Virtual Reality Head-mounted Display Research Articles

Training transfer validity of virtual reality simulator assessment

This study utilises computer-based simulations to explore the transfer effects of competency training in maritime education, addressing the current lack of research on their transferability to real-world scenarios.The research explores the accuracy of procedural knowledge assessment using virtual reality (VR), positing that head-mounted display (HMD) VR offers stronger concurrent validity through training transfer measures than 3D desktop VR. This is evaluated by regression on a training transfer condition. It also investigates motivation’s influence on training transfer and the regression model of this relationship.Fifteen marine engineering students were divided into two experimental groups using 3D desktop VR and HMD VR systems, with eight experts in the control group. The students had previously received traditional lecture-based instruction and were given practical training using a 2D desktop simulator in the same scenario as in the VR treatment and in the training transfer condition.The ANCOVA design experiment involved two levels of technical immersion before the operation of real-life equipment. Neither technical immersion nor expertise level as independent variables were found to have a significant effect in the relationship of the assessment predicting the training transfer. The direct relationship was significant (R2adj = 0.436) and further analysed with the influence of motivation, resulting in a moderation model with a decent effect size (R2 = 0.740). Based on these findings, we can infer that both types of VR simulations used for assessment demonstrate concurrent validity in predicting real-life performance before we discuss and define the characteristics of the observed transfer according to theory.

Evaluation of monocular and binocular contrast perception on virtual reality head-mounted displays.

Visualization of medical images on a virtual reality (VR) head-mounted display (HMD) requires binocular fusion of a stereoscopic pair of graphical views. However, current image quality assessment on VR HMDs for medical applications has been primarily limited to time-consuming monocular optical bench measurement on a single eyepiece. As an alternative to optical bench measurement to quantify the image quality on VR HMDs, we developed a WebXR test platform to perform contrast perceptual experiments that can be used for binocular image quality assessment. We obtained monocular and binocular contrast sensitivity responses (CSRs) from participants on a Meta Quest 2 VR HMD using varied interpupillary distance (IPD) configurations. The perceptual result shows that contrast perception on VR HMDs is primarily affected by optical aberration of the VR HMD. As a result, monocular CSR degrades at a high spatial frequency greater than 4 cycles per degree when gazing at the periphery of the display field of view, especially for mismatched IPD settings consistent with optical bench measurements. On the contrary, binocular contrast perception is dominated by the monocular view with superior image quality measured by the contrast. We developed a test platform to investigate monocular and binocular contrast perception by performing perceptual experiments. The test method can be used to evaluate monocular and/or binocular image quality on VR HMDs for potential medical applications without extensive optical bench measurements.

Experimental Analysis of Freehand Multi-object Selection Techniques in Virtual Reality Head-Mounted Displays

Object selection is essential in virtual reality (VR) head-mounted displays (HMDs). Prior work mainly focuses on enhancing and evaluating techniques for selecting a single object in VR, leaving a gap in the techniques for multi-object selection, a more complex but common selection scenario. To enable multi-object selection, the interaction technique should support group selection in addition to the default pointing selection mode for acquiring a single target. This composite interaction could be particularly challenging when using freehand gestural input. In this work, we present an empirical comparison of six freehand techniques, which are comprised of three mode-switching gestures (Finger Segment, Multi-Finger, and Wrist Orientation) and two group selection techniques (Cone-casting Selection and Crossing Selection) derived from prior work. Our results demonstrate the performance, user experience, and preference of each technique. The findings derive three design implications that can guide the design of freehand techniques for multi-object selection in VR HMDs.

