A meta-analysis of virtual reality training programs

Enhancing cancer care through a knowledge-sharing model: a systematic review of Project ECHO® programmes in India

BACKGROUND

Cancer poses a life-threatening public health challenge, particularly impacting low- and middle-income countries (LMICs). This study focuses on India, where the cancer burden is substantial, with approximately 1.2 million new cancer cases recorded in 2020, emphasising the urgent need for effective prevention, early detection, treatment, and support services. The lack of local workforce capacity in rural areas exacerbates this challenge, necessitating collaborative efforts. The nonprofit organization Extension for Community Healthcare Outcomes (ECHO) employs the 'Hub and Spoke' model in India to bridge gaps in cancer care. The review aimed to assess the scale and impact of ECHO's initiatives, evaluate findings, examine the model's implementation, and assess its acceptability among healthcare professionals (HCPs) in preventing and treating cancer.

METHOD

This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight studies, comprising six quasi-experimental and two observational studies, employing the ECHO Model for cancer care training programmes were identified. The quality of the selected articles was assessed using a standardized critical appraisal tool developed by the Joanna Briggs Institute (JBI).

RESULTS

The findings reveal that ECHO India actively collaborates with experts and institutions, conducting programmes and webinars in 12 states/Union Territories to enhance professionals' expertise in cancer care. Published literature, though limited, emphasises ECHO's training impact, with knowledge gains ranging from 7% to 51%. The model's adoption, retention, and reach are evident through 24 institutes/hubs implementing ECHO programmes in oncology. However, challenges such as low pre post assessment response rate and internet connectivity were observed.

CONCLUSION

ECHO India's work in cancer care is substantial, addressing gaps in workforce capacity. The systematic review highlights the need for more publications to capture ECHO's impact comprehensively. The findings contribute valuable insights to ongoing efforts to reduce India's cancer burden and improve the well-being of its population.

Immersive virtual reality is more effective than non-immersive devices for developing real-world skills in people with intellectual disability

BACKGROUND

People with intellectual disability (ID) demonstrate persistent challenges around developing life skills. Immersive virtual reality (IVR) is gaining interest as a tool for training life skills as it enables individuals to engage in hands-on learning in a safe, controlled and repeatable environment. However, there are concerns about the potential drawbacks of IVR, such as cybersickness and practical challenges with using the equipment, which may hinder its widespread adoption in educational settings. The current study aimed to compare the effectiveness of training in IVR and a non-immersive virtual environment for improving real-world skills in people with ID.

METHODS

In the present study, 36 adults (16 female, 20 male) with ID were recruited from a disability organisation. Participants completed a real-world assessment of waste management skills before and after training in either the IVR or non-immersive group.

RESULTS

Consistent with our hypotheses, the IVR group scored significantly higher in the real-world assessment after virtual training (d = 1), and at the 1-week follow-up (d = 1.12), compared with the non-immersive group. Further analyses showed that the IVR group, but not the non-immersive group, significantly improved performance in the real-world assessment across timepoints.

CONCLUSIONS

The findings indicate that IVR was more effective for improving and retaining real-world waste management skills. This study supports IVR as a viable tool for professionals and caregivers to develop skills for independent living among people with ID.

Scoping Review of Virtual Reality (VR)-Based Disaster Mitigation Education

This study explored the use of virtual reality (VR) in disaster preparedness education, focusing on VR scenarios, disaster types, and user interactivity to identify gaps in existing research. A scoping review methodology, based on the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Reviews (PRISMA-ScR) guidelines, was used, and the protocols were registered in the UMIN Clinical Trials Registry (UMIN000052800). The review included PubMed, CINAHL, the Cochrane Central Register of Controlled Trials in the Cochrane Library, and Ichushi-Web of the Japan Medical Abstract Society, with data up to January 31, 2024. Studies on disaster preparedness and mitigation education using VR were included, without restrictions on study design, country, or language. We excluded studies utilizing non-immersive VR, as well as non-academic letters to the editor, editorials, commentaries, review articles, conference abstracts, and non-academic manuscripts. In the first screening phase, 2 researchers independently reviewed the titles and abstracts of 516 articles and conducted the screening. A total of 17 articles were selected. In cases where there were differing opinions on inclusion or exclusion, the two researchers discussed the matter together. In the second screening phase, the 17 selected articles underwent full-text screening. Three articles were excluded because their outcomes did not align with our research. Eight articles were excluded based on our predefined criteria, which included commentaries, editorials, and review articles. Ultimately, six articles were included in the meta-analysis. Of these, three studies were from East Asia, one from Australia, one from North America, and one from an unspecified region. Disaster types included chemical, radiation, explosion, fire, and earthquake events. The VR training scenarios covered evacuation, first aid, patient transport, triage, decontamination, and other skills. Five of the studies emphasized user interactivity and were primarily aimed at professionals such as medical staff and nursing students. Current VR disaster response training primarily targets professionals, demonstrating its effectiveness and importance; however, there is a lack of studies focusing on training for the general public, especially in the least developed countries. Extending VR-based training programs to the general public is critical to improving countries' disaster response capabilities.

