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<p>Virtual reality (VR) is increasingly used for assessment in educational and clinical settings. However, users’ immersive competence (IC)—the ability to navigate and operate VR systems—may introduce bias unrelated to clinical skills or patient functioning. In this randomized controlled trial, 88 medical students received either general IC training, general+specific IC training, or no structured training before completing a VR-based assessment scenario. Multimodal data were collected, including electrodermal activity, cognitive-load ratings, procedural efficiency, and usability barriers. Specific IC training improved performance compared with control (28.3% ± 10.3% vs. 21.2% ± 10.8%, <i>p</i> = 0.010, <i>d</i> = 0.67), moderated by procedural efficiency and increased cognitive load. Prior 3D experience did not predict performance in the control group, likely due to a floor effect, but did in the specific training group. These findings indicate that IC is a causal, modifiable factor in VR-based assessments and should be considered to ensure fair and valid evaluations.</p>

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Immersive competence as a source of bias in virtual reality clinical assessment

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月9日

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  • Jan Schaal,
  • Tobias Leutritz,
  • Marco Lindner,
  • Alexander Zamzow,
  • Joy Backhaus,
  • Sarah König,
  • Tobias Mühling

摘要

Virtual reality (VR) is increasingly used for assessment in educational and clinical settings. However, users’ immersive competence (IC)—the ability to navigate and operate VR systems—may introduce bias unrelated to clinical skills or patient functioning. In this randomized controlled trial, 88 medical students received either general IC training, general+specific IC training, or no structured training before completing a VR-based assessment scenario. Multimodal data were collected, including electrodermal activity, cognitive-load ratings, procedural efficiency, and usability barriers. Specific IC training improved performance compared with control (28.3% ± 10.3% vs. 21.2% ± 10.8%, p = 0.010, d = 0.67), moderated by procedural efficiency and increased cognitive load. Prior 3D experience did not predict performance in the control group, likely due to a floor effect, but did in the specific training group. These findings indicate that IC is a causal, modifiable factor in VR-based assessments and should be considered to ensure fair and valid evaluations.