How does visual context of urban open spaces drive soundscape pleasantness and eventfulness: a laboratory experiment using a higher order Ambisonics speaker system and immersive virtual reality

Perception of sound environments is influenced by the context we experience them in. A big portion of the contextual information comes from the visual domain, including our understanding of what a place is but also from its visual features. A laboratory study combining questionnaire responses and eye-tracking tools was designed to investigate if the soundscape outcomes and participants' behaviour inside the simulation can be explained by the perceptual outcomes defined by visual information. 360 degree videos and First Order Ambisonics audio recordings of 27 different urban open spaces taken from the International Soundscape Database were used as the stimuli delivered via a Virtual Reality Head-Mounted Display and a Higher Order Ambisonics speaker array, while a neutral grey environment without sounds being reproduced represented the baseline scenario. A questionnaire tool was deployed within the IVR simulation to collect participants' responses describing their perception of the reproduced environments corresponding to the circumplex model featured in the Method A of the ISO/TS 12913-2. The results revealed a good coverage of the two-dimensional perceptual circumplex space and significant differences between perceptual outcomes driven by sound and those driven by visual stimuli.

Emotion recognition based on a limited number of multimodal physiological signals channels

Emotion constitutes a higher-order cognitive process, moreover, physiological signals can offer a more objective and realistically reflection of human emotional state. Electroencephalograph (EEG) signals, controlled by the central nervous system, are highly sensitive to emotional state fluctuations. Current research primarily focuses on recognizing emotions through feature extraction from multi-channel EEG signals. However, the acquisition of multi-channel EEG signals is hindered by difficulties acquiring from hair occlusion. The objective of this study is to construct a real-time physiological-emotion recognition model based on 2-channel EEG signals from the forehead without hair occlusion combined with 3-channel peripheral physiological (PPS) signals, employing signal preprocessing, feature extraction, feature normalization, and the ensemble learning algorithm Light Gradient Boosting Machine (LightGBM). In this paper, thirty participants sequentially viewed fourteen virtual reality (VR) scenes, rated for valence and arousal using the Self-Assessment Manikin (SAM) scale after each scene. The 2-channel EEG signals and 3-channel PPS signals were recorded synchronously from forehead by VR Head-Mounted Displays (HMD) Bio Pad developed in our research center. Our proposed model achieved median accuracy of 89.68% for valence, 90.11% for arousal in binary classification, and 84.93% for four classification of emotion recognition based on the collected samples. Furthermore, verification result of the proposed method on a public database (DEAP) achieved accuracy of 84.03%, 84.37%, and 72.23% on valence, arousal, and four classification, respectively. The proposed physiological-emotion recognition model, utilizing a limited number of multimodal physiological signals channels from wearable devices, demonstrates higher accuracy compared with the results in some literature, suggesting its potential for real-time implementation due to limited signal channels and low runtime.

Development and Initial Testing of an Artificial Intelligence-Based Virtual Reality Companion for People Living with Dementia in Long-Term Care.

Background/Objectives: Feelings of loneliness are common in people living with dementia (PLWD) in long-term care (LTC). The goals of this study were to describe the development of a novel virtual companion for PLWD living in LTC and assess its feasibility and acceptability. Methods: The computer-generated virtual companion, presented using a head-mounted virtual reality display, was developed in two stages. In Stage 1, the virtual companion asked questions designed to encourage conversation and reminiscence. In Stage 2, more powerful artificial intelligence tools allowed the virtual companion to engage users in nuanced discussions on any topic. PLWD in LTC tested the application at each stage to assess feasibility and acceptability. Results: Ten PLWD living in LTC participated in Stage 1 (4 men and 6 women; average 82 years old) and Stage 2 (2 men and 8 women; average 87 years old). Session lengths ranged from 0:00 to 5:30 min in Stage 1 and 0:00 to 53:50 min in Stage 2. Speech recognition issues and a limited repertoire of questions limited acceptance in Stage 1. Enhanced conversational ability in Stage 2 led to intimate and meaningful conversations with many participants. Many users found the head-mounted display heavy. There were no complaints of simulator sickness. The virtual companion was best suited to PLWD who could engage in reciprocal conversation. After Stage 2, response latency was identified as an opportunity for improvement in future versions. Conclusions: Virtual reality and artificial intelligence can be used to create a virtual companion that is acceptable and enjoyable to some PLWD living in LTC. Ongoing innovations in hardware and software will allow future iterations to provide more natural conversational interaction and an enhanced social experience.

