These days, digitization is commonly recognized as a global phenomenon. Digital lifestyles are emerging and continually evolving, further amplifying this phenomenon. Technologies such as artificial intelligence, virtual reality, robotics, and autonomous systems are becoming increasingly pervasive. Consequently, human life is undergoing profound digitization. Progressively, the extent of digitization progress is regarded as a crucial determinant of future public and state policy. Successful implementation of digitization projects has significantly influenced human communication, prompted a rethinking of value frameworks, and altered individuals’ perceptions of life’s meaning. In this context, examining the sociocultural and psychological effects of digitization in general - and network identity in particular - is highly pertinent. This study scrutinizes the nature of digitalization through its impact on individuals’ ideological beliefs and on the formation of their identity codes. Given digitalization’s contradictory character, Kazakhstan’s experience stands out: it juxtaposes the risks of migrating human activity into the digital sphere with the ambitious goals of digital transformation and their ensuing achievements. The peculiarities of Kazakhstan’s digitalization policy, with its emphasis on advanced technologies, underscore the need to thoroughly understand the broader phenomenon of digitization. The relevance of this research perspective derives from three imperatives: assessing the potential negative consequences of digitalization, grounding the process in a robust theoretical humanitarian framework, and pinpointing the primary risks associated with network identity in today’s digital landscape. This research leverages the epistemic resources of psychology, sociology, cultural studies, and philosophy. Such interdisciplinary synergy enables a more thorough understanding of digitalization’s role in shaping a new humanistic worldview. These analytical perspectives enable a comprehensive assessment of both Kazakhstan’s specific context and the wider digitization process.

This article explores the topic of virtual reality non-fiction experiences where creators position the viewer as a participant in an encounter. The first part presents a selection of voices in the critical discussion around humanitarian VR, a genre in which viewers are often positioned in this way. The concepts of toxic empathy by Lisa Nakamura, improper distance by Kate Nash, and synthetic vision by Jihoon Kim are discussed. The recapitulation of texts providing critical accounts of humanitarian VR sets the context for the presentation of The Choice VR experience, to which the second part of the article is devoted.

BackgroundEffective engagement and motivation during balance training can be achieved through using technology such as virtual reality and promotes positive adaptation and neural plasticity.ObjectiveThe aim of the study was to explore the effect of gamified balance training using virtual reality on postural control in children with spastic diplegic cerebral palsy.MethodsFifty children with spastic diplegic cerebral palsy from both genders with ages ranged from six to twelve years old participated in this study. The participants were allocated randomly into two groups (n = 25). The control group (A); received conventional physical therapy programs based on neurodevelopmental technique including balance and gait training exercises, while the study group (B); received conventional physical therapy programs based on neurodevelopmental technique including balance and gait training exercises in addition to virtual reality balance training. All children were examined clinically pre- and post-treatment using HUMAC balance and tilt system to asses Limit of Stability (LOS), Center of Pressure (COP), and the Modified Clinical Test of Sensory Integration of Balance (mCTSIB).ResultsThere were significant improvements of all measured variables in both control and study groups with significant difference between groups in favor to the study group (p < 0.05).ConclusionGamified balance training using virtual reality has a beneficial effect on improving postural control in children with spastic diplegic cerebral palsy.

