by the AI-supplemented six-degrees-of-freedom motion system considered, is essential for a more engaging, immersive and safe VR experience, which is critical for educational, cultural and entertainment applications.

Virtual environments to study emotional responses to clinical communication: A scoping review

OBJECTIVE

This scoping review explores the potential for virtual environments (VE) to evaluate emotional outcomes in clinical communication research. Authors representing multiple disciplines use review results to propose potential research opportunities and considerations.

METHODS

We utilized a structured framework for scoping reviews. We searched four literature databases for relevant articles. We applied multidisciplinary perspectives to synthesize relevant potential opportunities for emotion-focused communications research using VE.

RESULTS

Twenty-one articles met inclusion criteria. They applied different methodological approaches, including a range of VE technologies and diverse emotional outcome measures, such as psychophysiological arousal, emotional valence, or empathy. Major research topics included use of virtual reality to provoke and measure emotional responses, train clinicians in communication skills, and increase clinician empathy.

CONCLUSION

Researchers may leverage VE technologies to ethically and systematically examine how characteristics of clinical interactions, environments, and communication impact emotional reactions and responses among patients and clinicians. Variability exists in how VE technologies are employed and reported in published literature, and this may limit the internal and external validity of the research. However, virtual reality can provide a low-cost, low-risk, experimentally controlled, and ecologically valid approach for studying clinician-patient communication.

PRACTICE IMPLICATIONS

Future research should leverage psychophysiological measures to further examine emotional responses during clinical communication scenarios and clearly report virtual environment characteristics to support evaluation of study conclusions, study replicability, and meta-analyses.

Affective Virtual Reality: How to Design Artificial Experiences Impacting Human Emotions

Computer graphics is-in many cases-about visualizing what you cannot see. However, virtual reality (VR), from its beginnings, aimed at stimulating all human senses: not just the visual channel. Moreover, this set of multisensory stimuli allows users to feel present and able to interact with the virtual environment. In this way, VR aims to deliver experiences that are comparable to real-life ones in their level of detail and stimulation, intensity, and impact. Hence, VR is not only a means to see, but also to feel differently. With the spreading of VR technologies, there is a growing interest in using VR to evoke emotions, including positive and negative ones. This article discusses the current possibilities and the authors' experience collected in the field in trying to elicit emotions through VR. It explores how different design aspects and features can be used, describing their contributions and benefits in the development of affective VR experiences. This work aims at raising awareness of the necessity to consider and explore the full design space that VR technology provides in comparison to traditional media. Additionally, it provides possible tracks of VR affective applications, illustrating how they could impact our emotions and improve our life, and providing guidelines for their development.

Emotional arousal in 2D versus 3D virtual reality environments

Previous studies have suggested that virtual reality (VR) can elicit emotions in different visual modes using 2D or 3D headsets. However, the effects on emotional arousal by using these two visual modes have not been comprehensively investigated, and the underlying neural mechanisms are not yet clear. This paper presents a cognitive psychological experiment that was conducted to analyze how these two visual modes impact emotional arousal. Forty volunteers were recruited and were randomly assigned to two groups. They were asked to watch a series of positive, neutral and negative short VR videos in 2D and 3D. Multichannel electroencephalograms (EEG) and skin conductance responses (SCR) were recorded simultaneously during their participation. The results indicated that emotional stimulation was more intense in the 3D environment due to the improved perception of the environment; greater emotional arousal was generated; and higher beta (21-30 Hz) EEG power was identified in 3D than in 2D. We also found that both hemispheres were involved in stereo vision processing and that brain lateralization existed in the processing.

