Background: Virtual reality (VR) is a major driving factor in the growth of the medical education market. VR simulates objects, places, and interactions in a 3D multimedia sensory environment. Research shows its effectiveness in surgical training, anatomy, and role-playing in clinical encounters. However, minimal research has compared the effectiveness of different delivery modes. The purpose of this study was to compare fully-immersive and semi-immersive VR in diabetes training. Methods: In this quasi-experimental study, healthcare trainees participated in either a fully-immersive 360-degree VR training with head-mounted displays (prior to SARS-CoV-2 pandemic) or a semi-immersive online VR training (during pandemic) . Participants completed the Diabetes Attitude Scale-3, Jefferson Scale of Empathy, and Transcultural Self-Efficacy Tool pre- and post-training. We conducted paired t-tests and independent t-tests with mean change scores for each measure to examine differences between study arms. Results: A total of 115 trainees participated (22.0±3.7 years, 82.6% women, 79.1% White, 24.3% medical students) . Participants in the fully-immersive VR arm (n=69) showed improvements in all diabetes attitude subscales, empathy, and all cultural self-efficacy subscales. Participants in the semi-immersive arm (n=46) showed improvements in all diabetes attitude subscales and two of the three cultural self-efficacy subscales, but not empathy (t=1.360, p=.182) or affective cultural self-efficacy (t= -1.798, p=.081) . Comparisons between fully-immersive and semi-immersive VR revealed no differences in diabetes attitudes or cultural self-efficacy; however, the fully-immersive VR showed greater improvements in empathy (t= -4.325, p<.001) . Conclusion: Our findings suggest fully-immersive VR is more effective in improving empathy than semi-immersive VR training. Future research should use a randomized-control design to compare the two delivery modes and examine the measures over time. Disclosure E.A.Beverly: None. M.Love: None. C.Love: None.
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