Localization and Speech-in-Noise Performance in a Virtual Reality Test Environment: A Pilot Study of Adults With Single-Sided Deafness Using a Cochlear Implant.

The purpose of this exploratory study was to (a) construct a virtual reality (VR) test environment to measure speech recognition in noise (SIN) and localization, and (b) use the VR test environment to establish degree of binaural hearing benefit among a small number of adults with single-sided deafness (SSD) using a cochlear implant (CI). This pilot study included five adults implanted for SSD. The test environment was composed of an eight-speaker array that delivered restaurant noise and Institute of Electrical and Electronics Engineers sentences. VR head-mounted display goggles delivered a video recording of a busy restaurant. Participants completed SIN and localization in two conditions: (a) normal-hearing ear and a CI on the contralateral SSD side (CI-ON) and (b) normal-hearing ear and unaided on the contralateral SSD side (CI-OFF). Overall, CI benefits for SIN and localization within the VR test environment were improved for some participants, although not all. CI benefit for SIN and localization was dependent on speaker location. VR test environments present new opportunities for studying SIN and localization abilities in participants with CIs. This pilot study shows that, within a VR test environment, degree of CI benefit among SSD participants for SIN and localization varies across speaker location and across participants.

When virtual others are with me: exploring the influence of social presence in virtual reality wine tourism experiences

PurposeThe purpose of this study is to examine the role of social presence in enhancing positive behaviors in the virtual reality (VR)-based wine tourism context through an innovative approach.Design/methodology/approachTwo sequential experimental studies were conducted to test proposed hypotheses using Web and head-mounted display (HMD) VR formats. Specifically, Study 1 probed the influence of social presence on mental imagery, which subsequently impacted destination visit intention, drinking intent and memorable experience. Study 2 used a field experiment to explore the boundary effects of environmental cues (nature versus social) on social presence and a series of behavioral intentions using an HMD format.FindingsThe findings represent one of the first efforts to unravel the influence of social presence on positive behaviors through mental imagery and the moderating role of environmental cues.Research limitations/implicationsThis research enhances the understanding of wine tourism, drawing upon social presence theory and stimulus-organism-response framework.Practical implicationsThe outcomes provide valuable insights for wine tourism marketers in developing innovative marketing strategies by addressing the usage of social presence and environmental cues in a VR setting.Originality/valueTo the best of the authors’ knowledge, this study is the first to enrich the existing knowledge of wine tourism by exploring the role of social presence and environmental cues in both Web and HMD VR formats.

Virtual reality vs. Tablet video for venipuncture education in children: A randomized clinical trial.

Pediatric patients usually experience high levels of pain and distress due to venipuncture. This randomised study aimed to evaluate the effects of virtual reality-based preprocedural education in comparison with video-based education in terms of pain and distress experienced by children scheduled to undergo venipuncture. Ninety children aged 4-8 years who were scheduled to undergo venipuncture surgery were randomly assigned to either a video or virtual reality group. Children in the video group received preprocedural education on venipuncture via a video displayed on a tablet and those in the virtual reality group received the same education via a head-mounted virtual reality display unit. The educational content for the two groups was identical. An independent assessor blinded to the group assignment observed the children's behavior and determined their Children's Hospital of Eastern Ontario Pain Scale scores, parental satisfaction score, procedure-related outcomes, venipuncture time, number of repeated procedures and difficulty score for the procedure. The virtual reality group experienced less pain and distress, as indicated by their Children's Hospital of Eastern Ontario Pain Scale scores compared with the video group (5.0 [5.0-8.0] vs. 7.0 [5.0-9.0], P = 0.027). There were no significant intergroup differences in parental satisfaction scores or procedure-related outcomes. For pediatric patients scheduled to undergo venipuncture, preprocedural education via a head-mounted display for immersive virtual reality was more effective compared with video-based education via a tablet in terms of reducing pain and distress.

Decline in Sensory Integration in Old Age and Its Related Functional Brain Connectivity Correlates Observed during a Virtual Reality Task.

