Assessing the use of VR as a tool for teaching hypoxia in preclinical medical education: a mixed-methods study focusing on student experience and learning

Virtual reality (VR) has revolutionized medical education, yet its specific efficacy in teaching medical physiology remains underexplored. Conveying the complexities of physiological responses to hypoxia through traditional teaching methods poses logistical challenges, potentially hindering students' deep understanding. This study investigates the impact of incorporating VR into preclinical medical physiology teaching, focusing on students' self-reported <i>1</i>) knowledge acquisition and understanding of body responses to hypoxia, <i>2</i>) VR technology acceptance and satisfaction, and <i>3</i>) overall learning experience. In 2022, an Australian National University (ANU) Medical School teaching enhancement grant funded data collection to develop a comprehensive storyboard for a VR hypoxia simulation program. With support from the school's Technology-Enhanced Learning and Teaching team and the university's Center for Learning and Teaching, we created an in-house limited prototype focusing on key aspects of the scripted VR simulation module to test its feasibility and perceived usefulness within our Medicinae ac Chirurgiae Doctoranda (MChD) program. The module was integrated into a <i>year 1</i> practical session, followed by a two-part series of data collection, comprising a questionnaire and video interviews. The questionnaire used a mixed-methods approach, including five-point Likert scale closed-ended questions rating VR perceived usefulness and ease of use and open-ended questions allowing participants to provide qualitative responses. Interviews delved deeper into users' experience, interactivity, collaboration, realism, practicality, knowledge acquisition, improvement suggestions, and overall technology and learning satisfaction. Although the implemented intervention did not represent the full range of features envisioned for the final program, preliminary findings from the first round of data collection via questionnaires (<i>n</i> = 45/96) reported positive user experiences. Sixty percent of responses showed agreement [agree (<i>n</i> = 22) and strongly agree (<i>n</i> = 5)] that learning outcomes were clear and aided by VR. Qualitative findings revealed higher motivation to use VR for learning as a complementary tool to traditional approaches and an intuitive interface. Thematic analysis identified improvement opportunities, including clearer user instructions, enhancing hypoxia symptom discernibility, and refining visual resolution. These insights will inform the next study phase, refining features to improve the overall learning experience and address technical challenges. Grounded in constructivist learning theory and technology acceptance frameworks, our findings leverage realistic VR simulations to enhance knowledge acquisition and understanding of complex physiological responses.<b>NEW & NOTEWORTHY</b> Medical students' perceived usefulness of virtual reality (VR) in hypoxia physiology is strongly linked to the clarity of learning objectives and their alignment to the module content. Other key factors that contribute to positive attitudes toward VR include its novelty, fun and excitement, and embodied cognition.