Abstract
Augmented reality (AR) is rapidly being adopted by industry leaders and militaries around the globe. With the Defense Health Agency pushing AR as a solution to the distributed learning problem, along with AR applications being explored within primary care and operational medical settings, it is crucial for these immersive platforms to have a standardized, scientifically based paradigm on which they are designed and used. One area of particular concern is the potential for physiological maladaptation following prolonged AR exposure, which is expected to vary from that associated with virtual reality exposure. Such maladaptation is potentially driven by limitations that exist with regard to the types and extent of perceptual issues characteristic of AR head-worn displays (e.g., mismatches between visually displayed information and other senses, restricted field of view, mismatched interpupillary distance). Associated perceptual limitations can reduce training effectiveness or impose patient and/or trainee safety concerns. Thus, while AR technology has the potential to advance simulation training, there is a need to approach AR-based research—particularly that which relates to long-exposure-duration scenarios—from a bottom-up perspective, where its physiological impact is more fully understood. In the hopes of assisting this process, this study presents a comparison of cybersickness between two common forms of AR displays. Specifically, by comparing the Microsoft HoloLens, a head-worn display that has seen rapid adoption by the scientific community, with an AR Tablet–based platform within the context of long-duration AR training exposure, it will be possible to determine what differences, if any, exist between the two display platforms in terms of their physiological impact as measured via cybersickness severity and symptom profile. Results from this psychometric assessment will be used to evaluate the physiological impact of AR exposure and develop usage protocols to ensure AR is safe and effective to use for military medical training.
Highlights
Over the last several years, there have been vast improvements in virtual reality (VR) and augmented reality (AR) technology, and yet, many people still report experiencing cybersickness symptoms from their use (Rebenitsch and Owen, 2016; Gavgani et al, 2017; Duzmanska et al, 2018; AR: Vovk et al, 2018; Guna et al, 2019; VR: Saredakis et al, 2020)
Given that the Tactical Combat Casualty Care (TCCC) training scenarios were identical across these conditions, these results suggest that the adverse physiological impacts of AR exposure may be able to be moderated through usage protocols that carefully specify appropriate exposure duration in immersive AR systems; it is important to note that these protocols may be differentially effective based on individual differences
Understanding the potential for cybersickness and associated symptom profiles can assist in the design and development of optimal AR-based individual training protocols, such as those being developed for TCCC training
Summary
Over the last several years, there have been vast improvements in virtual reality (VR) and augmented reality (AR) technology, and yet, many people still report experiencing cybersickness symptoms from their use (Rebenitsch and Owen, 2016; Gavgani et al, 2017; Duzmanska et al, 2018; AR: Vovk et al, 2018; Guna et al, 2019; VR: Saredakis et al, 2020). The scores for nausea relate to gastrointestinal distress (i.e., nausea, stomach awareness, salivation, and burping); scores for oculomotor relate to visual distress (i.e., eyestrain, difficulty focusing, blurred vision, and headache); and scores for disorientation relate to vestibular distress (i.e., dizziness and vertigo; Kennedy et al, 2001) These three subcategories have been used to build symptom profiles (N vs O vs D) associated with specific VR systems, as well as to characterize the psychometrics of cybersickness associated with VR exposure (Kennedy and Stanney, 1996; Stanney and Kennedy, 1997; Hale and Stanney, 2006; Garcia-Agundez et al, 2019; Stanney et al, 2020a)
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