Background. Accurate anatomical assessment is essential for pre-procedural planning in structural heart disease. Advanced 3D imaging could offer improved visualization for more accurate reconstruction. We assessed the performance of a novel immersive 3D virtual reality (VEA) for the pre-procedural planning of transcatheter aortic valve implantation (TAVI) candidates. Methods. Measurement of cardiac-gated contrast-enhanced computed tomography (CT) scans was performed with the novel VEA and established tools: 3Mensio and Horos. Results. 50 consecutive patients were included. Annular and LVOT measurements obtained with VEA were strongly correlated with those derived from standard CT analysis. The intraclass correlation coefficient (ICC) confirmed excellent consistency for annular measurements (ICC = 0.93), while the concordance correlation coefficient indicated very good overall agreement (CCC = 0.83, 95% CI 0.73–0.90). Similarly, LVOT measurements obtained with VEA showed strong correlation with CT values, with good consistency (ICC = 0.90) and good overall agreement (CCC = 0.77, 95% CI 0.64–0.86). VEA-based planning improved prosthesis size selection accuracy, achieving higher concordance with implanted valves and a significant net reclassification gain over conventional CT. Conclusions. Given the increasing use of advanced 3D cardiac imaging technologies, understanding their diagnostic accuracy to guide pre-procedural planning of TAVI is paramount. In our study, VEA provided reliable assessment of aortic root anatomy for TAVI planning. This novel 3D software provides accurate, patient-specific reconstructions of the aortic root and surrounding structures that may optimize valve sizing, improve procedural safety and enhance procedural outcomes. This provides a rationale for future studies to assess the procedural benefit derived from a three-dimensional assessment of the aortic valve geometry.

Microbiology, the study of microorganisms, is of critical importance to a variety of fields, including medicine, nursing, genetics, and immunology, as well as to students training to enter those fields. By definition, the objects of microbiology are too small to be seen with the naked eye, so its practitioners are well accustomed to using technology to make the invisible visible. From this perspective, virtual reality (VR) is a natural evolution from the microscope and the petri dish. We have conceptualized, designed, and tested a new virtual reality environment to teach undergraduate students how to diagnose a range of human parasitic diseases. Here we present our VR module as well as the qualitative and quantitative student feedback received from our second-year microbiology student cohort (n = 30). Furthermore, we discuss the challenges and opportunities associated with integrating VR into an internationally recognized university microbiology curriculum. This includes considerations at the curriculum design level, where we identify specific VR learning activities that could be added throughout the course, and at the application development level, where we present lessons learned from the development of a VR learning resource for parasitology education.

The increasing use of Virtual Reality in education has demonstrated its potential to enhance student engagement and skill development. This study investigates the design and implementation of a VR platform aimed at helping university students improve their oral presentation skills, while also evaluating user satisfaction through structured surveys. A total of 40 university students from the Speech and Language Therapy program participated in this study, focusing on their interactions with a custom-built, realistic VR application inspired by the main auditorium of their university. The students faced various distraction scenarios that emulated real-life public speaking challenges. Cybersickness symptoms were continuously monitored throughout the sessions; no participants reported or exhibited symptoms requiring interruption of the VR exposure. The VR environment was constructed using Unity and featured adjustable audience sizes, ambient sound controls, and recording capabilities for presentations. The results demonstrated significant enhancements in oral presentation skills post-VR training. Participants exhibited significant improvements in speaking fluency and clarity of expression, as well as reduced anxiety, during the VR experience. Specifically, their fluency increased significantly, and their clarity ratings also improved substantially. Furthermore, behavioral indicators showed a marked decrease in anxiety levels. Participants reported that the immersive nature of the VR experience enhanced their enjoyment, contributing positively to the overall outcomes. The findings suggest that VR is an effective tool for enhancing oral presentation skills in university students, leading to improved confidence and performance in real-life situations.

With the replacement of predominantly traditional, frontal teaching methods, the aim is to introduce individually paced and experience-based instruction into healthcare simulation training including the theoretical education of first aid. To date, there has been no comprehensive or coordinated national study comparing conventional courses with those conducted in virtual environments. The educational system must adapt to the information acquisition and learning habits of younger generations. Virtual reality may have a significant impact on the individuals' willingness to provide first aid. Learners can encounter various scenarios (e.g., bleeding control, resuscitation) for the first time in a safe environment, which can be simulated an unlimited number of times across different adapted settings. This not only enhances professional first aid delivery but also allows for the replication of environmental and emotional influences that are essential for realistic visualization, skill development, and shaping a helping attitude. Moreover, virtual reality enables the identification of key components that contribute to effective education and learning processes such as the element of problem-solving. It is crucial for first aid providers to be able to assess the safety of a scene, examine the patient, and make sound decisions in response to changing conditions. Experiential and gamified learning plays a pivotal role in the long-term retention of knowledge, potentially activating relevant skills in real-life situations. Virtual reality can offer added value in understanding critical aspects of first aid such as evaluating the safety of the environment, recognizing changes in patient condition, and mastering the correct sequence of actions. Through immersion in simulation, virtual reality can foster focused attention. From an instructional perspective, it may also support more objective and precise student assessment by making the recognition of key aid related observations more tangible. It is presumed that the application of virtual reality in first aid education can become a cost-effective method by optimizing individual learning. Orv Hetil. 2025; 166(49): 1927-1934.

