skip to main content
10.1145/3489849.3489885acmconferencesArticle/Chapter ViewAbstractPublication PagesvrstConference Proceedingsconference-collections
research-article

Effects of Image Realism on the Stress Response in Virtual Reality

Published: 08 December 2021 Publication History

Abstract

Safety critical situations, as they occur in professions such as medicine, nursing, and aviation, are often trained in simulators to prevent damages to personnel and material. These jobs often come with a high amount of stress, to which prolonged exposure can have devastating effects. Over the past years, stress inoculation training in conjunction with Virtual Reality has become focus of the research community and software companies. Especially the nursing profession can benefit from it, since stress-related illnesses are often the reason for an early exit from the workforce. However, since training facilities often need to compromise on their simulations due to monetary reasons, trade-offs must be made in the degree of detail of such simulations in order to keep development and acquisition costs low. One such possibility is in using low graphical fidelity. We present a psycho-physiological study on the influence of image realism of virtual environments on the stress response. In a within subject design study, we ask participants to complete nursing related, virtually recreated tasks in an artificial intensive care unit, whilst exposed to different stress factors. We provide our findings in the form of objective and subjective measures. Results show that one can elicit different stress responses by manipulating image realism in a sufficiently drastic manner. However, a life-like reaction does not seem to depend on a highly realistic environment.

