Publication
Exploring immersive multimodal virtual reality training, affective states, and ecological validity in healthy firefighters: quasi-experimental study
| dc.contributor.author | Oliveira, Joana | |
| dc.contributor.author | Dias, Joana Aires | |
| dc.contributor.author | Correia, Rita | |
| dc.contributor.author | Pinheiro, Raquel | |
| dc.contributor.author | Reis, Vitor | |
| dc.contributor.author | Sousa, Daniela | |
| dc.contributor.author | Agostinho, Daniel | |
| dc.contributor.author | Simões, Marco | |
| dc.contributor.author | Castelo-Branco, Miguel | |
| dc.date.accessioned | 2024-11-12T13:41:24Z | |
| dc.date.available | 2024-11-12T13:41:24Z | |
| dc.date.issued | 2024-10 | |
| dc.description.abstract | Background: Firefighters face stressful life-threatening events requiring fast decision-making. To better prepare for those situations, training is paramount, but errors in real-life training can be harmful. Virtual reality (VR) simulations provide the desired realism while enabling practice in a secure and controlled environment. Firefighters’ affective states are also crucial as they are a higher-risk group. Objective: To assess the impact on affective states of 2 simulated immersive experiences in a sample of healthy firefighters (before, during, and after the simulation), we pursued a multivariate approach comprising cognitive performance, situational awareness, depression, anxiety, stress, number of previous adverse events experienced, posttraumatic stress disorder (PTSD) severity, and emotions. The efficacy and ecological validity of an innovative VR haptic system were also tested, exploring its impact on performance. Methods: In collaboration with the Portuguese National Fire Service School, we exposed 22 healthy firefighters to 2 immersive scenarios using the FLAIM Trainer VR system (neutral and arousing scenarios) while recording physiological data in a quasi-experimental study. Baseline cognitive performance, depression, anxiety, stress, number of adverse events, and severity of PTSD symptoms were evaluated. Positive and negative affective states were measured before, between, and after each scenario. Situational awareness, sense of presence, ecological validity, engagement, and negative effects resulting from VR immersion were tested. Results: Baseline positive affect score was high (mean 32.4, SD 7.2) and increased after the VR tasks (partial η2=0.52; Greenhouse-Geisser F1.82,32.78=19.73; P<.001). Contrarily, mean negative affect score remained low (range 11.0-11.9) throughout the study (partial η2=0.02; Greenhouse-Geisser F2.13,38.4=0.39; P=.69). Participants’ feedback on the VR sense of presence was also positive, reporting a high sense of physical space (mean score 3.9, SD 0.8), ecological validity (mean score 3.8, SD 0.6), and engagement (mean score 3.8, SD 0.6). Engagement was related to the number of previously experienced adverse events (r=0.49; P=.02) and positive affect (after the last VR task; r=0.55; P=.02). Conversely, participants reported few negative effects (mean score 1.7, SD 0.6). The negative effects correlated positively with negative affect (after the last VR task; r=0.53; P=.03); and avoidance (r=0.73; P<.001), a PTSD symptom, controlling for relevant baseline variables. Performance related to situational awareness was positive (mean 46.4, SD 34.5), although no relation was found to metacognitively perceived situational awareness (r=–0.12; P=.59). Conclusions: We show that VR is an effective alternative to in-person training as it was considered ecologically valid and engaging while promoting positive emotions, with few negative repercussions. This corroborates the use of VR to test firefighters’ performance and situational awareness. Further research is needed to ascertain that firefighters with PTSD symptomatology are not negatively affected by VR. This study favors the use of VR training and provides new insights on its emotional and cognitive impact on the trainee. | pt_PT |
