Effects of an Immersive 180° Video–Based Virtual Reality Instructional Module on Learning Satisfaction, Technology Acceptance, Motivation, and Quiz-Based Learning Achievement in Undergraduate Physical Therapy Students: Randomized Controlled Trial

Background: Virtual reality (VR) offers immersive learning opportunities in health professions education, yet its effects on learner experience and short-term learning outcomes in education on execution of musculoskeletal special tests remain underexplored. Objective: This randomized controlled trial evaluated the effects of an immersive 180° video-based VR instruction, compared with conventional 2D video-based instruction, on undergraduate physical therapy students' learning satisfaction, technology acceptance, learning motivation, and quiz-based learning achievement, reflecting short-term procedural knowledge. Methods: Undergraduate physical therapy students were randomly assigned to either the immersive 180° video-based VR instruction group (VR group) or the conventional 2D video-based instruction group (control group). Both groups received identical instructional content on 4 musculoskeletal special tests (pronator teres, Hawkins-Kennedy, Yergason, and Neer tests). The VR group participated in an immersive 180° video-based instructional module delivered via a head-mounted display, whereas the control group viewed the same content on a standard monitor. Participants completed 4 instructional sessions within a single day, each lasting approximately 3 to 4 minutes. The primary outcome was learning satisfaction. Secondary outcomes were technology acceptance, learning motivation, and quiz-based learning achievement. These outcomes were assessed before and after the intervention using validated questionnaires and a 12-item quiz. Between-group posttest differences were primarily analyzed using analysis of covariance (ANCOVA) with pretest scores as covariates. Supplementary within-group and unadjusted between-group analyses were also performed. Results: Fifty-two students were randomly assigned to receive either immersive 180° video-based VR instruction (VR group; n=28) or conventional 2D video-based instruction (control group; n=24) on 4 musculoskeletal special tests, with all 4 instructional sessions completed within a single day. After adjustment for baseline scores, the VR group showed significantly higher learning satisfaction (adjusted mean 107.04 vs 93.28; F1,49=13.710; P=.001; ηp2=0.219) and technology acceptance (adjusted mean 74.44 vs 68.03; F1,49=4.402; P=.04; ηp2=0.082) than the control group. Adjusted between-group differences were not significant for quiz-based learning achievement (F1,49=1.175; P=.28). For learning motivation, the homogeneity of regression slopes assumption was violated; therefore, the adjusted estimate was interpreted descriptively and did not indicate a clear between-group advantage (F1,48=1.729; P=.20). Conclusions: Compared with conventional 2D video-based instruction, immersive 180° video-based VR instruction showed a clear advantage in learning satisfaction, while technology acceptance also favored the VR group in exploratory secondary analysis, among undergraduate physical therapy students. Findings for learning motivation and quiz-based learning achievement were less conclusive. These results support immersive video as a supplementary educational approach rather than as evidence of superior psychomotor skills training.