Virtual Worlds, Volume 2, Issue 1 (March 2023) – 5 articles

Immersive experiential technologies find fertile grounds to grow and support healthcare education. Virtual, Augmented, or Mixed reality (VR/AR/MR) have proven to be impactful in both the educational and the affective state of the healthcare student’s increasing engagement. However, there is a lack of guidance for healthcare stakeholders on developing and integrating virtual reality resources into healthcare training. Thus, the authors applied Bardach’s Eightfold Policy Analysis Framework to critically evaluate existing protocols to determine if they are inconsistent, ineffective, or result in uncertain outcomes, following systematic pathways from concepts to decision-making. Co-creative VR resource development resulted as the preferred method. Best practices for co-creating VR Reusable e-Resources identified co-creation as an effective pathway to the prolific use of immersive media in healthcare education. Co-creation should be considered in conjunction with a training framework to enhance educational quality. Iterative cycles engaging all stakeholders enhance educational quality, while co-creation is central to the quality assurance process both for technical and topical fidelity, and tailoring resources to learners’ needs. Co-creation itself is seen as a bespoke learning modality. This paper provides the first body of evidence for co-creative VR resource development as a valid and strengthening method for healthcare immersive content development. Despite prior research supporting co-creation in immersive resource development, there were no established guidelines for best practices. Full article

Online classes are typically conducted by using video conferencing software such as Zoom, Microsoft Teams, and Google Meet. Research has identified drawbacks of online learning, such as “Zoom fatigue”, characterized by distractions and lack of engagement. This study presents the CUNY Affective and Responsive Virtual Environment (CARVE) Hub, a novel virtual reality hub that uses a facial emotion classification model to generate emojis for affective and informal responsive interaction in a 3D virtual classroom setting. A web-based machine learning model is employed for facial emotion classification, enabling students to communicate four basic emotions live through automated web camera capture in a virtual classroom without activating their cameras. The experiment is conducted in undergraduate classes on both Zoom and CARVE, and the results of a survey indicate that students have a positive perception of interactions in the proposed virtual classroom compared with Zoom. Correlations between automated emojis and interactions are also observed. This study discusses potential explanations for the improved interactions, including a decrease in pressure on students when they are not showing faces. In addition, video panels in traditional remote classrooms may be useful for communication but not for interaction. Students favor features in virtual reality, such as spatial audio and the ability to move around, with collaboration being identified as the most helpful feature. Full article

While VR-based training has been proven to improve learning effectiveness over conventional methods, there is a lack of study on its learning effectiveness due to the implementation of training modes. This study aims to investigate the learning effectiveness of engineering students under different training modes in VR-based construction design training. Three VR scenarios with varying degrees of immersiveness were developed based on Dale’s cone of learning experience, including (1) Audio-visual based training, (2) Interactive-based training, and (3) Contrived hands-on experience training. Sixteen students with varying backgrounds participated in this study. The results posit a positive correlation between learning effectiveness and the degree of immersiveness, with a mean score of 77.33%, 81.33%, and 82.67% in each training scenario, respectively. Participants with lower academic performance tend to perform significantly better in audio-visual and interactive-based training. Meanwhile, participants with experience in gaming tend to outperform the latter group. Results also showed that participants with less experience in gaming benefited the most from hands-on VR training. The findings suggest that the general audience retained the most information via hands-on VR training; however, training scenarios should be contextualized toward the targeted group to maximize learning effectiveness. Full article

Cybersickness is a drawback of virtual reality (VR), which also affects the cognitive and motor skills of users. The Simulator Sickness Questionnaire (SSQ) and its variant, the Virtual Reality Sickness Questionnaire (VRSQ), are two tools that measure cybersickness. However, both tools suffer from important limitations which raise concerns about their suitability. Two versions of the Cybersickness in VR Questionnaire (CSQ-VR), a paper-and-pencil and a 3D–VR version, were developed. The validation of the CSQ-VR and a comparison against the SSQ and the VRSQ were performed. Thirty-nine participants were exposed to three rides with linear and angular accelerations in VR. Assessments of cognitive and psychomotor skills were performed at baseline and after each ride. The validity of both versions of the CSQ-VR was confirmed. Notably, CSQ-VR demonstrated substantially better internal consistency than both SSQ and VRSQ. Additionally, CSQ-VR scores had significantly better psychometric properties in detecting a temporary decline in performance due to cybersickness. Pupil size was a significant predictor of cybersickness intensity. In conclusion, the CSQ-VR is a valid assessment of cybersickness with superior psychometric properties to SSQ and VRSQ. The CSQ-VR enables the assessment of cybersickness during VR exposure, and it benefits from examining pupil size, a biomarker of cybersickness. Full article

Augmented reality (AR) tools have been investigated with promising outcomes in rehabilitation. Recently, some studies have addressed the neuroplasticity effects induced by this type of therapy using functional connectivity obtained from resting-state functional magnetic resonance imaging (rs-fMRI). This work aims to perform an initial assessment of possible changes in brain functional connectivity associated with the use of NeuroR, an AR system for upper limb motor rehabilitation of poststroke participants. An experimental study with a case series is presented. Three chronic stroke participants with left hemiparesis were enrolled in the study. They received eight sessions with NeuroR to provide shoulder rehabilitation exercises. Measurements of range of motion (ROM) were obtained at the beginning and end of each session, and rs-fMRI data were acquired at baseline (pretest) and after the last training session (post-test). Functional connectivity analyses of the rs-fMRI data were performed using a seed placed at the noninjured motor cortex. ROM increased in two patients who presented spastic hemiparesis in the left upper limb, with a change in muscle tone, and stayed the same (at zero angles) in one of the patients, who had the highest degree of impairment, showing flaccid hemiplegia. All participants had higher mean connectivity values in the ipsilesional brain regions associated with motor function at post-test than at pretest. Our findings show the potential of the NeuroR system to promote neuroplasticity related to AR-based therapy for motor rehabilitation in stroke participants. Full article