BackgroundDealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner’s daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor’s response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas.ExperimentTwelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously.ResultsEight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants’ level of presence (together with participants’ feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening.

Group pressure can often result in people carrying out harmful actions towards others that they would not normally carry out by themselves. However, few studies have manipulated factors that might overcome this. Here male participants (n = 60) were in a virtual reality (VR) scenario of sexual harassment (SH) of a lone woman by a group of males in a bar. Participants were either only embodied as one of the males (Group, n = 20), or also as the woman (Woman, n = 20). A control group (n = 20) only experienced the empty bar, not the SH. one week later they were the teacher in a VR version of Milgram's obedience experiment where they were encouraged to give shocks to a female Learner by a group of 3 virtual males. Those who had been in the Woman condition gave about half the number of shocks of those in the Group condition, with the controls between these two. We explain the results through embodiment promoting identification with the woman or the group, and delegitimization of the group for those in the Woman condition. The experiment raised important ethical issues, showing that a VR study with positive ethical intentions can sometimes produce unexpected and non-beneficent results.Group pressure and the need to conform can result in significant distortions of an individual's judgment and decision making -a well-known case by Asch 1 being misjudgement of geometric shapes under peer pressure. However, Stanley Milgram argued for the distinction between signal conformity and action conformity 2,3 . In Asch's experiment people only verbally signalled conformity with the group but this had no further consequences (signal conformity). In contrast, in one experiment described by Milgram, participants were influenced to (apparently) administer electric shocks of greater and increasing voltage to a stranger at the behest of two confederates who demanded this, supposedly as a learning experiment. This is an example of action conformity since the behaviour of the subject would cause pain to another person. When there were no confederates, participants tended to choose the lowest shocks possible. Taking this out of the lab to real situations, conformity to group pressure can result in people engaging in evil acts that they would not normally do themselves individually, such as in the Stanford Prison Experiments 4 -even to the extent of taking part in mass killings -e.g., Stammers 5 , Chapter 18.The most salient finding of the obedience experiments has been that a surprisingly high proportion of people will administer apparently lethal shocks to a stranger at the behest of an authority figure. This was originally interpreted by Milgram as caused by their obedience to authority. However, alternative explanations have gained currency. Haslam, et al. 6 carried out an analysis of the results of all of Milgram's experiments, comprising 21 different conditions, and found an overall obedience level of 44%. A meta-analysis of the results of all the experiments open Scientific RepoRtS | (2020) 10:6207 | https://doi.org/10.1038/s41598-020-...

When people hold implicit biases against a group they typically engage in discriminatory behaviour against group members. In the context of the implicit racial bias of ‘White' against ‘Black' people, it has been shown several times that implicit bias is reduced after a short exposure of embodiment in a dark-skinned body in virtual reality. Embodiment usually leads to the illusion of ownership over the virtual body, irrespective of its skin colour. Previous studies have been carried out in virtual scenarios that are affectively neutral or positive. Here, we show that when the scenario is affectively negative the illusion of body ownership of White participants over a White body is lessened, and implicit bias is higher for White participants in a Black virtual body. The study was carried out with 92 White female participants, in a between-groups design with two factors: BodyType (their virtual body was White or Black) and a surrounding Crowd was Negative, Neutral or Positive towards the participant. We argue that negative affect prevents the formation of new positive associations with Black and distress leads to disownership of the virtual body. Although virtual reality is often thought of as an ‘empathy machine' our results suggest caution, that this may not be universally the case.

We review the concept of presence in virtual reality, normally thought of as the sense of “being there” in the virtual world. We argued in a 2009 paper that presence consists of two orthogonal illusions that we refer to as Place Illusion (PI, the illusion of being in the place depicted by the VR) and Plausibility (Psi, the illusion that the virtual situations and events are really happening). Both are with the proviso that the participant in the virtual reality knows for sure that these are illusions. Presence (PI and Psi) together with the illusion of ownership over the virtual body that self-represents the participant, are the three key illusions of virtual reality. Copresence, togetherness with others in the virtual world, can be a consequence in the context of interaction between remotely located participants in the same shared virtual environments, or between participants and virtual humans. We then review several different methods of measuring presence: questionnaires, physiological and behavioural measures, breaks in presence, and a psychophysics method based on transitions between different system configurations. Presence is not the only way to assess the responses of people to virtual reality experiences, and we present methods that rely solely on participant preferences, including the use of sentiment analysis that allows participants to express their experience in their own words rather than be required to adopt the terminology and concepts of researchers. We discuss several open questions and controversies that exist in this field, providing an update to the 2009 paper, in particular with respect to models of Plausibility. We argue that Plausibility is the most interesting and complex illusion to understand and is worthy of significant more research. Regarding measurement we conclude that the ideal method would be a combination of a psychophysical method and qualitative methods including sentiment analysis.

Figure 1: Two agents navigating with space-time precision through a complex dynamic environment. AbstractThis paper presents a real-time planning framework for multicharacter navigation that enables the use of multiple heterogeneous problem domains of differing complexities for navigation in large, complex, dynamic virtual environments. The original navigation problem is decomposed into a set of smaller problems that are distributed across planning tasks working in these different domains. An anytime dynamic planner is used to efficiently compute and repair plans for each of these tasks, while using plans in one domain to focus and accelerate searches in more complex domains. We demonstrate the benefits of our framework by solving many challenging multi-agent scenarios in complex dynamic environments requiring space-time precision and explicit coordination between interacting agents, by accounting for dynamic information at all stages of the decision-making process.