Classification of Complex Emotions Using EEG and Virtual Environment: Proof of Concept and Therapeutic Implication

During the last decades, neurofeedback training for emotional self-regulation has received significant attention from scientific and clinical communities. Most studies have investigated emotions using functional magnetic resonance imaging (fMRI), including the real-time application in neurofeedback training. However, the electroencephalogram (EEG) is a more suitable tool for therapeutic application. Our study aims at establishing a method to classify discrete complex emotions (e.g., tenderness and anguish) elicited through a near-immersive scenario that can be later used for EEG-neurofeedback. EEG-based affective computing studies have mainly focused on emotion classification based on dimensions, commonly using passive elicitation through single-modality stimuli. Here, we integrated both passive and active elicitation methods. We recorded electrophysiological data during emotion-evoking trials, combining emotional self-induction with a multimodal virtual environment. We extracted correlational and time-frequency features, including frontal-alpha asymmetry (FAA), using Complex Morlet Wavelet convolution. Thinking about future real-time applications, we performed within-subject classification using 1-s windows as samples and we applied trial-specific cross-validation. We opted for a traditional machine-learning classifier with low computational complexity and sufficient validation in online settings, the Support Vector Machine. Results of individual-based cross-validation using the whole feature sets showed considerable between-subject variability. The individual accuracies ranged from 59.2 to 92.9% using time-frequency/FAA and 62.4 to 92.4% using correlational features. We found that features of the temporal, occipital, and left-frontal channels were the most discriminative between the two emotions. Our results show that the suggested pipeline is suitable for individual-based classification of discrete emotions, paving the way for future personalized EEG-neurofeedback training.

Proof-of-Concept of the Virtual Reality Comprehensive Balance Assessment and Training for Sensory Organization of Dynamic Postural Control

Accurate quantification of the impact of visual, somatosensory, and vestibular systems on postural control may inform tailor-made balance intervention strategies. The aim of this proof-of-concept study was to determine the safety, sense of presence, system usability, and face validity of a newly developed Virtual Reality Comprehensive Balance Assessment and Training (VR-ComBAT) in healthy young individuals. The VR-ComBAT included six balance condition: (1) stable surface with fixed virtual reality (VR) surroundings; (2) stable surface with blacked out VR surroundings; (3) stable surface with VR visual conflict; (4) unstable surface with fixed VR surroundings; (5) unstable surface with blacked out VR surroundings; and (6) unstable surface with VR visual conflict. Safety was evaluated using the number of adverse events, including scores on the Simulator Sickness Questionnaire. Sense of presence was evaluated using the igroup Presence Questionnaire (iPQ). System usability was assessed using the Systems Usability Scale (SUS). Friedman analyses with post hoc Wilcoxon Signed Rank tests were employed to demonstrate face validity by quantifying center of pressure (COP) changes in mean distance, mean velocity, and mean frequency in the anteroposterior (AP) and mediolateral (ML) direction across the six conditions. Twenty-three participants (27.4 ± 8.0 years old; 13 women) reported no adverse events. Participants scores on average 44.9 ± 9.6 on the iPQ and 79.7 ± 9.9 on the SUS. Post hoc analyses showed significant changes in COP-based measures when compared to baseline. The mean frequency change of COP showed direction-dependence in which increased frequency change in AP was observed while decreased change in ML was noted. The VR-ComBAT provides a safe, feasible, and cost-effective VR environment that demonstrates consistent sensory re-weighting between visual, somatosensory, and vestibular systems. Future studies should investigate whether VR-ComBAT can be used to inform precision rehabilitation of balance and fall prevention in older adults without and with neurological conditions.

Acceptance and Usability of Immersive Virtual Reality in Older Adults with Objective and Subjective Cognitive Decline

Background: Virtual reality (VR) has recently emerged as a promising means for the administration of cognitive training of seniors at risk of dementia. Immersive VR could result in increased engagement and performances; however, its acceptance in older adults with cognitive deficits still has to be assessed. Objective: To assess acceptance and usability of an immersive VR environment requiring real walking and active participants’ interaction. Methods: 58 seniors with mild cognitive impairment (MCI, n = 24) or subjective cognitive decline (SCD, n = 31) performed a shopping task in a virtual supermarket displayed through a head-mounted display. Subjective and objective outcomes were evaluated. Results: Immersive VR was well-accepted by all but one participant (TAM3 positive subscales > 5.33), irrespective of the extent of cognitive decline. Participants enjoyed the experience (spatial presence 3.51±0.50, engagement 3.85±0.68, naturalness 3.85±0.82) and reported negligible side-effects (SSQ: 3.74; q1-q3:0–16.83). The environment was considered extremely realistic, such as to induce potentially harmful behaviors: one participant fell while trying to lean on a virtual shelf. Older participants needed more time to conclude trials. Participants with MCI committed more errors in grocery items’ selection and experienced less “perceived control” over the environment. Conclusion: Immersive VR was acceptable and enjoyable for older adults in both groups. Cognitive deficits could induce risky behaviors, and cause issues in the interactions with virtual items. Further studies are needed to confirm acceptance of immersive VR in individuals at risk of dementia, and to extend the results to people with more severe symptoms.