Framework for Microdosing Odors in Virtual Reality for Psychophysiological Stress Training

To better cope with stress in emergencies, emergency personnel undergo virtual reality (VR) stress training. Such training typically includes visual, auditory and sometimes tactile impressions, whereas olfactory stimuli are mostly neglected. This concept paper therefore examines whether odors might be beneficial for further enhancing the experience of presence and immersion into a simulated environment. The aim is to demonstrate the benefits of VR civilian stress training for emergency personnel and to investigate the role of odors as stressors by manipulating the degree of perceived psychophysiological stress via olfactory impressions. Moreover, the current paper presents the development and validation of a convenient and portable fragrance dosing system that allows personalized odor presentation in VR. The presented system can transport reproducible small quantities of an air-fragrance mixture close to the human nose using piezoelectric stainless steel micropumps. The results of the fluidic system validation indicate that the micropump is suitable for releasing odors close to the nose with constant amounts of odor presentation. Furthermore, the theoretical background and the planned experimental design of VR stress training, including odor presentation via olfactory VR technology, are elucidated.

The Behavioral Intention to Use Virtual Reality in Schools: A Technology Acceptance Model

This paper presents the impact of using virtual reality (VR) in education and focuses on the main factors that affect the behavioral intention of using this new technology for the benefit of both professors and students. As part of our research methodology, we conducted a survey based on the Technology Acceptance Model and used partial least squares structural equation modelling. The results show that the intention to use VR technology in education is influenced by both usage satisfaction and the task-technology fit. The system quality of the VR technology proved to be important in influencing both the task-technology fit and perceived usefulness. The findings are useful for professors considering the adoption of new technologies that might improve the efficiency of learning for their students. Additionally, managers of educational institutions can use these insights to direct investments towards this type of innovation, which appeals to newer generations.

Degree of Acceptance of Virtual Reality by Health Sciences Students

Virtual Reality (VR) is an emerging technology with educational benefits demonstrated in numerous studies. Its integration into the curriculum implies the use of cognitive resources by students and the training of digital skills by teachers. The objective of this study is to determine the degree of acceptance of students with learning objects produced in VR and in 360°, as well as to analyze their evaluation and the established relationships. A sample of 136 medical students who completed questionnaires on the Technology Acceptance Model (TAM) and the quality of the training activity was used. The results show high levels of acceptance, both in VR and 360° objects. The students perceived the usefulness of the training activity as high, with significant correlations between the different dimensions. This study demonstrates the potential of VR as an educational technology and offers new perspectives for future research.

Virtual Reality — Substitute for a Real Experience? The Role of User Motivation, Expectations and Experience Type

Virtual reality (VR) offers the opportunity to create virtual worlds that could replace real experiences. This research investigates the influence of user motivation, temporal distance and experience type on the satisfaction with the VR experience, and the degree of acceptance of a VR experience as a substitute for a real experience. The results suggest that the degree of acceptance of a VR experience as a substitute for a real experience is higher for passive VR experiences compared to active VR experiences. Furthermore, the results support the assumption that users are more satisfied with passive VR experiences.

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.

Simulation-Based VR Training for the Nuclear Sector—A Pilot Study

Simulation-based training has seen an increased use of extended reality, that is, augmented reality (AR), virtual reality (VR) and mixed reality (MR) displays. The health professions have been using VR for simulation-based training more extensively than others. This method can offer the possibility of immediate feedback, which promotes more accurate training to self-correct mistakes in environments that are otherwise risky or provide unsafe conditions. The nuclear industry has attempted to seize the same digital and educational transformation to train their personnel to handle dangerous scenarios. We ran a pilot study with the aim of evaluating the VR training scenario developed for the specific target group and the acceptance of the VR technology itself for this kind of training. We used the Kirkpatrick framework to evaluate the training and the VR-HAM acceptance model to evaluate the acceptance of VR. A VR scenario was developed to test specific technical skills of nuclear power plant personnel. The 13 participants showed results within the basic level of the Kirkpatrick framework and held both positive reactions and concerns, that is, they enjoyed the training with VR and expressed concerns regarding the stability of the VR technology. The participants also showed positive attitudes towards the perceived ease of use and usefulness of the VR-HAM and its various constructs. Even though the COVID-19 pandemic limited our testing, we could show valuable data and positive attitudes and perceived ease by the participants. Simulation-based VR training could be an important complement to traditional training methods, especially where safety is a priority, but we still need to provide solid evidence.

A study of the use of virtual reality headsets in Chinese adolescents with intellectual disability

Background: Virtual reality technologies (VRTs) present many characteristics that can facilitate learning, especially in individuals with intellectual disabilities (ID). The VRT head-mounted display (HMD) has recently shown significant technological improvement. This study aims to prove the suitability of the newer commercially available VRT HMDs used in interventions for adolescents with ID in China. To this end, we explored the acceptance, immersion, and negative effects for adolescents with ID in a series of virtual environments. Methods: Forty-nine adolescents with ID (33 boys and 16 girls, IQ < 70), aged 11 to 21, from three special schools participated in this study. Questionnaires, observations, and interviews were used to investigate their views while using a VR HMD. Results: Our analysis found that most participants narrated a pleasant experience using HMD and a series of VR experiences and experienced a high level of immersion accompanied by low negative effects. In addition, our study found that the gender variable was independent of the acceptance of HMDs and the immersion experience. Conclusions: Overall, this study suggests that the HMD is accepted by most Chinese adolescents with ID; thus, its application has great potential in China.