| dc.description.sponsorship | This study was supported by grants from the Foundation for Science and Technology (in Portuguese, Fundação para a Ciência e Tecnologia) cofinanced by the European Regional Development Fund, PCIF/SSO/0082/2018, DSAIPA/DS/0041/2020, and FCT/UIDB&P/4950/2020. The authors would like to thank the Portuguese National Fire Service School (Sintra division) team and all firefighters who collaborated on this study, as well as the multimedia and reporting team, authors of the 2 images of firefighters’ performance during the experiments, which were included in this work. The authors are grateful to Ana Dionísio (a former Coimbra Institute for Biomedical Imaging and Translational Research collaborator) who collaborated in experiments and supported the team during the initial virtual reality experiences. Also worthy of mention are psychologist Salomé Caldeira, PhD, and psychiatrist João Redondo, MD, from the Centre for Prevention and Treatment of Psychological Trauma, Coimbra University Hospital Centre, who provided expertise in the stress and trauma field. The authors also thank the Portuguese authors who gave permission for using the instruments used in this study. Finally, the authors would like to acknowledge the FLAIM systems team, who provided technical support for the FLAIM Trainer simulator system, in particular to James Mullins and Martijn Boosman. No generative artificial intelligence was used in any portion of manuscript writing. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Oliveira, J., Aires Dias, J., Correia, R., Pinheiro, R., Reis, V., Sousa, D., Agostinho, D., Simões, M., & Castelo-Branco, M. (2024). Exploring Immersive Multimodal Virtual Reality Training, Affective States, and Ecological Validity in Healthy Firefighters: Quasi-Experimental Study. JMIR serious games, 12, e53683. | pt_PT |
| dc.identifier.doi | 10.2196/53683 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.2/16769 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.relation | Training critical decision-making and managing posttraumatic stress disorder in fire fighters | |
| dc.relation.publisherversion | https://games.jmir.org/2024/1/e53683 | pt_PT |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | pt_PT |
| dc.subject | Virtual reality | pt_PT |
| dc.subject | Firefighter | pt_PT |
| dc.subject | Training | pt_PT |
| dc.subject | Posttraumatic stress disorder | pt_PT |
| dc.subject | PTSD | pt_PT |
| dc.subject | Emotion | pt_PT |
| dc.subject | Situational awareness | pt_PT |
| dc.subject | Engagement | pt_PT |
| dc.subject | Ecological validity | pt_PT |
| dc.subject | Multivariate approach | pt_PT |
| dc.title | Exploring immersive multimodal virtual reality training, affective states, and ecological validity in healthy firefighters: quasi-experimental study | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.awardTitle | Training critical decision-making and managing posttraumatic stress disorder in fire fighters | |
| oaire.awardURI | info:eu-repo/grantAgreement/FCT/3599-PPCDT/PCIF%2FSSO%2F0082%2F2018/PT | |
| oaire.awardURI | info:eu-repo/grantAgreement/FCT/3599-PPCDT/DSAIPA%2FDS%2F0041%2F2020/PT | |
| oaire.citation.startPage | e53683 | pt_PT |
| oaire.citation.title | JMIR Serious Games | pt_PT |
| oaire.citation.volume | 12 | pt_PT |
| oaire.fundingStream | 3599-PPCDT | |
| oaire.fundingStream | 3599-PPCDT | |
| person.familyName | Aires Dias | |
| person.familyName | Canais Rodrigues Pinheiro | |
| person.familyName | Figueiredo dos Reis | |
| person.familyName | Simões | |
| person.familyName | Castelo-Branco | |
| person.givenName | Joana | |
| person.givenName | Raquel | |
| person.givenName | Vitor Manuel | |
| person.givenName | Marco | |
| person.givenName | Miguel | |
| person.identifier.ciencia-id | 411B-C507-32B9 | |
| person.identifier.ciencia-id | 9D14-A3C3-DEB0 | |
| person.identifier.ciencia-id | 9011-B8B8-990E | |
| person.identifier.ciencia-id | 7A12-48FE-7B56 | |
| person.identifier.orcid | 0000-0003-3499-7622 | |
| person.identifier.orcid | 0000-0002-1578-1773 | |
| person.identifier.orcid | 0000-0003-3661-2386 | |
| person.identifier.orcid | 0000-0003-3713-2464 | |
| person.identifier.orcid | 0000-0003-4364-6373 | |
| project.funder.identifier | http://doi.org/10.13039/501100001871 | |
| project.funder.identifier | http://doi.org/10.13039/501100001871 | |
| project.funder.name | Fundação para a Ciência e a Tecnologia | |
| project.funder.name | Fundação para a Ciência e a Tecnologia | |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |
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