Application of Virtual Environments for Biophilic Design: A Critical Review

Biophilic design as a new design approach promotes the integration of natural elements into the built environment, leading to a significant impact on human health, well-being, and productivity. On the other hand, scholars have explored Virtual Environment (VE) to create virtual nature and provide a complex experience of exposure to natural elements virtually. However, there is a lack of understanding about such studies in general, which use VE as a reliable tool to support biophilic design. Thus, the authors conducted a literature review on the applications, capabilities, and limitations of VE for biophilic design. The literature review shows that VE is capable of supporting critical features of biophilic design studies such as representing combinations of biophilic patterns, providing multimodal sensory inputs, simulating stress induction tasks, supporting required exposure time to observe biophilic patterns, and measuring human’s biological responses to natural environment. However, factors affecting user’s experience of a virtual biophilic environment exist, such as VE experience dimensions, user-related factors, cybersickness, navigational issues, and possible limitations of VE sensory input. Overall, biophilic design studies in VEs are still limited. Nevertheless, there are many opportunities for further research in this field.

Exploring the Use of Virtual Reality to Support Environmentally Sustainable Behavior: A Framework to Design Experiences

The current and future challenges of sustainable development require a massive transformation of habits and behaviors in the whole society at many levels. This demands a change of perspectives, priorities, and practices that can only result from the development of more aware, informed, and instructed communities and individuals. The field of design for sustainable behavior is answering this need through the development of products, systems, and services to support the change of people’s habits and decision-making processes. In this regard, Virtual Reality (VR) is a promising tool: it has already been explored to drive sustainable behavior change in several situations, through a wide range of devices, technologies, and modalities. This variety provides uncountable opportunities to designers, but it comes with a series of ethical, psychological, and technical questions. Hence, VR developers should be able to distinguish and identify possible strategies, delivering suitable solutions for each case study. In this work, we present a framework for the development of VR experiences to support sustainable behavior change, based on a systematic review. We consider the various features to manage and possible alternatives when creating a VR experience, linking them to the behavioral aspects that can be addressed according to the project’s aim. The framework will provide designers with a tool to explore and orient themselves towards possible sets of optimal choices generating tailored solutions.

Moving foraging into three dimensions: Feature- versus conjunction-based foraging in virtual reality

Visual attention evolved in a three-dimensional (3D) world, yet studies on human attention in three dimensions are sparse. Here we present findings from a human foraging study in immersive 3D virtual reality. We used a foraging task introduced in Kristjánsson et al. to examine how well their findings generalise to more naturalistic settings. The second goal was to examine what effect the motion of targets and distractors has on inter-target times (ITTs), run patterns, and foraging organisation. Observers foraged for 50 targets among 50 distractors in four different conditions. Targets were distinguished from distractors by either a single feature (feature foraging) or a conjunction of features (conjunction foraging). Furthermore, those conditions were performed both with static and moving targets and distractors. Our results replicate previous foraging studies in many aspects, with constant ITTs during a "cruise-phase" within foraging trials and response time peaks at the end of foraging trials. Some key differences emerged, however, such as more frequent switches between target types during conjunction foraging than previously seen and a lack of clear mid-peaks during conjunction foraging, possibly reflecting that differences between feature and conjunction processing are smaller within 3D environments. Observers initiated their foraging in the bottom part of the visual field and motion did not have much of an effect on selection times between different targets (ITTs) or run behaviour patterns except for the end-peaks. Our results cast new light upon visual attention in 3D environments and highlight how 3D virtual reality studies can provide important extensions to two-dimensional studies of visual attention.