The article presents a comprehensive analysis of developing multimodal interface technologies, focusing on force feedback systems for human-machine interaction in robotics, teleoperation, and virtual reality environments; emphasizes the significance of multimodality in reducing the operator’s cognitive load and enhancing the presence in remote or virtual settings. The work focuses on critical ergonomic challenges, including psychophysiological stresses, perception difficulties, latency issues, and safety concerns; reviews current methodologies and technologies, such as adaptive control algorithms, novel tactile devices, and their applications in medical simulators and VR systems. The authors identify key obstacles hindering widespread adoption (latency, hardware limitations), along with promising directions for advancement, including artificial intelligence integration, hybrid multimodal system creation, and energy-efficient interface development utilizing smart materials. The ultimate design goal is to develop an intuitive, safe, and physically comfortable interface seamlessly integrated into the operator’s sensorimotor loop.

Effects of a multistage virtual reality intervention on perioperative anxiety and recovery in patients undergoing elective gynecological surgery: a prospective single-blind randomized controlled trial.

BackgroundThe United States faces significant challenges in physical therapy (PT) access due to high demand, a shortage of professionals, and patient-related obstacles, which can adversely affect recovery and function. Limited access to PT may lead to increased dependence on medications for pain management, highlighting the need for nonpharmacologic options to reduce opioid overprescribing. Low back pain, a leading cause of disability and high medical costs, is a common reason for requiring PT following surgery. Studies have shown that virtual reality (VR)–guided movements can improve motor function and reduce pain intensity.ObjectiveThe objective of this study was to design, develop, and evaluate a VR-based prototype for individualized postoperative PT for patients recovering from back surgery to investigate its potential to improve convenience, access, and health outcomes in future research.MethodsStudy methods involved participatory design and development of VR software for PT back exercises using the design box method, an inductive, problem-oriented collaborative design approach. A usability evaluation of the resulting prototype was conducted with patients recovering from back surgery using a think-aloud protocol and usability survey.ResultsSix participants evaluated the VR prototype and reported usability challenges that included mismatched VR boundaries, limited familiarity with VR, and difficulties with the headset and hand controls. The System Usability Scale resulted in a total usability score of 58.3 out of 100, indicating a below-average score (68 being average).ConclusionsIn the design and evaluation of a VR-based PT prototype, we found that while participants were enthusiastic, they faced usability challenges due to insufficient instructions and difficulties operating the VR device, highlighting the need for effective onboarding and extensive prototype testing to improve accessibility and engagement in health care. Future evaluations will investigate disparities among different groups to ensure accessibility and effectiveness for all users.

This study examined healthcare providers' perceptions of the benefits, challenges, and design preferences for Virtual Reality (VR)-based interventions to support treatment preparedness in lung cancer care. Our study involves 50 surveys and 10 interview responses, in a mixed-method design. We conducted descriptive statistics and thematic analysis through a hybrid inductive-deductive approach. Analysis of the quantitative data helped us capture demographic characteristics, VR familiarity, and perceived VR usefulness. Qualitative analysis gave us a deeper understanding of the VR tool design and Implementation. Descriptive statistics and Fisher's exact tests were used to assess associations, while thematic analysis was conducted on interview transcripts. Only 28% of respondents were familiar with virtual reality. However, many of them admitted to its promise in potentially improving understanding (70%), managing expectations (56%), and engagement in care (68%). The respondents identified several challenges to VR use, including discomfort with technology (74%), usability-related issues (92%), and accessibility limitations (64%). They preferred that the content have short, video-based modules integrating multimodality of delivery (e.g., audio, avatars). Providers supported flexible delivery models that integrated both in-clinic and at-home delivery modes, emphasizing the importance of provider training and patient technical support. It is noteworthy that the respondents' perceptions of VR usefulness were not associated with their demographic and specialty characteristics. Our findings provide valuable insight into the design of equitable and provider-informed VR tools, highlighting the need for real-world testing and Implementation, especially in cancer care.

