{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T16:08:15Z","timestamp":1780762095433,"version":"3.54.1"},"reference-count":67,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005644","name":"Paris Lodron University of Salzburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005644","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Virtual Reality"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This study assesses the integration of mixed reality (MR) technologies in medical first responder (MFR) training, focusing on identifying key factors influencing behavioral intention to use MR systems and practical implications for technology acceptance and enhanced realism through haptic feedback. Through a user-centered design approach, involving co-creation workshops, iterative development, and evaluations in pilot and field trials across six countries, this study evaluated technology acceptance, presence, user experience, and workload among MFRs. Both quantitative measures and qualitative feedback were collected to analyze the determinants of technology acceptance and user engagement. The\n                    <jats:italic>MED1stMR<\/jats:italic>\n                    training system, developed as a result, demonstrates that performance expectancy, effort expectancy, and social presence are significant predictors of behavioral intention to use MR training systems among MFRs. High technology acceptance and positive user experience were reported, with specific emphasis on the educational value of haptic feedback in skill training. Trainer feedback highlighted the importance of real-time performance metrics and openness to AI-driven training assistance for enhancing training outcomes. The study underscores the critical role of realistic patient interaction and the importance of aligning training challenges with users\u2019 skills to create engaging MR training environments for MFRs. Identifying factors influencing behavioral intention offers valuable insights for the development of MR training systems, suggesting a focus on social presence and interactive capabilities to improve realism and educational value. The findings advocate for the integration of adaptive training features and further exploration of AI support in scenario optimization and performance enhancement.\n                  <\/jats:p>","DOI":"10.1007\/s10055-025-01144-x","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:28:17Z","timestamp":1745465297000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Mixed reality training for medical first responders: system evaluation and recommendations"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-7987","authenticated-orcid":false,"given":"Jakob Carl","family":"Uhl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9673-3716","authenticated-orcid":false,"given":"Olivia","family":"Zechner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5366-8184","authenticated-orcid":false,"given":"Anke","family":"Baetzner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3046-0900","authenticated-orcid":false,"given":"Tanja","family":"Birrenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3028-904X","authenticated-orcid":false,"given":"Sebastian","family":"Egger-Lampl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5327-2494","authenticated-orcid":false,"given":"Helmut","family":"Schrom-Feiertag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6056-7285","authenticated-orcid":false,"given":"Manfred","family":"Tscheligi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"issue":"1","key":"1144_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13049-022-01056-8","volume":"30","author":"AS Baetzner","year":"2022","unstructured":"Baetzner