Impact of Body Size Match to an Avatar on the Body Ownership Illusion and User's Subjective Experience

The current study sought to investigate the effects of matching body movement and body size between an avatar and a participant on the body ownership illusion (BOI), the body size illusion, the sense of presence, simulator sickness, and emotional responses within an immersive virtual reality (IVR). Forty participants experienced their life-sized virtual avatars from a first-person perspective using a full-body motion-capture system. The experiment used a 2 (Motion: Synchrony and Asynchrony) × 2 (Size: Matched and Unmatched) within-subject design. Each participant completed a self-reported questionnaire that evaluated BOI, body size illusion, presence, simulator sickness, and emotional valence. Results showed that matching participant's motion to that of an avatar increased the BOI and sense of presence, while reducing simulator sickness. Furthermore, participants reported more positive emotions when motion was synchronized to the virtual avatar. Most notably, synchronizing body movement between participants and avatars resulted in strong body size illusion even when the body size of an avatar was larger than the one of a participant. To the best of our knowledge, this is the first study to directly link synchronization of user motion and body size to a virtual avatar with user's subjective experience (BOI, body size illusion, sense of presence, simulator sickness, and valence) in IVR. Our findings suggest beneficial effects of synchronized body motion and matched body size between a user and avatar on user's subjective experience in IVR, which can possibly boost the effects of virtual reality applications in the fields of entertainment, psychotherapy, and education.

Assessing the emotional impact of virtual reality-based teacher training

Purpose

The purpose of this paper is to propose the use of a virtual reality (VR)-based approach to improve teacher education and life-long professional development. Through constant training in real-life based situations but within a safe three-dimensional virtual school environment, teachers are given the opportunity to experience and learn how to react to different types of incidents that may take place in a school environment.

Design/methodology/approach

The current paper presents the design cycle that was followed for the implementation of the VR teacher training system. The effectiveness of the proposed approach is demonstrated with a case study that aimed to promote teachers’ understanding of student’s problematic situations related to substance use. As part of the experimental investigation, the impact of the VR system on participants’ emotions and mood states is evaluated through Electroencephalogram (EEG) measurements, heart rate (HR) recordings and self-reported data.

Findings

Results indicate significant changes to participant’s negative emotional and mood states, suggesting that the scenario and the VR experience had a strong impact on them. Moreover, participants’ HR was increased during the experiment, while the analysis of the EEG signal indicated that the participants experienced a stressful situation that could justify the change in their negative emotions and mood states.

Originality/value

The proposed VR-based approach aims to provide an innovative framework to teacher education and the related training methodology. In the long-term, the proposed VR system aims to form a new paradigm of teacher training, an alternative safe method that will allow user-teachers to learn through trial and error techniques that reflect real-life situations within a three-dimensional school space and without the risk of harming real students. To the best of our knowledge this is one of the first systematic attempts to use a VR-based methodology to address real teachers’ needs. The development of the VR application is linked to both strong theoretical foundations in education derived from the literature but also from real teachers’ problems and requirements derived from an extensive literature analysis, survey and interviews with experts including teachers, school counselors and psychologists. The VR tool addresses specific teachers’ competences as outcome, after an extensive documentation of existing Teachers’ Competence Models and significant guidance by experts who pointed specific competencies of primary importance to teachers.

Joint Attention Virtual Classroom: A Preliminary Study

OBJECTIVE

Previous studies have suggested that a virtual classroom is immersive and ecologically valid neuropsychological assessment, but those studies have limited components for social attentions. Therefore, the objective in the current study is the development of a joint attention virtual reality (JA-VR) classroom to incorporate social attentions between a participant and a virtual avatar teacher.

METHODS

Fifty-eight participants were recruited for current study (25 for pilot and 33 for main studies; 32.8% female, n=19; age: M=24.5, SD=4.0). We suggested a JA-VR classroom, and compared it with previous methods including a VR classroom without JA components. We conducted attention experiments with AX-version of continuous performance tasks.

RESULTS

Our results suggest that the new JA-VR classroom had convergent validity with previous methods, and that the JA-VR classroom promoted attentional processing among participants better than both old VR and non-VR measures.

