Eye contact in virtual reality – A psychophysiological study

Virtual Reality Simulation in Interprofessional Pediatric Cardiology Education

Introduction In acute care settings, pediatric congenital heart patients require comprehensive team-based care. Physicians and advanced practice providers (APPs) co-manage these patients in the same manner. However, there may be few opportunities to train together. Virtual reality (VR) simulation in the pediatric cardiology setting offers a portable, immersive experience and can be a cost-saving alternative to traditional manikin-based simulation. We sought to study the effectiveness of VR as a tool for providing interprofessional education to physicians and APPs working with cardiology patients in both the cardiac intensive care unit (CICU) and the emergency department (ED). Methods Physicians and APP pairs who clinically manage pediatric cardiology patients in the emergency department, cardiology acute care, and CICUs were identified to participate in two of eight VR simulations developed by a stand-alone pediatric hospital. The APP specialty was used to determine the appropriate selection of simulations for each provider pair. Four scenarios were designed in a virtual CICU, and four were in a virtual ED. Each physician-APP pair met for one hour, during which a 10-minute orientation, a five- to 10-minute simulation, a 10-minute debrief, and a second simulation were conducted. Each simulation was based on actual clinical situations, including five priority objectives for patient management to be met in five minutes or less, and whether a physician or APP initiated each objective was recorded. Following the VR simulations, participants completed a debrief and exit questionnaire. Results Seventeen physician-APP pairs participated in 33 simulations. An average of 3.4 objectives were met across all scenarios. Of the objectives met, 41% were initiated by an APP. Thirty-one participants completed post-simulation surveys. All agreed or strongly agreed that the VR environment enhanced their simulation experience and believed VR-based simulation could be useful for education in various pediatric settings. Conclusion Virtual reality simulation offers an immersive educational experience for providers across different professions within a pediatric cardiology setting. Further endeavors include evaluating bedside nurses' use of VR and comparing the use of VR with manikin-based approaches.

Psychophysiological responses to eye contact with a humanoid robot: Impact of perceived intentionality

Eye contact with a social robot has been shown to elicit similar psychophysiological responses to eye contact with another human. However, it is becoming increasingly clear that the attention- and affect-related psychophysiological responses differentiate between direct (toward the observer) and averted gaze mainly when viewing embodied faces that are capable of social interaction, whereas pictorial or pre-recorded stimuli have no such capability. It has been suggested that genuine eye contact, as indicated by the differential psychophysiological responses to direct and averted gaze, requires a feeling of being watched by another mind. Therefore, we measured event-related potentials (N170 and frontal P300) with EEG, facial electromyography, skin conductance, and heart rate deceleration responses to seeing a humanoid robot's direct versus averted gaze, while manipulating the impression of the robot's intentionality. The results showed that the N170 and the facial zygomatic responses were greater to direct than to averted gaze of the robot, and independent of the robot's intentionality, whereas the frontal P300 responses were more positive to direct than to averted gaze only when the robot appeared intentional. The study provides further evidence that the gaze behavior of a social robot elicits attentional and affective responses and adds that the robot's seemingly autonomous social behavior plays an important role in eliciting higher-level socio-cognitive processing.

Examination of gaze behaviour in social anxiety disorder using a virtual reality eye-tracking paradigm: protocol for a casecontrol study

INTRODUCTION

Social anxiety disorder (SAD) has an early onset, a high lifetime prevalence, and may be a risk factor for developing other mental disorders. Gaze behaviour is considered an aberrant feature of SAD. Eye-tracking, a novel technology device, enables recording eye movements in real time, making it a direct and objective measure of gaze behaviour. Virtual reality (VR) is a promising tool for assessment and diagnostic purposes. Developing an objective screening tool based on examination of gaze behaviour in SAD may potentially aid early detection. The objective of this current study is, therefore to examine gaze behaviour in SAD utilising VR.

METHODS AND ANALYSIS

A case-control study design is employed in which a clinical sample of 29 individuals with SAD will be compared with a matched healthy control group of 29 individuals. In the VR-based eye-tracking paradigm, participants will be presented to stimuli consisting of high-res 360° 3D stereoscopic videos of three social-evaluative tasks designed to elicit social anxiety. The study will investigate between-group gaze behaviour differences during stimuli presentation.

ETHICS AND DISSEMINATION

The study has been approved by the National Committee on Health Research Ethics for the Capital Region of Denmark (H-22041443). The study has been preregistered on OSF registries: https://doi.org/10.17605/OSF.IO/XCTAKAll participants will be provided with written and oral information. Informed consent is required for all the participants. Participation is voluntarily, and the participants can at any time terminate their participation without any consequences. Study results; positive, negative or inconclusive will be published in relevant scientific journals.

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.

A survey of challenges and methods for Quality of Experience assessment of interactive VR applications

User acceptance of virtual reality (VR) applications is dependent on multiple aspects, such as usability, enjoyment, and cybersickness. To fully realize the disruptive potential of VR technology in light of recent technological advancements (e.g., advanced headsets, immersive graphics), gaining a deeper understanding of underlying factors and dimensions impacting and contributing to the overall end-user experience is of great benefit to hardware manufacturers, software and content developers, and service providers. To provide insight into user behaviour and preferences, researchers conduct user studies exploring the influence of various user-, system-, and context-related factors on the overall Quality of Experience (QoE) and its dimensions. When planning and executing such studies, researchers are faced with numerous methodological challenges related to study design aspects, such as specification of dependant and independent variables, subjective and objective assessment methods, preparation of test materials, test environment, and participant recruitment. Approaching these challenges from a multidisciplinary perspective, this paper reviews different aspects of performing perception-based QoE assessment for interactive VR applications and presents options and recommendations for research methodology design. We provide an overview of different influence factors and dimensions that may affect the overall QoE, with a focus on presence, immersion, and discomfort. Furthermore, we address ethical and practical issues regarding participant choice and test material, present different assessment methods and measures commonly used in VR research, and discuss approaches to choosing study duration and location. Lastly, we provide a concise analysis of key challenges that need to be addressed in future studies centered around VR QoE.

Age-related changes in gaze behaviour during social interaction: An eye-tracking study with an embodied conversational agent

Previous research has highlighted age-related differences in social perception, in particular emotional expression processing. To date, such studies have largely focused on approaches that use static emotional stimuli that the participant has to identify passively without the possibility of any interaction. In this study, we propose an interactive virtual environment to better address age-related variations in social and emotional perception. A group of 22 young (18-30 years) and 20 older (60-80 years) adults were engaged in a face-to-face conversation with an embodied conversational agent. Participants were invited to interact naturally with the agent and to identify his facial expression. Their gaze behaviour was captured by an eye-tracking device throughout the interaction. We also explored whether the Big Five personality traits (particularly extraversion) and anxiety modulated gaze during the social interaction. Findings suggested that age-related differences in gaze behaviour were only apparent when decoding social signals (i.e., listening to a partner's question, identifying facial expressions) and not when communicating social information (i.e., when speaking). Furthermore, higher extraversion levels consistently led to a shorter amount of time gazing towards the eyes, whereas higher anxiety levels led to slight modulations of gaze only when participants were listening to questions. Face-to-face conversation with virtual agents can provide a more naturalistic framework for the assessment of online socio-emotional interaction in older adults, which is not easily observable in classical offline paradigms. This study provides novel and important insights into the specific circumstances in which older adults may experience difficulties in social interactions.