References

[1]
Ivan Alsina-Jurnet and José Gutiérrez-Maldonado. 2010. Influence of personality and individual abilities on the sense of presence experienced in anxiety triggering virtual environments. International journal of human-computer studies 68, 10 (2010), 788–801.
[2]
Karl Blum, Matthias Offermanns, and Petra Steffen. 2018. Situation und Entwicklung der Pflege bis 2030.
[3]
Stéphane Bouchard, Julie St-Jacques, Geneviève Robillard, and Patrice Renaud. 2008. Anxiety increases the feeling of presence in virtual reality. Presence: Teleoperators and Virtual Environments 17, 4(2008), 376–391.
[4]
Todd P. Chang, Youssef Beshay, Trevor Hollinger, and Joshua M. Sherman. 2019. Comparisons of Stress Physiology of Providers in Real-Life Resuscitations and Virtual Reality–Simulated Resuscitations. Simulation in Healthcare 14, 2 (2019), 104–112. https://doi.org/10.1097/SIH.0000000000000356
[5]
Rory M S Clifford, Sungchul Jung, Simon Hoermann, Robert W Lindeman, and Mark Billinghurst. 2019. Creating a Stressful Decision Making Environment for Aerial Firefighter Training in Virtual Reality. In Proceedings of 2019 IEEE Conference on Virtual Reality and 3D User Interfaces (VR). IEEE, Osaka, Japan, 9. https://doi.org/10.1109/VR.2019.8797889
[6]
Julia Diemer, Nora Lohkamp, Andreas Mühlberger, and Peter Zwanzger. 2016. Fear and physiological arousal during a virtual height challenge—effects in patients with acrophobia and healthy controls. Journal of Anxiety Disorders 37 (2016), 30–39. https://doi.org/10.1016/j.janxdis.2015.10.007
[7]
Ralf Dörner, Wolfgang Broll, Paul Grimm, and Bernhard Jung. 2019. Virtual und Augmented Reality (VR/AR): Grundlagen und Methoden der Virtuellen und Augmentierten Realität. Springer-Verlag, Berlin, Germany.
[8]
Anna Felnhofer, Oswald D. Kothgassner, Thomas Hetterle, Leon Beutl, Helmut Hlavacs, and Ilse Kryspin-Exner. 2014. Afraid to Be There? Evaluating the Relation Between Presence, Self-Reported Anxiety, and Heart Rate in a Virtual Public Speaking Task. Cyberpsychology, Behavior, and Social Networking 17, 5(2014), 310–316. https://doi.org/10.1089/cyber.2013.0472 arXiv:https://doi.org/10.1089/cyber.2013.0472PMID: 24605993.
[9]
Michael Feuerstein, Elise E. Labbé, and Andrzej R. Kuczmierczyk. 2013. Health Psychology: A Psychobiological Perspective. Springer Science & Business Media, New York, NY, USA. 00225.
[10]
H. Fliege, M. Rose, P. Arck, S. Levenstein, and B. F. Klapp. 2009. PSQ - Perceived Stress Questionnaire. Diagnostica 47(2009). https://doi.org/10.23668/psycharchives.2889 Accepted: 2020-05-05T08:22:52Z Publisher: ZPID (Leibniz Institute for Psychology Information) – Testarchiv.
[11]
Susan G. Forman. 1982. Stress management for teachers: A cognitive-behavioral program. Journal of School Psychology 20, 3 (1982), 180–187. https://doi.org/10.1016/0022-4405(82)90047-4
[12]
Susan E French, Rhonda Lenton, Vivienne Walters, and John Eyles. 2000. An empirical evaluation of an expanded nursing stress scale. Journal of nursing measurement 8, 2 (2000), 161–178.
[13]
Giorgos Giannakakis, Dimitris Grigoriadis, Katerina Giannakaki, Olympia Simantiraki, Alexandros Roniotis, and Manolis Tsiknakis. 2019. Review on psychological stress detection using biosignals. IEEE Transactions on Affective Computing(2019), 1–1. https://doi.org/10.1109/TAFFC.2019.2927337
[14]
Daniel Gromer, Max Reinke, Isabel Christner, and Paul Pauli. 2019. Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure. 10 (2019), 141. https://doi.org/10.3389/fpsyg.2019.00141
[15]
Dwi Hartanto, Isabel L Kampmann, Nexhmedin Morina, Paul GM Emmelkamp, Mark A Neerincx, and Willem-Paul Brinkman. 2014. Controlling social stress in virtual reality environments. PloS one 9, 3 (2014), e92804.
[16]
Jason Jerald. 2015. The VR book: Human-centered design for virtual reality. Morgan & Claypool, New York, NY, USA.
[17]
Derek Johnston, Cheryl Bell, Martyn Jones, Barbara Farquharson, Julia Allan, Patricia Schofield, Ian Ricketts, and Marie Johnston. 2015. Stressors, Appraisal of Stressors, Experienced Stress and Cardiac Response: A Real-Time, Real-Life Investigation of Work Stress in Nurses. Annals of Behavioral Medicine 50, 2 (2015), 187–197. https://doi.org/10.1007/s12160-015-9746-8 00031.
[18]
Joung Huem Kwon, John Powell, and Alan Chalmers. 2013. How level of realism influences anxiety in virtual reality environments for a job interview. International journal of human-computer studies 71, 10 (2013), 978–987.
[19]