CONCLUSION

We add an important social attention concept to the virtual classroom, and believe that this work is an methodological foundation for the study of social attention in school life. We hope it ultimately help people with mental handicaps in social attention.

Spatial Learning and Memory Using a Radial Arm Maze with a Head-Mounted Display

OBJECTIVE

A radial arm maze (RAM) is an essential tool for assessing spatial learning and memory. Although this tool is widely used to study deficits in spatial memory in animal models, it has several restrictions that prevent its adaptation to human research and training. Therefore, we developed a head-mounted-display RAM (HMD-RAM) program for humans and verified its validity by comparing it to the results obtained by previous RAM studies. We also compared the HMD and a flat monitor as experimental devices.

METHODS

Forty participants were recruited for the current study (Study 1: 20 participants with the HMD device; Study 2: 20 participants with the flat monitor). They navigated a virtual room as a first-person viewer and used environmental landmarks to remember their spatial position and orientation. The main dependent measures were working memory error, reference memory error, detection time, travel distance, and participant's head movements. To validate the program, participants also conducted neuropsychological assessments and self-reported measures.

RESULTS

The results for HMD-RAM tasks were consistent with the results of previous research conducted on animals, and the HMD elicited a higher sense of presence, immersion, and simulator sickness than the flat monitor. According to post-experiment questions on navigation strategy, creating landmarks was important when people were discovering locations in their environment, and an HMD was beneficial for better navigation strategy.

CONCLUSION

These results suggest that the HMD-RAM is valuable for estimating spatial learning and memory in humans and may be a useful tool for early diagnosis of deficits in spatial learning and memory, including amnestic mild cognitive impairment and Alzheimer's disease.

Measuring visual search and distraction in immersive virtual reality

An important issue of psychological research is how experiments conducted in the laboratory or theories based on such experiments relate to human performance in daily life. Immersive virtual reality (VR) allows control over stimuli and conditions at increased ecological validity. The goal of the present study was to accomplish a transfer of traditional paradigms that assess attention and distraction to immersive VR. To further increase ecological validity we explored attentional effects with daily objects as stimuli instead of simple letters. Participants searched for a target among distractors on the countertop of a virtual kitchen. Target-distractor discriminability was varied and the displays were accompanied by a peripheral flanker that was congruent or incongruent to the target. Reaction time was slower when target-distractor discriminability was low and when flankers were incongruent. The results were replicated in a second experiment in which stimuli were presented on a computer screen in two dimensions. The study demonstrates the successful translation of traditional paradigms and manipulations into immersive VR and lays a foundation for future research on attention and distraction in VR. Further, we provide an outline for future studies that should use features of VR that are not available in traditional laboratory research.

Behavioral Monitoring of Sexual Offenders Against Children in Virtual Risk Situations: A Feasibility Study

The decision about unsupervised privileges for sexual offenders against children (SOC) is one of the most difficult decisions for practitioners in forensic high-security hospitals. Facing the possible consequences of the decision for the society, a valid and reliable risk management of SOCs is essential. Some risk management approaches provide frameworks for the construction of relevant future risk situations. Due to ethical reasons, it is not possible to evaluate the validity of constructed risk situations in reality. The aim of the study was to test if behavioral monitoring of SOCs in high-immersive virtual risk situations provides additional information for risk management. Six SOCs and seven non-offender controls (NOC) walked through three virtual risk situations, confronting the participant with a virtual child character. The participant had to choose between predefined answers representing approach or avoidance behavior. Frequency of chosen answers were analyzed in regards to knowledge of the participants about coping skills and coping skills focused during therapy. SOCs and NOCs behavior differed only in one risk scenario. Furthermore, SOCs showed in 89% of all cases a behavior not corresponding to their own belief about adequate behavior in comparable risk situations. In 62% of all cases, SOCs behaved not corresponding to coping skills they stated that therapists focused on during therapy. In 50% of all cases, SOCs behaved in correspondence to coping skills therapists stated that they focused on during therapy. Therapists predicted the behavior of SOCs in virtual risk situations incorrect in 25% of all cases. Thus, virtual risk scenarios provide the possibility for practitioners to monitor the behavior of SOCs and to test their decisions on unsupervised privileges without endangering the community. This may provide additional information for therapy progress. Further studies are necessary to evaluate the predictive and ecological validity of behavioral monitoring in virtual risk situations for real life situations.

