Introduction: Virtual humans have expanded the training opportunities available to healthcare learners. Particularly, virtual humans have allowed simulation to display visual cues that were not previously possible in other forms of healthcare training. However, the effect of virtual human fidelity on the perception of visual cues is unclear. Therefore, we explore the effect of virtual human rendering style on the perceptions of visual cues in a healthcare context.Methods: To explore the effect of rendering style on visual cues, we created a virtual human interface that allows users to interact with virtual humans that feature different rendering styles. We performed a mixed design user study that had undergraduate healthcare students (n = 107) interact with a virtual patient. The interaction featured a patient experiencing an allergic reaction and required trainees to identify visual cues (patient symptoms). The rendering styles explored include a 3D modeled virtual human and an AI generated photorealistic virtual human. Visual cues were applied using a Snapchat Lens.Results: When users are given a frame of reference (users could directly compare symptoms on both rendering styles), they rated the realism and severity of the photorealistic virtual human’s symptoms significantly higher than the realism of the 3D virtual human’s symptoms. However, we were unable to find significant differences in symptom realism and severity ratings when users were not given a frame of reference (users only interacted with one style of virtual humans). Additionally, we were unable to find significant differences in user interpersonal communication behaviors between the 3D and photorealistic rendering styles.Conclusion: Our findings suggest 1) higher fidelity rendering styles may be preferred if the learning objectives of a simulation require observing subtle visual cues on virtual humans and 2) the realism of virtual human rendering style does not necessarily affect participants’ interpersonal communication behaviors (time spent, questions asked).

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Millions of students worldwide have adopted online learning due to the isolation restrictions imposed by the Covid-19 pandemic. In this context, video conferencing platforms have garnered immense popularity as tools for teaching. However, these tools have several limitations compared to real-world encounters, especially in activities involving collaboration and teamwork. A growing number of researchers and educators have turned to avatar-based communication platforms, such as Mozilla Hubs, as alternatives that can complement video conferencing in social and teaching activities. Several previous research efforts have focused on developing tools that implement avatar-based communication systems or have explored creating activities in these 3D virtual spaces, such as poster sessions in scientific conferences or the classroom environment. In this work, we describe our semester-long efforts to develop Mozilla Hubs rooms toward promoting interaction and communication to help students self-form teams in the context of an introductory virtual reality course at the University of Florida. We describe hands-on activities to prepare students to use Mozilla Hubs effectively, including teaching them skills to customize and create avatars. We describe the implementation of three virtual rooms developed based on researchers' observations and students' survey responses. By observing students' behavior and communication patterns in those rooms, we propose a set of guidelines for building virtual rooms that can promote communication, interaction, and teamwork. We discuss the rooms' design, students' attendance, and avatar choices. Our findings suggest that highly detailed, small, closed spaces are preferred over large, open spaces with few details when promoting interaction and collaboration among students.

Effective communication among healthcare professionals is critical to delivering safe, high-quality patient care. One important real-world skill that nursing students must acquire is generating accurate handoff communication reports. The central aim of this study was to build, assess, and revise a virtual experience simulation that allows nursing students to observe a standardized clinical situation in an immersive environment and then practice the situation-background-assessment-recommendation communication method. This between-groups experimental study, which was modified in light of COVID-19 concerns, evaluated how well 69 prelicensure nursing students understood a handoff communication report after viewing a virtual human patient and nurse interact during a triage assessment scenario. Results indicate student comprehension levels did not differ based on which of two metacognitive learning strategies was used. Participants in both study groups were able to accurately complete a situation-background-assessment-recommendation instrument based on the virtual experience. Further, they believed that watching a virtual nurse perform a triage assessment would help them perform one themselves in a similar virtual environment. There was also an unexpected study finding related to patient safety within the context of the simulation. This finding warrants further research that will lead to revision of the virtual experience used to train future nurses.

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