AS, Wespi R, Hill Y, Gyllencreutz L, Sauter TC, Saveman B-I, Frenkel MO (2022) Preparing medical first responders for crises: a systematic literature review of disaster training programs and their effectiveness. Scand J Trauma Resusc Emerg Med 30(1):1\u201323. https:\/\/doi.org\/10.1186\/s13049-022-01056-8","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"1144_CR2","doi-asserted-by":"crossref","unstructured":"Barrie M, Socha JJ, Mansour L, Patterson ES (2019) Mixed reality in medical education: a narrative literature review. In: Proceedings of the international symposium on human factors and ergonomics in health care, vol 8, pp 28\u201332","DOI":"10.1177\/2327857919081006"},{"key":"1144_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13017-016-0064-7","volume":"11","author":"O Ben-Ishay","year":"2016","unstructured":"Ben-Ishay O, Mitaritonno M, Catena F, Sartelli M, Ansaloni L, Kluger Y (2016) Mass casualty incidents-time to engage. World J Emerg Surg 11:1\u20133. https:\/\/doi.org\/10.1186\/s13017-016-0064-7","journal-title":"World J Emerg Surg"},{"key":"1144_CR4","doi-asserted-by":"crossref","unstructured":"Berndt H, Wessel D, Mentler T, Herczeg M (2018a) Human-centered design of a virtual reality training simulation for mass casualty incidents. In: 2018 10th international conference on virtual worlds and games for serious applications (vs-games). pp 1\u20138","DOI":"10.1109\/VS-Games.2018.8493427"},{"key":"1144_CR5","unstructured":"Berndt H, Wessel D, Willer L, Herczeg M, Mentler T (2018b) Immersion and presence in virtual reality training for mass casualty incidents. Boersma K, Tomaszeski B (eds) Iscram 2018 conference proceedings\u201415th international conference on information systems for crisis response and management. Rochester Institute of Technology, Rochester, pp 806\u2013817"},{"key":"1144_CR6","unstructured":"Biocca F, Harms C (2002) Defining and measuring social presence: contribution to the networked minds theory and measure. In: Proceedings of the PRESENCE, pp 7\u201336"},{"issue":"5","key":"1144_CR7","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1162\/105474603322761270","volume":"12","author":"F Biocca","year":"2003","unstructured":"Biocca F, Harms C, Burgoon JK (2003) Toward a more robust theory and measure of social presence: review and suggested criteria. Presence Teleop Virt 12(5):456\u2013480. https:\/\/doi.org\/10.1162\/105474603322761270","journal-title":"Presence Teleop Virt"},{"issue":"2","key":"1144_CR8","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1207\/S15327965PLI1302_01","volume":"13","author":"J Blascovich","year":"2002","unstructured":"Blascovich J, Loomis J, Beall AC, Swinth KR, Hoyt CL, Bailenson JN (2002) Immersive virtual environment technology as a methodological tool for social psychology. Psychol Inq 13(2):103\u2013124. https:\/\/doi.org\/10.1207\/S15327965PLI1302_01","journal-title":"Psychol Inq"},{"issue":"3","key":"1144_CR9","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1080\/17439760.2016.1262613","volume":"12","author":"V Clarke","year":"2017","unstructured":"Clarke V, Braun V (2017) Thematic analysis. J Posit Psychol 12(3):297\u2013298. https:\/\/doi.org\/10.1080\/17439760.2016.1262613","journal-title":"J Posit Psychol"},{"key":"1144_CR10","volume-title":"Case method fast-track: a rad approach","author":"D Clegg","year":"1994","unstructured":"Clegg D, Barker R (1994) Case method fast-track: a rad approach. Addison-Wesley, Englewood Cliffs"},{"issue":"12","key":"1144_CR11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0294914","volume":"18","author":"M Coduri","year":"2023","unstructured":"Coduri M, Calandrino A, Addiego Mobilio G, Casadio M, Ricci S (2023) Rineo mr: a mixed