Marieke AG Martens, Angus Antley, Daniel Freeman, Mel Slater, Paul J Harrison, and Elizabeth M Tunbridge. 2019. It feels real: physiological responses to a stressful virtual reality environment and its impact on working memory. Journal of Psychopharmacology 33, 10 (2019), 1264–1273.
[20]
Andrew McVicar. 2003. Workplace stress in nursing: a literature review. 44, 6 (2003), 633–642. https://doi.org/10.1046/j.0309-2402.2003.02853.x
[21]
Michael Meehan, Brent Insko, Mary Whitton, and Frederick P. Brooks. 2002. Physiological Measures of Presence in Stressful Virtual Environments. ACM Trans. Graph. 21, 3 (July 2002), 645–652. https://doi.org/10.1145/566654.566630
[22]
Donald Meichenbaum and Ray Novaco. 1985. Stress Inoculation: A Preventative Approach. Issues in Mental Health Nursing 7, 1-4 (Jan. 1985), 419–435. https://doi.org/10.3109/01612848509009464 Publisher: Taylor & Francis _eprint: https://doi.org/10.3109/01612848509009464.
[23]
Eleni Moustaka and Theodorus C Constantinidis. [n.d.]. Sources and effects of Work-related stress in nursing. 4, 4 ([n. d.]), 7. 00171.
[24]
Sang Hee Park, Pyoung Jik Lee, Timothy Jung, and Alasdair Swenson. 2020. Effects of the aural and visual experience on psycho-physiological recovery in urban and rural environments. Applied Acoustics 169 (Dec. 2020), 107486. https://doi.org/10.1016/j.apacoust.2020.107486
[25]
Mores Prachyabrued, Disathon Wattanadhirach, Richard B. Dudrow, Nat Krairojananan, and Pusit Fuengfoo. 2019. Toward Virtual Stress Inoculation Training of Prehospital Healthcare Personnel: A Stress-Inducing Environment Design and Investigation of an Emotional Connection Factor. In 2019 IEEE Conference on Virtual Reality and 3D User Interfaces (VR). IEEE, Osaka, Japan, 671–679. https://doi.org/10.1109/VR.2019.8797705
[26]
Susanne Putze, Dmitry Alexandrovsky, Felix Putze, Sebastian Höffner, Jan David Smeddinck, and Rainer Malaka. 2020. Breaking The Experience: Effects of Questionnaires in VR User Studies. Association for Computing Machinery, New York, NY, USA, 1–15. https://doi.org/10.1145/3313831.3376144
[27]
Tyler Rose and Karen B. Chen*. 2018. Effect of levels of immersion on performance and presence in virtual occupational tasks. Proceedings of the Human Factors and Ergonomics Society Annual Meeting 62, 1 (Sept. 2018), 2079–2083. https://doi.org/10.1177/1541931218621469
[28]
Thomas Schubert, Frank Friedmann, and Holger Regenbrecht. 2001. The experience of presence: Factor analytic insights. Presence: Teleoperators & Virtual Environments 10, 3(2001), 266–281.
[29]
Nandita Sharma and Tom Gedeon. 2012. Objective measures, sensors and computational techniques for stress recognition and classification: A survey. Computer Methods and Programs in Biomedicine 108, 3(2012), 1287–1301. https://doi.org/10.1016/j.cmpb.2012.07.003
[30]
Richard Skarbez, Frederick P. Brooks, and Mary C. Whitton. 2018. Immersion and Coherence in a Stressful Virtual Environment. Proceedings of the 24th ACM Symposium on Virtual Reality Software and Technology, Article 24(2018), 11 pages. https://doi.org/10.1145/3281505.3281530
[31]
Mel Slater. 2009. Place illusion and plausibility can lead to realistic behaviour in immersive virtual environments. Philosophical Transactions of the Royal Society B: Biological Sciences 364, 1535 (2009), 3549–3557. https://doi.org/10.1098/rstb.2009.0138
[32]
Mel Slater and Sylvia Wilbur. 1997. A Framework for Immersive Virtual Environments (FIVE): Speculations on the Role of Presence in Virtual Environments. Presence: Teleoperators and Virtual Environments 6, 6 (Dec. 1997), 603–616. https://doi.org/10.1162/pres.1997.6.6.603
[33]
Jacob Stuart, Ileri Akinnola, Frank Guido-Sanz, Mindi Anderson, Desiree Diaz, Greg Welch, and Benjamin Lok. 2020. Applying Stress Management Techniques in Augmented Reality: Stress Induction and Reduction in Healthcare Providers During Virtual Triage Simulation. In 2020 IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops (VRW). 171–172. https://doi.org/10.1109/VRW50115.2020.00037
[34]
Sebastian Weiß, Vanessa Cobus, and Wilko Heuten. 2019. Bedarfe für Virtual Reality Basierte Stress Trainings in der Pflege, In 2. Clusterkonferenz. Tagungsband der Clusterkonferenz 2019, 4.
[35]
Sebastian Weiß, Ani Withöft, and Wilko Heuten. 2020. aVRaid of Heights? - Exploring Integrated Non-Invasive Sensors For Stress Testing. In 2020 IEEE International Conference on Healthcare Informatics (ICHI). IEEE, Oldenburg, Germany, 1–10. https://doi.org/10.1109/ICHI48887.2020.9374361