Sensory integration is an essential human function whose decline impacts quality of life, particularly in older adults. Herein, we propose an arm-reaching task based on a virtual reality head-mounted display system to assess sensory integration in daily life, and we examined whether reaching task performance was associated with resting-state functional connectivity (rsFC) between the brain regions involved in sensory integration. We hypothesized that declining sensory integration would affect performance during a reaching task with multiple cognitive loads. Using a task in which a young/middle-aged group showed only small individual differences, older adults showed large individual differences in the gap angle between the reaching hand and the target position, which was used to assess sensory integration function. Additionally, rsfMRI data were used to identify correlations between rsFC and performance in older adults, showing that performance was correlated with connectivity between the primary motor area and the left inferior temporal gyrus and temporo-occipital region. Connectivity between areas is related to visuomotor integration; thus, the results suggest the involvement of visuomotor integration in the decline of sensory integration function and the validity of the gap angle during this VR reaching task as an index of functional decline.

The acute hypoalgesic effects of active head-mounted display virtual reality games.

The purpose of this study was to determine: (1) whether physically active virtual reality (VR) games exert an acute hypoaglesic effect on the thigh and bicep compared to a non-active VR game and an exercise only condition matched for exercise intensity in healthy individuals, and (2) whether movement variables during gameplay are associated with the hypoalgesic effect of the games. Twenty young adults completed five separate study sessions, with each session devoted to playing one head-mounted display VR game or stationary cycling for 15 minutes. The games included Holopoint at level 2 and level 3, Hot Squat, and Relax Walk. Pressure pain thresholds at the thigh and bicep were measured pre and post VR gameplay and cycling. Participants wore a heart rate monitor and accelerometers on the wrist and thigh during play to measure the intensity and quantity of movement. Repeated measures ANOVAs revealed that pressure pain thresholds on the bicep increased from pre to posttest for each condition. The results also revealed that pressure pain thresholds on the thigh increased only for the conditions eliciting the greatest cardiovascular response, which included Holopoint at level 3, Hot Squat, and cycling. Bivariate correlations indicated that moderate to vigorous physical activity of the thigh was associated with pain reduction at the thigh during Holopoint. These results revealed that active VR games and exercise exerted a more widespread hypoalgesic effect compared to the non-active VR game, which was likely driven in part by the intensity and quantity of movement during gameplay.

Virtual Reality Videos for Symptom Management in Hospice and Palliative Care

ObjectiveTo learn more about the effect of virtual reality videos on patients’ symptoms near the end of life, including which are most effective, how long the effect lasts, and which patients benefit the most. Patients and MethodsWe conducted a prospective study of 30 patients in a regional hospice and palliative care program from March 11, 2022, through July 14, 2023. Using a head-mounted display virtual reality, all participants viewed a 15-minute video of serene nature scenes with ambient sounds. Fifteen patients also participated in a second session of viewing bucket-list video clips they selected. Symptoms were measured with the revised Edmonton Symptom Assessment Scale before, immediately after, and 2 days after each experience. Participants rated their bucket-list selections by level of previous experience, strength of connection, and overall video quality. Functional status was also recorded. ResultsNature scenes significantly improved total symptom scores (30% decrease, P<.001), as well as scores for drowsiness, tiredness, depression, anxiety, well-being, and dyspnea. The improved scores were not sustained 2 days later. Overall, bucket-list videos did not significantly improve symptoms. Neither previous experience with an activity nor a strong connection correlated with significant improvement; however, when patients rated video quality as outstanding, scores improved (31% decrease, P=.03). Patients with lower functional status tended to have more symptoms beforehand and improve the most. ConclusionSerene nature head-mounted display virtual reality scenes safely reduce symptoms at the end of life. Bucket-list experiences may be effective if they are high-quality. More infirm patients may benefit the most.

