Validation of the Virtual Reality Everyday Assessment Lab (VR-EAL): An Immersive Virtual Reality Neuropsychological Battery with Enhanced Ecological Validity

Abstract

Objective: The assessment of cognitive functions such as prospective memory, episodic memory, attention, and executive functions benefits from an ecologically valid approach to better understand how performance outcomes generalize to everyday life. Immersive virtual reality (VR) is considered capable of simulating real-life situations to enhance ecological validity. The present study attempted to validate the Virtual Reality Everyday Assessment Lab (VR-EAL), an immersive VR neuropsychological battery, against an extensive paper-and-pencil neuropsychological battery. Methods: Forty-one participants (21 females) were recruited: 18 gamers and 23 non-gamers who attended both an immersive VR and a paper-and-pencil testing session. Bayesian Pearson’s correlation analyses were conducted to assess construct and convergent validity of the VR-EAL. Bayesian t-tests were performed to compare VR and paper-and-pencil testing in terms of administration time, similarity to real-life tasks (i.e., ecological validity), and pleasantness. Results: VR-EAL scores were significantly correlated with their equivalent scores on the paper-and-pencil tests. The participants’ reports indicated that the VR-EAL tasks were significantly more ecologically valid and pleasant than the paper-and-pencil neuropsychological battery. The VR-EAL battery also had a shorter administration time. Conclusion: The VR-EAL appears as an effective neuropsychological tool for the assessment of everyday cognitive functions, which has enhanced ecological validity, a highly pleasant testing experience, and does not induce cybersickness.

How immersive virtual reality methods may meet the criteria of the National Academy of Neuropsychology and American Academy of Clinical Neuropsychology: A software review of the Virtual Reality Everyday Assessment Lab (VR-EAL)

“…The VRNQ was found to be a valid tool for assessing VR software in terms of user The VR-EAL scores were significantly correlated with their equivalent scores on the ecologically valid paper-and-pencil tests, which support the convergent, construct, and ecological validity of the VR-EAL (Kourtesis et al, 2020a). The participants' reports indicated that the VR-EAL tasks were considered significantly more similar to real-world tasks and more pleasant than the paper-and-pencil neuropsychological battery.…”

“…The development and compatibility of VR-EAL was based on a systematic literature review (Kourtesis et al, 2019a) and a study on the acceptability of VR technologies (Kourtesis et al, 2019ab). The suitability of VR-EAL was thoroughly examined during the development phase (Kourtesis et al, 2020b) and its validity and advantages were evaluated against an extensive paper-and-pencil neuropsychological battery (Kourtesis et al, 2020a). The contribution of VR-EAL in the understanding of everyday cognitive functions was also examined .…”

“…The VR-EAL is immediately available after its installation on a personal computer and automatically produces accurate performance scores that are exported into a .txt file (Kourtesis et al, 2020b). Consequently, the VR-EAL has no costs for administration and scoring, and it requires a substantially shorter administration time as compared to the equivalent paper-and-pencil batteries (Kourtesis et al, 2020a).…”

“…Guidelines were also proposed that described the development of the Virtual Reality Everyday Assessment Lab (VR-EAL), the first immersive VR neuropsychological battery, programmed using Unity game development software (Kourtesis, Korre, Collina, Doumas, & MacPherson, 2020b). Furthermore, the convergent, construct, and ecological validity of VR-EAL as an assessment of prospective memory, episodic memory, visual attention, visuospatial attention, auditory attention, and executive functions were examined (Kourtesis, Collina, Doumas, & MacPherson, 2020a). Finally, using VR-EAL, prospective memory in everyday life was examined by comparing performance on diverse prospective memory tasks (i.e., focal and non-focal event-based, and time-based tasks; Kourtesis, Collina, Doumas, & MacPherson, 2021) and identifying the cognitive functions which predict everyday prospective memory functioning .…”

Memory for Spatio-temporal Contextual Details During the Retrieval of Naturalistic Episodes

“…Overall, encoding in VR has been associated with an increase of memory performance [22][23][24]; see also [25] for review.…”