Cited By

View all
  • (2025)Viewing mock crimes in virtual reality increases presence without impacting memoryBehavior Research Methods10.3758/s13428-024-02575-157:3Online publication date: 3-Feb-2025
  • (2024)Closing the Loop: The Effects of Biofeedback Awareness on Physiological Stress Response Using Electrodermal Activity in Virtual RealityExtended Abstracts of the CHI Conference on Human Factors in Computing Systems10.1145/3613905.3650830(1-7)Online publication date: 11-May-2024
  • (2023)Evaluating the Effect of the Color-Word Stroop Test and VR as a Psychological StressorAdjunct Proceedings of the 2023 ACM International Joint Conference on Pervasive and Ubiquitous Computing & the 2023 ACM International Symposium on Wearable Computing10.1145/3594739.3610698(93-97)Online publication date: 8-Oct-2023
  • Show More Cited By

Recommendations

Comments

Information & Contributors

Information

Published In

cover image ACM Conferences
VRST '21: Proceedings of the 27th ACM Symposium on Virtual Reality Software and Technology
December 2021
563 pages
ISBN:9781450390927
DOI:10.1145/3489849
Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

Sponsors

Publisher

Association for Computing Machinery

New York, NY, United States

Publication History

Published: 08 December 2021

Permissions

Request permissions for this article.

Check for updates

Author Tags

  1. image realism
  2. nursing
  3. stress
  4. virtual reality

Qualifiers

  • Research-article
  • Research
  • Refereed limited

Funding Sources

Conference

VRST '21

Acceptance Rates

Overall Acceptance Rate 66 of 254 submissions, 26%

Contributors

Other Metrics

Bibliometrics & Citations

Bibliometrics

Article Metrics

  • Downloads (Last 12 months)110
  • Downloads (Last 6 weeks)5
Reflects downloads up to 10 Feb 2025

Other Metrics

Citations

Cited By

View all
  • (2025)Viewing mock crimes in virtual reality increases presence without impacting memoryBehavior Research Methods10.3758/s13428-024-02575-157:3Online publication date: 3-Feb-2025
  • (2024)Closing the Loop: The Effects of Biofeedback Awareness on Physiological Stress Response Using Electrodermal Activity in Virtual RealityExtended Abstracts of the CHI Conference on Human Factors in Computing Systems10.1145/3613905.3650830(1-7)Online publication date: 11-May-2024
  • (2023)Evaluating the Effect of the Color-Word Stroop Test and VR as a Psychological StressorAdjunct Proceedings of the 2023 ACM International Joint Conference on Pervasive and Ubiquitous Computing & the 2023 ACM International Symposium on Wearable Computing10.1145/3594739.3610698(93-97)Online publication date: 8-Oct-2023
  • (2023)Social Presence Mediates Audience Behavior Effects on Social Stress in Virtual Public Speaking2023 11th International Conference on Affective Computing and Intelligent Interaction (ACII)10.1109/ACII59096.2023.10388126(1-8)Online publication date: 10-Sep-2023
  • (2023)Virtuelle und Erweiterte Realitäten für den Einsatz in der PflegePflegeinnovationen in der Praxis10.1007/978-3-658-39302-1_5(73-95)Online publication date: 4-Aug-2023
  • (2022)Simulation-based skills training: a qualitative interview study exploring surgical trainees’ experience of stressAdvances in Simulation10.1186/s41077-022-00231-27:1Online publication date: 22-Oct-2022

View Options

Login options

View options

PDF

View or Download as a PDF file.

PDF

eReader

View online with eReader.

eReader

HTML Format

View this article in HTML Format.

HTML Format

Figures

Tables

Media

Share

Share

Share this Publication link

Share on social media