Augmented Reality Improved Knowledge and Efficiency of Root Canal Anatomy Learning: A Comparative Study

Teaching root canal anatomy has traditionally been reliant on static methods, but recent studies have explored the potential of advanced technologies like augmented reality (AR) to enhance learning and address the limitations of traditional training methods, such as the requirement for spatial imagination and the inability to simulate clinical scenarios fully. This study evaluated the potential of AR as a tool for teaching root canal anatomy in preclinical training in endodontics for predoctoral dental students. Six cone beam computed tomography (CBCT) images of teeth were selected. Board-certified endodontist and radiologist recorded the tooth type and classification of root canals. Then, STereoLithography (STL) files of the same images were imported into a virtual reality (VR) application and viewed through a VR head-mounted display. Forty-three third-year dental students were asked questions about root canal anatomy based on the CBCT images, and then, after the AR model. The time to respond to each question and feedback was recorded. Student responses were paired, and the difference between CBCT and AR scores was examined using a paired-sample t-test and set to p = 0.05. Students demonstrated a significant improvement in their ability to answer questions about root canal anatomy after utilizing the AR model (p &lt; 0.05). Female participants demonstrated significantly higher AR scores compared to male participants. However, gender did not significantly influence overall test scores. Furthermore, students required significantly less time to answer questions after using the AR model (M = 4.09, SD = 3.55) compared to the CBCT method (M = 15.21, SD = 8.01) (p &lt; 0.05). This indicates that AR may improve learning efficiency alongside comprehension. In a positive feedback survey, 93% of students reported that the AR simulation led to a better understanding of root canal anatomy than traditional CBCT interpretation. While this study highlights the potential of AR in learning root canal anatomy, further research is needed to explore its long-term impact and efficacy in clinical settings.

Virtual Reality Head-Mounted Display (HMD) and Preoperative Patient-Specific Simulation: Impact on Decision-Making in Pediatric Urology: Preliminary Data.

To assess how virtual reality (VR) patient-specific simulations can support decision-making processes and improve care in pediatric urology, ultimately improving patient outcomes. Children diagnosed with urological conditions necessitating complex procedures were retrospectively reviewed and enrolled in the study. Patient-specific VR simulations were developed with medical imaging specialists and VR technology experts. Routine CT images were utilized to create a VR environment using advanced software platforms. The accuracy and fidelity of the VR simulations was validated through a multi-step process. This involved comparing the virtual anatomical models to the original medical imaging data and conducting feedback sessions with pediatric urology experts to assess VR simulations' realism and clinical relevance. A total of six pediatric patients were reviewed. The median age of the participants was 5.5 years (IQR: 3.5-8.5 years), with an equal distribution of males and females across both groups. A minimally invasive laparoscopic approach was performed for adrenal lesions (n = 3), Wilms' tumor (n = 1), bilateral nephroblastomatosis (n = 1), and abdominal trauma in complex vascular and renal malformation (ptotic and hypoplastic kidney) (n = 1). Key benefits included enhanced visualization of the segmental arteries and the deep vascularization of the kidney and adrenal glands in all cases. The high depth perception and precision in the orientation of the arteries and veins to the parenchyma changed the intraoperative decision-making process in five patients. Preoperative VR patient-specific simulation did not offer accuracy in studying the pelvic and calyceal anatomy. VR patient-specific simulations represent an empowering tool in pediatric urology. By leveraging the immersive capabilities of VR technology, preoperative planning and intraoperative navigation can greatly impact surgical decision-making. As we continue to advance in medical simulation, VR holds promise in educational programs to include even surgical treatment of more complex urogenital malformations.