reality simulator for newborn life support training. PLoS ONE 18(12):e0294914. https:\/\/doi.org\/10.1371\/journal.pone.0294914","journal-title":"PLoS ONE"},{"key":"1144_CR12","volume-title":"Flow: the psychology of optimal experience","author":"M Csikszentmihalyi","year":"1990","unstructured":"Csikszentmihalyi M, Csikzentmihaly M (1990) Flow: the psychology of optimal experience, vol 1990. Harper & Row, New York"},{"issue":"3","key":"1144_CR13","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2307\/249008","volume":"13","author":"FD Davis","year":"1989","unstructured":"Davis FD (1989) Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q 13(3):319\u2013340","journal-title":"MIS Q"},{"key":"1144_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11042-023-17878-2","volume":"66","author":"C Elsenbast","year":"2024","unstructured":"Elsenbast C, Dahlmann P, Schnier D (2024) Virtual team training with mixed reality and virtual reality-benefits and limitations illustrated on the example of two paramedic classes. Multimed Tools Appl 66:1\u201325. https:\/\/doi.org\/10.1007\/s11042-023-17878-2","journal-title":"Multimed Tools Appl"},{"key":"1144_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10916-016-0459-8","volume":"40","author":"D Escobar-Castillejos","year":"2016","unstructured":"Escobar-Castillejos D, Noguez J, Neri L, Magana A, Benes B (2016) A review of simulators with haptic devices for medical training. J Med Syst 40:1\u201322. https:\/\/doi.org\/10.1007\/s10916-016-0459-8","journal-title":"J Med Syst"},{"key":"1144_CR16","doi-asserted-by":"crossref","unstructured":"Fairclough S, Gilleade K (2012) Construction of the biocybernetic loop: a case study. In: Proceedings of the 14th ACM international conference on multimodal interaction. Association for Computing Machinery, New York, pp 571\u2013578","DOI":"10.1145\/2388676.2388797"},{"key":"1144_CR17","unstructured":"Finseth T (2021) Adaptive virtual reality stress training for spaceflight emergency procedures (Ph.D. dissertation). Iowa State University"},{"issue":"4","key":"1144_CR18","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.ecns.2016.02.004","volume":"12","author":"CL Foronda","year":"2016","unstructured":"Foronda CL, Shubeck K, Swoboda SM, Hudson KW, Budhathoki C, Sullivan N, Hu X (2016) Impact of virtual simulation to teach concepts of disaster triage. Clin Simul Nurs 12(4):137\u2013144. https:\/\/doi.org\/10.1016\/j.ecns.2016.02.004","journal-title":"Clin Simul Nurs"},{"issue":"1","key":"1144_CR19","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1109\/TAFFC.2019.2927337","volume":"13","author":"G Giannakakis","year":"2022","unstructured":"Giannakakis G, Grigoriadis D, Giannakaki K, Simantiraki O, Roniotis A, Tsiknakis M (2022) Review on psychological stress detection using biosignals. IEEE Trans Aff Comput 13(1):440\u2013460. https:\/\/doi.org\/10.1109\/TAFFC.2019.2927337","journal-title":"IEEE Trans Aff Comput"},{"key":"1144_CR20","doi-asserted-by":"crossref","unstructured":"Girau E, Mura F, Bazurro S, Casadio M, Chirico M, Solari F, Chessa M (2019) A mixed reality system for the simulation of emergency and first-aid scenarios. In: 2019 41st annual international conference of the IEEE engineering in medicine and biology society (EMBC), pp 5690\u20135695","DOI":"10.1109\/EMBC.2019.8856777"},{"key":"1144_CR21","doi-asserted-by":"crossref","unstructured":"Hart SG, Staveland LE (1988) Development of nasa-tlx (task load index): results of empirical and theoretical research. In: Advances in psychology, vol\u00a052. Elsevier, pp 139\u2013183","DOI":"10.1016\/S0166-4115(08)62386-9"},{"issue":"3","key":"1144_CR22","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1207\/s15327752jpa5303_14","volume":"53","author":"I