Effects of Different Types of Virtual Reality Display on Presence and Learning in a Safety Training Scenario

The increasing availability of head-mounted displays (HMDs) for home use motivates the study of the possible effects that adopting this new hardware might have on users. Moreover, while the impact of display type has been studied for different kinds of tasks, it has been scarcely explored in procedural training. Our study considered three different types of displays used by participants for training in aviation safety procedures with a serious game. The three displays were respectively representative of: (i) desktop VR (a standard desktop monitor), (ii) many setups for immersive VR used in the literature (an HMD with narrow field of view and a 3-DOF tracker), and (iii) new setups for immersive home VR (an HMD with wide field of view and 6-DOF tracker). We assessed effects on knowledge gain, and different self-reported measures (self-efficacy, engagement, presence). Unlike previous studies of display type that measured effects only immediately after the VR experience, we considered also a longer time span (2 weeks). Results indicated that the display type played a significant role in engagement and presence. The training benefits (increased knowledge and self-efficacy) were instead obtained, and maintained at two weeks, regardless of the display used. The paper discusses the implications of these results.

Thermoregulation and nausea

The major symptoms of motion sickness are well known and include facial pallor, nausea and vomiting, and sweating, but it is poorly recognized that they actually reflect severely perturbed thermoregulation. Thus, the purpose of this chapter is to present and discuss existing data related to this subject. While hypothermia during seasickness was first noted nearly 150 years ago, detailed studies of this phenomenon were conducted only during the last two decades. Our own research confirmed that motion sickness-induced hypothermia is quite broadly expressed phylogenetically as, besides humans, it could be provoked in several other animals (rats, musk shrews, and mice). Evidence from human and animal experiments indicates that the physiologic mechanisms responsible for the motion sickness-induced hypothermia include cutaneous vasodilation and sweating (leading to an increase of heat loss) and reduced thermogenesis. Together, these results suggest that motion sickness triggers a highly coordinated physiologic response aiming to reduce body temperature. The chapter is concluded by presenting hypotheses of how and why motion sickness evokes this hypothermic response.

Computer tool to evaluate the cue reactivity of chemically dependent individuals

BACKGROUND AND OBJECTIVE

Anxiety is one of the major influences on the dropout of relapse and treatment of substance abuse treatment. Chemically dependent individuals need (CDI) to be aware of their emotional state in situations of risk during their treatment. Many patients do not agree with the diagnosis of the therapist when considering them vulnerable to environmental stimuli related to drugs. This research presents a cue reactivity detection tool based on a device acquiring physiological signals connected to personal computer. Depending on the variations of the emotional state of the drug addict, alteration of the physiological signals will be detected by the computer tool (CT) which will modify the displayed virtual sets without intervention of the therapist.

METHODS

Developed in 3ds Max® software, the CT is composed of scenarios and objects that are in the habit of marijuana and cocaine dependent individual's daily life. The interaction with the environment is accomplished using a Human-Computer Interface (HCI) that converts incoming physiological signals indicating anxiety state into commands that change the scenes. Anxiety was characterized by the average variability from cardiac and respiratory rate of 30 volunteers submitted stress environment situations. To evaluate the effectiveness of cue reactivity a total of 50 volunteers who were marijuana, cocaine or both dependent were accompanied.

RESULTS

Prior to CT, the results demonstrated a poor correlation between the therapists' predictions and those of the chemically dependent individuals. After exposure to the CT, there was a significant increase of 73% in awareness of the risks of relapse.

CONCLUSION

We confirmed the hypothesis that the CT, controlled only by physiological signals, increases the perception of vulnerability to risk situations of individuals with dependence on marijuana, cocaine or both.

Human field of regard, field of view, and attention bias

BACKGROUND AND OBJECTIVE

Human field of regard (FOR) is an important concept that should be considered along with field of view (FOV) for people with/without handicaps, but previous studies have neglected this aspect of human perception. In the current study, we suggest and test a new virtual reality (VR) software with which to evaluate individual's detection abilities in the human FOR.