Virtual reality (VR) is increasingly recognized as a promising tool in medical education, offering immersive, interactive, and risk-free learning experiences. Its ability to provide three-dimensional visualization of complex anatomical structures may overcome limitations of traditional didactic lectures and cadaver-based learning. This study evaluated the effectiveness of VR-based neuroanatomy training compared to conventional teaching methods among undergraduate medical students. A total of 117 final-year MBBS students at SRIHER were enrolled between December 2024 and April 2025. Students were stratified into three groups with comparable baseline scores. Group 1 received lectures and notes, Group 2 received lectures plus VR sessions on skull base and Circle of Willis models, and Group 3 initially received lectures and notes followed by delayed VR exposure. Knowledge acquisition was assessed using pre-tests, immediate post-tests, and a three-month delayed post-test. Statistical analysis employed a mixed-effects linear model to account for repeated measures and attrition. Group 2 demonstrated significantly higher mean scores in the first post-test (14.1 vs. 10.3 in traditional groups; p = 0.03). At the three-month follow-up, Group 2 maintained superior performance, while Group 3 (delayed VR) showed intermediate improvement compared to controls. Attrition was markedly lower among students exposed to VR (98.4% vs. 58.9%), suggesting higher engagement and sustained interest. Qualitative feedback revealed increased motivation and a notable rise in interest in neurosurgery careers (from 3 to 27 students). VR-based training significantly enhances neuroanatomy learning outcomes compared to conventional teaching, particularly when introduced early. Its immersive and interactive features promote deeper engagement, retention, and motivation. While cost remains a barrier, VR holds substantial potential as a sustainable adjunct to medical curricula and a means to inspire interest in surgical specialities.

This systematic review on novel 3D technologies aims to discuss the current evidence on the usefulness of 3D printing, virtual reality (VR) and augmented reality (AR) simulators in the education and training of young urologists for kidney cancer surgery, highlighting the modalities employed, their educational impact, and areas for future development. We performed a comprehensive literature search limited to the last 10 years across PubMed and Embase libraries, identifying studies evaluating the use of 3D technologies as educational tools in urologist training for kidney cancer surgery. The review followed PRISMA guidelines, and two reviewers independently screened eligible studies. We extracted data on study designs and on urologists' education outcomes, through different subcategories. Seventeen studies were included, mostly small-scale validation or descriptive investigations. Twelve investigated 3D-printed models and five VR/AR platforms. Simulations focused on laparoscopic and robot-assisted partial nephrectomy, often using patient-specific models for rehearsal and skill development. Training outcomes included improved spatial anatomy understanding, increased technical performance, greater procedural confidence, and enhanced familiarity with complex surgical steps. However, considerable heterogeneity in methodology and limited sample sizes across studies underscore the need for standardized evaluation of these educational tools. 3D technologies, including 3D-printed models and VR/AR platforms, show promise in enhancing surgical training for renal cancer by improving anatomical understanding and procedural skills. These technologies demonstrate good precision and can help assess trainee surgical skill. However, evidence remains limited, and further research is needed to validate their effectiveness, cost-efficiency, and integration into standardized urological training curricula.