Houtman","year":"1989","unstructured":"Houtman I, Bakker FC (1989) The anxiety thermometer: a validation study. J Pers Assess 53(3):575\u2013582. https:\/\/doi.org\/10.1207\/s15327752jpa5303_14","journal-title":"J Pers Assess"},{"issue":"1","key":"1144_CR23","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12903","volume":"4","author":"NE Kman","year":"2023","unstructured":"Kman NE, Price A, Berezina-Blackburn V, Patterson J, Maicher K, Way DP, Danforth D (2023) First responder virtual reality simulator to train and assess emergency personnel for mass casualty response. JACEP Open 4(1):e12903. https:\/\/doi.org\/10.1002\/emp2.12903","journal-title":"JACEP Open"},{"issue":"1","key":"1144_CR24","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1111\/j.1468-2885.2004.tb00302.x","volume":"14","author":"KM Lee","year":"2006","unstructured":"Lee KM (2006) Presence, explicated. Commun Theory 14(1):27\u201350. https:\/\/doi.org\/10.1111\/j.1468-2885.2004.tb00302.x","journal-title":"Commun Theory"},{"key":"1144_CR25","doi-asserted-by":"crossref","unstructured":"Lima R, Asif M, Sousa H, Berm\u00fadez i Badia S (2022) Adaptive control of cardio-respiratory training in a virtual reality hiking simulation: a feasibility study. In: Proceedings of the 15th international joint conference on biomedical engineering systems and technologies (biostec 2022)\u2014biosignals. SciTePress, pp 91\u201399","DOI":"10.5220\/0011004400003123"},{"key":"1144_CR26","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.chb.2017.02.066","volume":"72","author":"G Makransky","year":"2017","unstructured":"Makransky G, Lilleholt L, Aaby A (2017) Development and validation of the multimodal presence scale for virtual reality environments: a confirmatory factor analysis and item response theory approach. Comput Hum Behav 72:276\u2013285. https:\/\/doi.org\/10.1016\/j.chb.2017.02.066","journal-title":"Comput Hum Behav"},{"issue":"2","key":"1144_CR27","first-page":"159","volume":"1","author":"P Mayring","year":"2004","unstructured":"Mayring P et al (2004) Qualitative content analysis. Companion Qual. Res. 1(2):159\u2013176","journal-title":"Companion Qual. Res."},{"key":"1144_CR28","doi-asserted-by":"crossref","unstructured":"Milgram P, Takemura H, Utsumi A, Kishino F (1995) Augmented reality: a class of displays on the reality-virtuality continuum. In: Das H (ed) Telemanipulator and telepresence technologies, vol 2351. SPIE, pp 282\u2013292","DOI":"10.1117\/12.197321"},{"issue":"4","key":"1144_CR29","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1080\/10903127.2019.1676345","volume":"24","author":"B Mills","year":"2020","unstructured":"Mills B, Dykstra P, Hansen S, Miles A, Rankin T, Hopper L, Bartlett D (2020) Virtual reality triage training can provide comparable simulation efficacy for paramedicine students compared to live simulation-based scenarios. Prehosp Emerg Care 24(4):525\u2013536. https:\/\/doi.org\/10.1080\/10903127.2019.1676345","journal-title":"Prehosp Emerg Care"},{"key":"1144_CR30","doi-asserted-by":"crossref","unstructured":"Muender T, Reinschluessel AV, Drewes S, Wenig D, D\u00f6ring T, Malaka R (2019) Does it feel real? Using tangibles with different fidelities to build and explore scenes in virtual reality. In: Proceedings of the 2019 chi conference on human factors in computing systems, pp 1\u201312","DOI":"10.1145\/3290605.3300903"},{"key":"1144_CR31","doi-asserted-by":"crossref","unstructured":"Mu\u00f1oz JE, Cameir\u00e3o M, Berm\u00fadez i Badia S, Gouveia ER (2018) Closing the loop in exergaming\u2014health benefits of biocybernetic adaptation in senior adults. In: Proceedings of the 2018 annual symposium on computer\u2013human