METHODS

We conducted measurements of human FOV, FOR, and FOR with visual cue (FOR-cue), and we evaluated healthy adults' responses in a first experiment. Participants were asked to detect targets on a head-mounted display (HMD) as quickly as possible in three conditions: (a) FOV: the head rotation doesn't change the view of the screen in the HMD; (b) FOR: the head rotation changes the view of the screen in the HMD; and (c) FOR-cue: same with the FOR condition but an endogenous visual cue indicating the direction of stimulus. To address the need to increase the number of trials in the FOR condition, we also conducted a second experiment with new samples and four times of trial numbers.

RESULTS

The participants' detection time results indicated that the FOV condition was faster than the FOR-cue and FOR conditions, and the FOR-cue was faster than the FOR condition. Interestingly, we found a unique characteristic in the FOR conditions that did not exist in the FOV condition: The target responses were faster for the left side than the right side. The results of the second experiment were consistent with the first, and head motion trajectory analysis showed that participants had more movement toward the left side than the right side in the early parts of each trial.

CONCLUSIONS

In this study, we suggested a new virtual reality (VR) evaluation technique and measured the human searching pattern in the FOR condition. We found a unique left-side attention bias in the FOR condition, and discussed implication of these results and potential attention bias factors. We believe this work is an important foundation for interactive 3D UI design, and we hope it will help people who have FOR handicaps.

The effect of an integrated education model on anxiety and uncertainty in patients undergoing cervical disc herniation surgery

BACKGROUND

Educating patients about receiving surgical procedures is becoming an important issue, as it can reduce anxiety and uncertainty while helping to hasten decisions for undergoing time sensitive surgeries. We evaluated a new integrated education model for patients undergoing cervical disc herniation surgery using a quasi-experimental design.

METHODS

The participants were grouped into either the new integrated educational model (n = 32) or the standard group (n = 32) on the basis of their ward numbers assigned at admission. Anxiety, uncertainty, and patient satisfaction were measured before (pre-test) and after the educational intervention (post-test-1) and post-surgery (post-test-2) to assess the effectiveness of the model in this intervention.

RESULTS

We found that the generalized estimating equation modeling demonstrated this new integrated education model was more effective than the conventional model in reducing patients' anxiety and uncertainty (p <0.05). Patients were also more satisfied with our newly developed model as it takes a more holistic approach to individual health.

CONCLUSION

This novel systemic educational model enhances patient's understanding of the medical condition and surgery while promoting patient-caregiver interaction for optimal patient health outcomes. We present a comprehensive and consistent platform for educational purposes in patients undergoing surgery as well as reducing the psychological burden from anxiety and uncertainty. Integrating medicine, nursing, and new technologies into an e-practice and e-learning platform offers the potential of easier understanding and usage. It could revolutionize patient education in the future.

Feasibility of a walking virtual reality system for rehabilitation: objective and subjective parameters

BACKGROUND

Even though virtual reality (VR) is increasingly used in rehabilitation, the implementation of walking navigation in VR still poses a technological challenge for current motion tracking systems. Different metaphors simulate locomotion without involving real gait kinematics, which can affect presence, orientation, spatial memory and cognition, and even performance. All these factors can dissuade their use in rehabilitation. We hypothesize that a marker-based head tracking solution would allow walking in VR with high sense of presence and without causing sickness. The objectives of this study were to determine the accuracy, the jitter, and the lag of the tracking system and its elicited sickness and presence in comparison of a CAVE system.

METHODS

The accuracy and the jitter around the working area at three different heights and the lag of the head tracking system were analyzed. In addition, 47 healthy subjects completed a search task that involved navigation in the walking VR system and in the CAVE system. Navigation was enabled by natural locomotion in the walking VR system and through a specific device in the CAVE system. An HMD was used as display in the walking VR system. After interacting with each system, subjects rated their sickness in a seven-point scale and their presence in the Slater-Usoh-Steed Questionnaire and a modified version of the Presence Questionnaire.