Evaluating User Engagement and Preference in Virtual Reality and Augmented Virtuality for Interactive Storytelling

Abstract Technologies like virtual reality (VR) and augmented virtuality (AV) based on head-mounted display (HMD) have made immersive interactive narrative experience possible. To investigate the differences between HMD VR and HMD AV for interactive storytelling, an app entitled the Extended Journey has been designed, developed and deployed on both VR headsets and optical see-through (OST) mixed reality (MR) headsets. Subsequently, a within-subjects design experiment with sixty participants was conducted to measure different factors of user experience in HMD VR and HMD AV conditions. Additionally, a between-subjects design experiment with 62 participants was conducted to evaluate narrative immersion and presence. Quantitative results from the experiments reveal that HMD VR narrative had statistically significantly better narrative immersion, presence, enjoyment and perceived affinity of computer-generated (CG) characters compared with HMD AV narrative in the context of galleries and museums. Based on Sundar's Modality-Agency-Interactivity-Navigability (MAIN) model, we proposed and validated that sense of being-there and interaction mediated the relationship between immersive media modality and narrative immersion as well as empathy. Qualitative data and behavioral tests showed that young people have a higher preference for HMD VR over HMD AV, but for specific use scenarios, there is still a certain possibility of choosing HMD AV due to security and space limitations. These findings have theoretical implications for the psychology of VR and AV, and practical applications for HMD-based immersive narrative in general.

An Empirical Study of VR Head-Mounted Displays Based on VR Games Reviews

With the development of virtual reality (VR) technology, various VR devices are flooding the market. VR head-mounted displays (HMDs) sales are overgrowing as the primary medium for experiencing VR games. Therefore, exploring user concerns about HMDs is significant, enabling developers to design better VR devices and VR games. In this work, we conduct an empirical study of 7,413 VR games and 176,428 player reviews collected from three platforms (i.e., Oculus, Steam, and Viveport). First, we investigate the evolutionary trends of HMDs based on VR games. Subsequently, we extract nine topics (e.g., cybersickness, performance, and privacy) related to HMDs from game reviews that users are concerned about, analyze the emotional trends, and explore the voices of players. We find that users complain less about the cybersickness and immersion of HMDs and more about other topics (e.g., performance, tracking, and compatibility). In addition, more users have expressed concerns about privacy in recent years.

Viewpoint-sharing method with reduced motion sickness in object-based VR/AR collaborative virtual environment

We propose a viewpoint-sharing method with reduced motion sickness in an object-based remote collaborative virtual environment (CVE). The method is designed with an assumption of asymmetric, object-based CVE where collaborators use non-homogeneous devices, such as immersive virtual reality head-mounted display (VR HMD) and tablet-based augmented reality (AR), and simultaneously interact with 3D virtual objects. Therefore, collaborators interact with different interfaces such as virtual reality (VR) users relying on controllers for virtual locomotion and object manipulation, while AR users perform physical locomotion and multi-touch input for object manipulation. The proposed viewpoint-sharing method allows both users to observe and manipulate the objects in interest from the shared point of view, enabling participants to interact with the objects without the need for virtual/physical locomotion. While viewpoint-sharing, instead of changing point of view, the proposed method performs seamless object transformation to provide a shared point of view, reducing motion sickness and associated discomfort. From our user experiment, the viewpoint-share condition resulted in a 35.47% faster task completion time than the baseline condition which is without proposed viewpoint-sharing. The advantage of viewpoint-sharing regarding system usability was significant, while task workloads were similar in the baseline and viewpoint-sharing conditions. We expect that the proposed viewpoint-sharing method allows users to quickly, efficiently, and collaboratively communicate in an object-based CVE, and represents a step forward in the development of effective remote, asymmetric CVE.

The Effectiveness of Virtual Reality-Based Training on Cognitive, Social, and Physical Functioning in High-Functioning Older Adults (CoSoPhy FX): 2-Arm, Parallel-Group Randomized Controlled Trial.