Drug-resistant epilepsy affects nearly one-third of individuals with epilepsy and remains a major cause of neurological morbidity worldwide. Surgical intervention offers a potential cure, but its success critically depends on the precise identification of the epileptogenic zone and the preservation of eloquent cortical and subcortical regions. This review aims to provide a comprehensive synthesis of current evidence on the role of multimodal neuroimaging in the personalized presurgical evaluation and planning of epilepsy surgery. We analyze how structural, functional, metabolic, and electro-physiological imaging modalities contribute synergistically to improving localization accuracy and surgical outcomes. Structural MRI remains the cornerstone of presurgical assessment, with advanced sequences, post-processing techniques, and ultra-high-field (7 T) MRI enhancing lesion detection in previously MRI-negative cases. Functional and metabolic imaging, including FDG-PET, ictal/interictal SPECT, and arterial spin labeling MRI, offer complementary insights by revealing regions of altered metabolism or perfusion associated with seizure onset. Functional MRI enables non-invasive mapping of language, memory, and motor networks, while diffusion tensor imaging and tractography delineate critical white-matter pathways to minimize postoperative deficits. Electrophysiological integration through EEG source imaging and magnetoencephalography refines localization when combined with MRI and PET data, forming the basis of multimodal image integration platforms used for surgical navigation. Our review also briefly explores emerging intraoperative applications such as augmented and virtual reality, intraoperative MRI, and laser interstitial thermal therapy, as well as advances driven by artificial intelligence, such as automated lesion detection and predictive modeling of surgical outcomes. By consolidating recent developments and clinical evidence, this review underscores how multimodal imaging transforms epilepsy surgery from a lesion-centered to a patient-centered discipline. The purpose is to highlight best practices, identify evidence gaps, and outline future directions toward precision-guided, minimally invasive, and function-preserving neurosurgical strategies for patients with drug-resistant focal epilepsy.

Objective To explore secondary school students' perceptions of a metaverse platform called Meta-OHE (metaverse for oral health education).Methods Focus group discussions (FGDs) were conducted with purposively sampled 16-year-old secondary school students from semi-government schools in Malaysia. Participants engaged with the Meta-OHE platform on Mitoworld for one week before the FGDs sessions on https://mitoworld.io/world/w/2808/meta-ohe . The FGDs, conducted in both English and Malay, each lasted between 30-60 minutes and were guided by a semi-structured topic guide until data saturation was achieved. The data were analysed through framework analysis, using NVivo 14.0 to systematically code and develop themes.Results A total of 81 students participated in 16 FGDs. Emerging themes in their perceptions of the metaverse platform Meta-OHE included freedom and exploration, interactive features, access to oral health information, and immersive learning experiences. Participants favoured visually appealing environments, customisable avatars, diverse oral health education content, and the integration of augmented reality and virtual reality technologies. Desired platform features from the participants also included gamification, reward systems, up-to-date information, diverse environments, social features, short videos, educational simulations, and age-appropriate content.Conclusion The study revealed positive perceptions of Meta-OHE for oral health education, suggesting its potential as an innovative tool for engaging secondary school students in oral health promotion and education. However, frequent updates, maintenance and expansions to content, technical diversity and features were emphasised to maintain interest and relevance.

Abstract This study explored the impact of high‐immersion virtual reality (VR) as an innovative andragogical tool in undergraduate biology education. Amidst concerns about traditional lecture‐based teaching methods, VR can offer interactive hands‐on experiences. The study hypothesized that students who opt in for a supplementary VR experience will outperform the students presented with text‐based lectures and the students presented with video‐assisted content in content‐related quizzes and assignments. The study involved 456 students of an undergraduate contemporary biology course. Three conditions were presented over four semesters: a VR activity focused on teaching genetics and Punnett squares that supplemented a video lecture, video lecture only and long‐form text‐based materials only. Pre‐ and post‐VR activity tests were conducted to assess knowledge gains and perceptions of the VR experience of the 49 students who chose the additional VR experience. Results suggest significant improvements in the immediate content‐related post‐test scores, delivered in multiple‐choice format. A significant difference was observed in the mean scores of the genetics module assignments (delivered in long‐form text format) among the three groups (ie, VR‐and‐video‐assisted group; video‐assisted group; text‐only materials group). The text‐only group scored the lowest, while the video‐and‐VR‐assisted group scored the highest, but only marginally higher than the video‐assisted group. The results suggest that VR provides a viable, scalable and cost‐effective complement to traditional laboratory practice. Rather than outperforming lecture‐based approaches, VR offers an accessible way to practical experiences that would otherwise require specialized facilities or costly equipment. Our findings provide a baseline and highlight a need for further research to investigate the full potential and limitations of integrating VR in biology education. Practitioner notes What is already known about this topic Virtual reality (VR) has emerged as an increasingly viable method of engaging users in educational experiences. VR as a medium can engage users in ways traditional media struggle to achieve, such as fostering empathy and delivering immersive experiences. Hands‐on learning opportunities remain highly relevant to STEM education, an area highly appropriate for exploration in VR. VR has gained considerable traction in biology education. What this paper adds Evidence for the integration of VR into a high‐enrollment, accredited curriculum implemented in a naturalistic, ecologically valid context. A comparison of VR‐assisted biology lessons with more traditional, video‐ or text‐based lecture in high‐enrollment undergraduate courses. VR experiences may be more beneficial than lecture‐based instruction for complex topics in undergraduate education. Implications for practice and/or policy VR is particularly useful in addressing typically challenging learning concepts. The integration of VR technology with large‐enrollment undergraduate courses is possible. The availability of VR experiences and equipment remains necessary for the successful integration of VR.