RESULTS

Better performance was registered at higher heights, where accuracy was less than 0.6 cm and the jitter was about 6 mm. The lag of the system was 120 ms. Participants reported that both systems caused similar low levels of sickness (about 2.4 over 7). However, ratings showed that the walking VR system elicited higher sense of presence than the CAVE system in both the Slater-Usoh-Steed Questionnaire (17.6 ± 0.3 vs 14.6 ± 0.6 over 21, respectively) and the modified Presence Questionnaire (107.4 ± 2.0 vs 93.5 ± 3.2 over 147, respectively).

CONCLUSIONS

The marker-based solution provided accurate, robust, and fast head tracking to allow navigation in the VR system by walking without causing relevant sickness and promoting higher sense of presence than CAVE systems, thus enabling natural walking in full-scale environments, which can enhance the ecological validity of VR-based rehabilitation applications.

Immersive Virtual Environment Technology to Supplement Environmental Perception, Preference and Behavior Research: A Review with Applications

Immersive virtual environment (IVE) technology offers a wide range of potential benefits to research focused on understanding how individuals perceive and respond to built and natural environments. In an effort to broaden awareness and use of IVE technology in perception, preference and behavior research, this review paper describes how IVE technology can be used to complement more traditional methods commonly applied in public health research. The paper also describes a relatively simple workflow for creating and displaying 360° virtual environments of built and natural settings and presents two freely-available and customizable applications that scientists from a variety of disciplines, including public health, can use to advance their research into human preferences, perceptions and behaviors related to built and natural settings.

Virtual Viewing Time: The Relationship between Presence and Sexual Interest in Androphilic and Gynephilic Men

Virtual Reality (VR) has successfully been used in the research of human behavior for more than twenty years. The main advantage of VR is its capability to induce a high sense of presence. This results in emotions and behavior which are very close to those shown in real situations. In the context of sex research, only a few studies have used high-immersive VR so far. The ones that did can be found mostly in the field of forensic psychology. Nevertheless, the relationship between presence and sexual interest still remains unclear. The present study is the first to examine the advantages of high-immersive VR in comparison to a conventional standard desktop system regarding their capability to measure sexual interest. 25 gynephilic and 20 androphilic healthy men underwent three experimental conditions, which differed in their ability to induce a sense of presence. In each condition, participants were asked to rate ten male and ten female virtual human characters regarding their sexual attractiveness. Without their knowledge, the subjects' viewing time was assessed throughout the rating. Subjects were then asked to rate the sense of presence they had experienced as well as their perceived realism of the characters. Results suggested that stereoscopic viewing can significantly enhance the subjective sexual attractiveness of sexually relevant characters. Furthermore, in all three conditions participants looked significantly longer at sexually relevant virtual characters than at sexually non-relevant ones. The high immersion condition provided the best discriminant validity. From a statistical point of view, however, the sense of presence had no significant influence on the discriminant validity of the viewing time task. The study showed that high-immersive virtual environments enhance realism ratings as well as ratings of sexual attractiveness of three-dimensional human stimuli in comparison to standard desktop systems. Results also show that viewing time seems to be influenced neither by sexual attractiveness nor by realism of stimuli. This indicates how important task specific mechanisms of the viewing time effect are.

Motion sickness, nausea and thermoregulation: The "toxic" hypothesis

Principal symptoms of motion sickness in humans include facial pallor, nausea and vomiting, and sweating. It is less known that motion sickness also affects thermoregulation, and the purpose of this review is to present and discuss existing data related to this subject. Hypothermia during seasickness was firstly noted nearly 150 years ago, but detailed studies of this phenomenon were conducted only during the last 2 decades. Motion sickness-induced hypothermia is philogenetically quite broadly expressed as besides humans, it has been reported in rats, musk shrews and mice. Evidence from human and animal experiments indicates that the physiological mechanisms responsible for the motion sickness-induced hypothermia include cutaneous vasodilation and sweating (leading to an increase of heat loss) and reduced thermogenesis. Together, these results suggest that motion sickness triggers highly coordinated physiological response aiming to reduce body temperature. Finally, we describe potential adaptive role of this response, and describe the benefits of using it as an objective measure of motion sickness-induced nausea.