Virtual reality (VR) has emerged as a promising technology for enhancing the health care of older individuals, particularly in the domains of cognition, physical activity, and social engagement. However, existing VR products and services have limited availability and affordability; hence, there is a need for a scientifically validated and personalized VR service to be used by older adults in their homes, which can improve their overall physical, cognitive, and social well-being. The main purpose of the CoSoPhy FX (Cognitive, Social, and Physical Effects) study was to analyze the effects of a VR-based digital therapeutics app on the cognitive, social, and physical performance abilities of healthy (high-functioning) older adults. This paper presents the study protocol and the results from the recruitment phase. A group of 188 healthy older adults aged 65-85 years, recruited at the Medical University of Lodz, Poland, were randomly allocated to the experimental group (VR dual-task training program) or to the control group (using a VR headset app showing nature videos). A total of 3 cognitive exercises were performed in various 360° nature environments delivered via a VR head-mounted display; the participants listened to their preferred music genre. Each patient received 3 sessions of 12 minutes per week for 12 weeks, totaling a minimum of 36 sessions per participant. Attention and working memory (Central Nervous System Vital Signs computerized cognitive battery) were used as primary outcomes, while other cognitive domains in the Central Nervous System Vital Signs battery, quality of life (World Health Organization-5 Well-Being Index), health-related quality of life (EQ-5D-5L), and anxiety (General Anxiety Disorder 7-item questionnaire) were the secondary outcomes. The group-by-time interaction was determined using linear mixed models with participants' individual slopes. In total, 122 (39%) of the initial 310 participants failed to meet the inclusion criteria, resulting in a recruitment rate of 61% (188/310). Among the participants, 68 successfully completed the intervention and 62 completed the control treatment. The data are currently being analyzed, and we plan to publish the results by the end of September 2024. VR interventions have significant potential among healthy older individuals. VR can address various aspects of well-being by stimulating cognitive functions, promoting physical activity, and facilitating social interaction. However, challenges such as physical discomfort, technology acceptance, safety concerns, and cost must be considered when implementing them for older adults. Further research is needed to determine the long-term effects of VR-based interventions, optimal intervention designs, and the specific populations that would benefit most. ClinicalTrials.gov NCT05369897; https://clinicaltrials.gov/study/NCT05369897. DERR1-10.2196/53261.

Design and evaluation of alphabetic and numeric input methods for virtual reality

In today’s virtual reality (VR), users have various ways to influence their VR experience, including alphanumeric input. While typing characters and numbers is straightforward on desktop computers, it presents challenges and opportunities in head-mounted display VR due to specific interaction methods and a lack of real-world visual stimuli. Addressing these open questions, our work implements and evaluates ten approaches to alphabetic and numeric inputs in VR. We describe the design motivation behind these input methods and evaluate them in a user study with 40 participants divided into groups for alphabetic and numeric keyboards. This comparison investigates each method’s performance and user interactions. Our findings suggest that different input methods significantly impact words per minute and error rates, and that certain keyboard designs may receive better subjective evaluations despite poorer objective performance.

Effect of Self-Training Using Virtual Reality Head-Mounted Display Simulator on the Acquisition of Holmium Laser Enucleation of the Prostate Surgical Skills.

We aimed to evaluate the effect of self-training using a virtual reality head-mounted display simulator on the acquisition of surgical skills for holmium laser enucleation surgery. Thirteen medical students without surgical skills for holmium laser enucleation of the prostate were trained using multimedia to learn the technique via simulator manipulation. Thereafter, participants performed the technique on a virtual benign prostatic hyperplasia model A (test A). After a 1-week wash-out period, they underwent self-training using a simulator and performed the technique on model B (test B). Subsequently, participants were asked to respond to Training Satisfaction Questions. Video footage of hand movements and endoscope view were recorded during tests A and B for later review by 2 expert surgeons. A 20-step Assessment Checklist, 6-domain Global Rating Scale, and a Pass Rating were used to compare performance on tests A and B. Thirteen participants completed both tests A and B. The 20-step Assessment Checklist and 6-domain Global Rating Scale evaluation results showed significantly improved scores in test B than in test A (P<0.05). No evaluator rated participants as passed after test A, but 11 participants (84.6%) passed after test B. Ten participants (76.9%) indicated that the simulator was helpful in acquiring surgical skills for holmium laser enucleation of the prostate. The virtual reality head-mounted display holmium laser enucleation of the prostate simulator was effective for surgical skill training. This simulator may help to shorten the learning curve of this technique in real clinical practice in the future.