interaction in play. Association for Computing Machinery, New York, NY, USA, pp 329\u2013339","DOI":"10.1145\/3242671.3242673"},{"issue":"April","key":"1144_CR32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fpsyg.2020.00683","volume":"11","author":"JE Mu\u00f1oz","year":"2020","unstructured":"Mu\u00f1oz JE, Quintero L, Stephens CL, Pope AT (2020) A psychophysiological model of firearms training in police officers: a virtual reality experiment for biocybernetic adaptation. Front Psychol 11(April):1\u201314. https:\/\/doi.org\/10.3389\/fpsyg.2020.00683","journal-title":"Front Psychol"},{"key":"1144_CR33","doi-asserted-by":"crossref","unstructured":"Nguyen Q, Pretolesi D, Gallhuber K (2023) Collaborative scenario builder: a vr co-design tool for medical first responders. In: Proceedings of the 2023 ACM conference on information technology for social good (goodit\u201923). Association for Computing Machinery, New York, NY, USA, pp 342\u2013350","DOI":"10.1145\/3582515.3609553"},{"issue":"1","key":"1144_CR34","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s41239-021-00310-w","volume":"19","author":"SM Noble","year":"2022","unstructured":"Noble SM, Saville JD, Foster LL (2022) Vr as a choice: What drives learners\u2019 technology acceptance? Int J Educ Technol High Educ 19(1):6. https:\/\/doi.org\/10.1186\/s41239-021-00310-w","journal-title":"Int J Educ Technol High Educ"},{"issue":"2","key":"1144_CR35","doi-asserted-by":"publisher","first-page":"325","DOI":"10.5811\/westjem.2015.1.23720","volume":"16","author":"MT Paddock","year":"2015","unstructured":"Paddock MT, Bailitz J, Horowitz R, Khishfe B, Cosby K, Sergel MJ (2015) Disaster response team fast skills training with a portable ultrasound simulator compared to traditional training: pilot study. West J Emerg Med 16(2):325. https:\/\/doi.org\/10.5811\/westjem.2015.1.23720","journal-title":"West J Emerg Med"},{"key":"1144_CR36","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182111676","author":"Z Papadakis","year":"2021","unstructured":"Papadakis Z, Stamatis A, Kukic F, Koropanovski N (2021) Moving past the one-size-fits-all education-training model of police academies to the self-prescribed individualized exercise prescription model. Int J Environ Res Public Health. https:\/\/doi.org\/10.3390\/ijerph182111676","journal-title":"Int J Environ Res Public Health"},{"key":"1144_CR37","doi-asserted-by":"crossref","unstructured":"Prachyabrued M, Wattanadhirach D, Dudrow RB, Krairojananan N, Fuengfoo P (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), pp 671\u2013679","DOI":"10.1109\/VR.2019.8797705"},{"key":"1144_CR38","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynstr.2021.100382","volume":"15","author":"J Rodrigues","year":"2021","unstructured":"Rodrigues J, Studer E, Streuber S, Sandi C (2021) Imvest, an immersive multimodal virtual environment stress test for humans that adjusts challenge to individual\u2019s performance. Neurobiol Stress 15:100382. https:\/\/doi.org\/10.1016\/j.ynstr.2021.100382","journal-title":"Neurobiol Stress"},{"key":"1144_CR39","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.628178","volume":"9","author":"IM Saiboon","year":"2021","unstructured":"Saiboon IM, Zahari F, Isa HM, Sabardin DM, Robertson CE (2021) E-learning in teaching emergency disaster response among undergraduate medical students in Malaysia. Front Public Health 9:628178. https:\/\/doi.org\/10.3389\/fpubh.2021.628178","journal-title":"Front Public Health"},{"issue":"1","key":"1144_CR40","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1080\/15710880701875068","volume":"4","author":"EB Sanders","year":"2008","unstructured":"Sanders EB, Stappers PJ (2008) Co-creation and the new landscapes