Introduction While endovascular treatment has gained popularity for its minimally invasive approach, microsurgical clipping for unruptured intracranial aneurysms (UIAs) has also evolved using surgical adjuncts such as virtual reality (VR) and keyhole techniques to enhance patient outcomes. Immersive 3D VR images allow for the creation of an accurate 3D anatomical model, making it a valuable tool for surgical planning. This study investigated the impact of VR-based surgical planning on approach type and craniotomy size. Methods This retrospective cohort study included all patients who underwent elective microsurgical clipping for UIAs from 1 January 2009 to 31 December 2024 at the University Hospital of Basel, Switzerland, and was approved by the local ethics board. Demographic, surgical, and outcome parameters were collected. SpectoMedical®, developed at the University of Basel, was the VR platform used. The primary outcome was craniotomy size (cm 2 ) measured using the anterior-posterior method. Descriptive and comparative statistics were conducted. To assess the factors influencing the craniotomy size, we calculated a multivariable linear regression model. Results We included a total of 163 aneurysms in 159 patients with a mean age of 58.52 (±10.23), and 114 (69.9%) were female. VR-based surgical planning resulted in a significantly smaller craniotomy size [no VR vs. VR, 20.31 (±19.21) cm 2 vs. 13.22 (±7.85) cm 2 , p = 0.007] and shorter hospital stay [no VR vs. VR, 10.04 (±5.58) vs. 7.89 (±2.79) days, p = 0.031]. Operative time was shorter in the VR group but lacked statistical significance [no VR vs. VR, 226.41 (±86.18) min vs. 207.93 (±54.92) min, p = 0.160]. The multivariable regression model showed that the use of VR-based surgical planning reduced the craniotomy size by 6.2 cm 2 . Conclusion VR-based surgical planning was associated with significantly smaller craniotomy sizes and shorter hospital stays. It results in an intraoperative déjà-vu effect for the surgeon, which supports its use as a valuable adjunct in preoperative planning.

Introduction As a defining feature of virtual reality, the sense of presence has been a focal point of research for decades. Navigating the extensive body of presence research can be challenging, yet it is essential for understanding the evolution of the concept over time, recognising the contributions of key scholars, and charting new research pathways. This study applied a bibliometric analysis to map networks of influence and conceptual frameworks spanning over 30 years of presence research to highlight the disciplines, authors, articles, and concepts that have gained prominence in scholarly discourse. Method Bibliographic data for 6636 documents from 1992 to 2024 were extracted from Web of Science (WoS) and Scopus citation indexes for analysis using Biblioshiny and VOSviewer. Outputs from WoS and Scopus databases were combined to provide high-quality bibliographic records for co-occurrence, co-citation, and bibliographic network analysis using Biblioshiny and VOSviewer. An extended analysis of contemporary research discusses considerations for presence research. Results Publication output since 2015 has grown rapidly. A source analysis reflects a dominance of the discipline of computer science and engineering, while interdisciplinary connections in applied settings are an emerging area of growth. Citation and publication output are heavily dominated by the top 10 authors, indicating a reliance on relatively few contributors. Terminology that co-occurs with presence remains dominated by the technical aspects of immersion and experience design, while also reflecting more recent growth in the use of virtual reality in applied settings. This demonstrates that recent contributors and newer concepts have yet to be significantly reflected in global presence research. Discussion This analysis underscores the need to view presence as a multidimensional construct that requires a multidisciplinary approach and methodologies providing user-centred, holistic perspectives that embrace the nuances of individual psychological experiences. The present bibliometric review provides a valuable overview of the evolving landscape of presence research as a complement to previous, more focused systematic and scoping reviews. This bibliometric analysis of the past 30 years of research demonstrates that presence remains a defining concept in virtual reality and a field that warrants further investigation and development to achieve compelling, relevant and memorable virtual reality experiences.

