Document Type


Publication Date




Publication Title

Simulation in Healthcare: Journal of the Society for Simulation in Healthcare








Introduction: Virtual-reality solutions have successfully been used to train distributed teams. This study aimed to investigate the correlation between user characteristics and sense of presence in an online virtual-reality environment where distributed teams are trained. A greater sense of presence has the potential to make training in the virtual environment more effective, leading to the formation of teams that perform better in a real environment. Being able to identify, before starting online training, those user characteristics that are predictors of a greater sense of presence can lead to the selection of trainees who would benefit most from the online simulated training.

Methods: This is an observational study with a retrospective postsurvey of participants' user characteristics and degree of sense of presence. Twenty-nine members from 3 Air Force National Guard Medical Service expeditionary medical support teams participated in an online virtual environment training exercise and completed the Independent Television Commission-Sense of Presence Inventory survey, which measures sense of presence and user characteristics. Nonparametric statistics were applied to determine the statistical significance of user characteristics to sense of presence.

Results: Comparing user characteristics to the 4 scales of the Independent Television Commission-Sense of Presence Inventory using Kendall tau test gave the following results: the user characteristics "how often you play video games" (tau(26) = -0.458, P < 0.01) and "television/film production knowledge" (tau(27) = -0.516, P < 0.01) were significantly related to negative effects. Negative effects refer to adverse physiologic reactions owing to the virtual environment experience such as dizziness, nausea, headache, and eyestrain. The user characteristic "knowledge of virtual reality" was significantly related to engagement (tau(26) = 0.463, P < 0.01) and negative effects (tau(26) = -0.404, P < 0.05).

Conclusions: Individuals who have knowledge about virtual environments and experience with gaming environments report a higher sense of presence that indicates that they will likely benefit more from online virtual training. Future research studies could include a larger population of expeditionary medical support, and the results obtained could be used to create a model that predicts the level of presence based on the user characteristics. To maximize results and minimize costs, only those individuals who, based on their characteristics, are supposed to have a higher sense of presence and less negative effects could be selected for online simulated virtual environment training.


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Original Publication Citation

De Leo, G., Diggs, L. A., Radici, E., & Mastaglio, T. W. (2014). Measuring sense of presence and user characteristics to predict effective training in an online simulated virtual environment. Simulation in Healthcare: Journal of the Society for Simulation in Healthcare, 9(1), 1-6. doi:10.1097/SIH.0b013e3182a99dd9


0000-0001-6836-8360 (De Leo), 0000-0003-4822-2350 (Diggs)