of design. CoDesign 4(1):5\u201318. https:\/\/doi.org\/10.1080\/15710880701875068","journal-title":"CoDesign"},{"key":"1144_CR41","doi-asserted-by":"crossref","unstructured":"Scherfgen D, Schild J (2021) Estimating the pose of a medical manikin for haptic augmentation of a virtual patient in mixed reality training. In: Proceedings of the 23rd symposium on virtual and augmented reality, pp 33\u201341","DOI":"10.1145\/3488162.3488166"},{"key":"1144_CR42","doi-asserted-by":"publisher","first-page":"1891","DOI":"10.1007\/978-1-4419-1005-9_64","volume-title":"Encyclopedia of behavioral medicine","author":"W Schlotz","year":"2013","unstructured":"Schlotz W (2013) Stress reactivity. In: Gellman MD, Turner JR (eds) Encyclopedia of behavioral medicine. Springer, New York, pp 1891\u20131894"},{"issue":"S1","key":"1144_CR43","doi-asserted-by":"publisher","first-page":"s31","DOI":"10.1017\/S1049023X2300119X","volume":"38","author":"F Schulz","year":"2023","unstructured":"Schulz F, Nguyen Q, Baetzner A, Schrom-Feiertag H, Gyllencreutz L (2023) Mixed reality-exploring the requirements of realism in the context of mass casualty incident training. Prehosp Disaster Med 38(S1):s31\u2013s31. https:\/\/doi.org\/10.1017\/S1049023X2300119X","journal-title":"Prehosp Disaster Med"},{"key":"1144_CR44","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.ecns.2019.09.006","volume":"38","author":"J-C Servotte","year":"2020","unstructured":"Servotte J-C, Goosse M, Campbell SH, Dardenne N, Pilote B, Simoneau IL, Ghuysen A (2020a) Virtual reality experience: immersion, sense of presence, and cybersickness. Clin Simul Nurs 38:35\u201343. https:\/\/doi.org\/10.1016\/j.ecns.2019.09.006","journal-title":"Clin Simul Nurs"},{"key":"1144_CR45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s41077-020-00150-0","volume":"5","author":"J-C Servotte","year":"2020","unstructured":"Servotte J-C, Welch-Horan TB, Mullan P, Piazza J, Ghuysen A, Szyld D (2020b) Development and implementation of an end-of-shift clinical debriefing method for emergency departments during covid-19. Adv Simul 5:1\u201311. https:\/\/doi.org\/10.1186\/s41077-020-00150-0","journal-title":"Adv Simul"},{"key":"1144_CR46","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1007\/978-1-4614-0064-6_23","volume-title":"Handbook of augmented reality","author":"A Sherstyuk","year":"2011","unstructured":"Sherstyuk A, Vincent D, Berg B, Treskunov A (2011) Mixed reality manikins for medical education. In: Furht B (ed) Handbook of augmented reality. Springer, New York, pp 479\u2013500"},{"issue":"4","key":"1144_CR47","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/j.cpha.2019.06.010","volume":"4","author":"M Showstark","year":"2019","unstructured":"Showstark M, Lovejoy B (2019) Crisis standards of care. Phys Assist Clin 4(4):663\u2013673. https:\/\/doi.org\/10.1016\/j.cpha.2019.06.010. (Disaster Medicine)","journal-title":"Phys Assist Clin"},{"key":"1144_CR48","doi-asserted-by":"publisher","DOI":"10.3389\/frvir.2021.647997","volume":"2","author":"R Skarbez","year":"2021","unstructured":"Skarbez R, Smith M, Whitton MC (2021) Revisiting milgram and Kishino\u2019s reality-virtuality continuum. Front Virtual Real 2:647997. https:\/\/doi.org\/10.3389\/frvir.2021.647997","journal-title":"Front Virtual Real"},{"key":"1144_CR49","doi-asserted-by":"publisher","DOI":"10.3389\/frvir.2022.914392","volume":"3","author":"M Slater","year":"2022","unstructured":"Slater M, Banakou D, Beacco A, Gallego J, Macia-Varela F, Oliva R (2022) A separate reality: an update on place illusion and plausibility in virtual reality. Front virtual Real 3:914392. https:\/\/doi.org\/10.3389\/frvir.2022.914392","journal-title":"Front virtual