Abstract In virtual reality (VR), users underestimate distances between themselves and objects relative to reality. Such issues can negatively impact users’ spatial perception and interactions in VR environments by affecting elements of the VR user experience, such as presence. Therefore, enhancement of depth perception should be studied to improve the VR user experience. In this study, an eye-tracking-based depth perception visualization interface system is proposed to enhance depth perception and improve presence in VR. The visualization interface system consists of a three-dimensional (3D) depth interface or a two-dimensional (2D) depth interface, depending on the interface depth. Experiments on depth perception and presence were conducted to analyze whether the proposed visualization interface affects user experience. An analysis of the experimental results suggests that the proposed visualization interface system can benefit depth perception and presence with the 3D depth interface potentially being more effective than the 2D depth interface.

BackgroundSpatial navigation impairment is prevalent in people with Alzheimer disease (AD) and may appear in its initial clinical stage. Detecting this deficit in people at risk may not only help prevent them from getting lost or going missing but also provide a useful clinical aid to accurate diagnosis. Traditional assessments for spatial navigation impairment include questionnaires, paper-and-pencil and maze tests, or video games. While a real-world setting is more valid, direct, and accurate, it is plagued by unpredictable conditions such as weather, obstacles, or accidents. Owing to modern technology, virtual reality (VR) offers a new way to test spatial navigation impairment.ObjectiveThe aims of this study were to test the feasibility of a VR setting to assess sense of location in people with mild cognitive impairment (MCI) and the power of VR to discriminate among groups with different clinical conditions.MethodsWe used the Pai-Jan virtual reality (PJVR) device to test spatial navigation ability in those who were cognitively unimpaired (CU) and those who experienced subjective cognitive decline (SCD) and MCI. The PJVR device is the VR version (VIVE Pro Eye head-mounted display) of the Pai-Jan device, which has demonstrated its power to discriminate among CU, AD MCI, and mild AD dementia. With a map provided and using joysticks or handles, participants were asked to reach 5 points on a 660-m path. Linear deviation (LD; in meters) from each target point and vector deviation (in degrees) from the direction to the start point at each location were treated as the variables for comparison.ResultsA total of 113 participants provided informed consent to initiate the study. Of these 113 participants, 93 (82.3%) completed the trials, including 22 (24%) who were CU, 39 (42%) with SCD, and 32 (34%) with MCI. In total, 17.7% (20/113) failed the trials due to cybersickness. The mean LD of the CU, SCD, and MCI groups was 38.2 (SD 39.5), 50.4 (SD 40.7), and 100.4 (SD 46.2) meters, respectively (P<.001). The MCI group showed greater vector deviation (mean 63.2, SD 42.4 degrees) than either the SCD (mean 39.4, SD 33.0 degrees) or CU (mean 38.6, SD 37.4 degrees; P=.02) group. The LD of the PJVR device was correlated with the total scores on the caregiver version of the Questionnaire on Everyday Navigational Ability (P<.001), indicating good ecological validity.ConclusionsThe PJVR device is feasible for older adults and participants with MCI. It can detect spatial navigation deficits related to AD pathology, and the results show a close correlation with real-world navigation ability.