Users agreed that the teaching approach improved their understanding of ophthalmoscopy (n = 14), their ability to identify landmarks in the eye (n = 14) and their ability to recognise abnormalities (n = 15). They found the app easy to use (n = 15), the teaching approach informative (n = 13) and that it would increase students' confidence when performing these tasks in future (n = 15). Performing eye examinations is an important clinical skill DISCUSSION: The evaluation showed that a VR app can successfully simulate the processes involved in performing eye examinations. The app was highly rated for all elements of perceived usefulness, ease of use and usability. Medical students stated that they would like to be taught other medical skills in this way in future.

In order to be used for skill development and skill maintenance, virtual environments require accurate simulation of the physical phenomena involved in the process of the task being trained. The accuracy needs to be conveyed in a multimodal fashion with varying parameterisations still being quantified, and these are a function of task, prior knowledge, sensory efficacy and human perception. Virtual reality (VR) has been integrated from a didactic perspective in many serious games and shown to be effective in the pedological process. This paper interrogates whether didactic processes introduced into a VR serious game, by taking advantage of augmented virtuality to modify game attributes, can be effective for both beginners and experts to a task. The task in question is subjective performance in a clay pigeon shooting simulation. The investigation covers whether modified game attributes influence skill and learning in a complex motor task and also investigates whether this process is applicable to experts as well as beginners to the task. VR offers designers and developers of serious games the ability to provide information in the virtual world in a fashion that is impossible in the real world. This introduces the question of whether this is effective and transfers skill adoption into the real world and also if a-priori knowledge influences the practical nature of this information in the pedagogic process. Analysis is conducted via a between-subjects repeated measure ANOVA using a 2 × 2 factorial design to address these questions. The results show that the different training provided affects the performance in this task (N = 57). The skill improvement is still evidenced in repeated measures when information and guidance is removed. This effect does not exist under a control condition. Additionally, we separate by an expert and non-expert group to deduce if a-priori knowledge influences the effect of the presented information, it is shown that it does not.

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