Abstract:

Introduction:
Practical exams of clinical skills including interviews are commonly used to assess health science students’ competencies and are typically stress-inducing. Anxiety among health science students is a potential problem that may diminish their performance during practical exams. Given the rising concerns for university students' mental health and real-world preparedness, educators have a responsibility in identifying and implementing strategies to help mitigate these growing concerns. Virtual reality (VR) is becoming a viable option in reducing test anxiety while enhancing student levels of perceived preparedness.

Objective:
This research explores the use of VR to help Health Sciences students better prepare for clinical practical exams and subsequently reduce their test-related anxiety.

Methods:
First-year Occupational Therapy students participated in this prospective mixed-methods study. Quantitative and qualitative data were gathered pre and post VR sessions to determine student levels of anxiety and levels of preparedness. Data was compared to a control baseline (no VR) and included state anxiety questionnaires and perceived level of preparation surveys. The VR simulation included modules of real-world exam elements, allowing students to perform history taking, physical and psychological assessments on a virtual patient. Interaction with this virtual patient allowed students to speak in natural language- voice recognition software was used to process student questions by the VR headset’s microphone. Focus groups and interviews were conducted to enrich understanding of student experiences.

Results:
Results indicate student anxiety had a rise-then-fall trend, peaking 1-week before their practical exam. Compared to the baseline group (no VR), students accessing the VR simulation exam simulation reported having less anxiety for their upcoming clinical practical exam. Triangulation of data indicates the relationship of students’ anxiety, mental preparedness, and exam preparation strategies. Student levels of perceived preparedness had increased in all attributes including confidence, awareness, knowledge, understanding and skill ability for the upcoming clinical practical exam.

Conclusion:
These results indicate that VR simulations may reduce student test-related anxiety while facilitating their perceived levels of preparation for practical exams. VR may improve the quality of the student learning experience, increasing student engagement and perceived preparation levels while reducing test anxiety. VR simulation can potentially lead to a future of positive mental health change in students from the virtual to the real world.

Keywords:

Virtual reality, simulation, anxiety, performance, occupational therapy, health science, education.