Real"},{"key":"1144_CR50","doi-asserted-by":"publisher","unstructured":"Stephens C, Dehais F, Roy RN, Harrivel A, Last MC, Kennedy K, Pope A (2018) Biocybernetic adaptation strategies: machine awareness of human engagement for improved operational performance. In: Lecture notes in computer science (including subseries lecture notes in artificial intelligence and lecture notes in bioinformatics), 10915 LNAI(December), pp 89\u201398. https:\/\/doi.org\/10.1007\/978-3-319-91470-1_9","DOI":"10.1007\/978-3-319-91470-1_9"},{"key":"1144_CR51","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.ajem.2021.01.085","volume":"48","author":"D Tin","year":"2021","unstructured":"Tin D, Hertelendy AJ, Ciottone GR (2021) Disaster medicine training: the case for virtual reality. Am J Emerg Med 48:370. https:\/\/doi.org\/10.1016\/j.ajem.2021.01.085","journal-title":"Am J Emerg Med"},{"issue":"1063519","key":"1144_CR53","doi-asserted-by":"publisher","first-page":"1","DOI":"10.25304\/rlt.v31.2827","volume":"31","author":"JC Uhl","year":"2023","unstructured":"Uhl JC, Neundlinger K, Regal G (2023a) Social presence as a training resource: comparing VR and traditional training simulations. Res Learn Technol 31(1063519):1\u201314. https:\/\/doi.org\/10.25304\/rlt.v31.2827","journal-title":"Res Learn Technol"},{"key":"1144_CR54","doi-asserted-by":"crossref","unstructured":"Uhl JC, Regal G, Gafert M, Murtinger M, Tscheligi M (2023b) Stress embodied: developing multi-sensory experiences for vr police training. In: Abdelnour Nocera J, Krist\u00edn\u00a0L\u00e1rusd\u00f3ttir M, Petrie H, Piccinno A, Winckler M (eds) Human\u2013computer interaction\u2014interact 2023. Springer, Cham, pp 573\u2013583","DOI":"10.1007\/978-3-031-42280-5_36"},{"key":"1144_CR55","doi-asserted-by":"crossref","unstructured":"Uhl JC, Regal G, Schrom-Feiertag H, Murtinger M, Tscheligi M (2023c) Xr for first responders: concepts, challenges and future potential of immersive training. In: International conference on virtual reality and mixed reality, pp 192\u2013200","DOI":"10.1007\/978-3-031-48495-7_13"},{"key":"1144_CR56","doi-asserted-by":"crossref","unstructured":"Uhl JC, Schrom-Feiertag H, Regal G, Gallhuber K, Tscheligi M (2023d) Tangible immersive trauma simulation: is mixed reality the next level of medical skills training? In: Proceedings of the 2023 chi conference on human factors in computing systems, pp 1\u201317","DOI":"10.1145\/3544548.3581292"},{"key":"1144_CR52","doi-asserted-by":"crossref","unstructured":"Uhl JC, Gutierrez R, Regal G, Schrom-Feiertag H, Schuster B, Tscheligi M (2024) Choosing the right reality: a comparative analysis of tangibility in immersive trauma simulations. In: Proceedings of the 2024 chi conference on human factors in computing systems, pp 1\u201317","DOI":"10.1145\/3613904.3641912"},{"issue":"138","key":"1144_CR57","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2022.104709","volume":"138","author":"L van Dammen","year":"2022","unstructured":"van Dammen L, Finseth TT, McCurdy BH, Barnett NP, Conrady RA, Leach AG, Shirtcliff EA (2022) Evoking stress reactivity in virtual reality: a systematic review and meta-analysis. Neurosci Biobehav Rev 138(138):104709. https:\/\/doi.org\/10.1016\/j.neubiorev.2022.104709","journal-title":"Neurosci Biobehav Rev"},{"issue":"3","key":"1144_CR58","doi-asserted-by":"publisher","first-page":"425","DOI":"10.2307\/30036540","volume":"27","author":"V Venkatesh","year":"2003","unstructured":"Venkatesh V, Morris MG, Davis GB, Davis FD (2003) User acceptance of information technology: toward a unified view. MIS Q 27(3):425\u2013478. https:\/\/doi.org\/10.2307\/30036540","journal-title":"MIS Q"},{"issue":"1","key":"1144_CR59","doi-asserted-by":"publisher","first-page":"157","DOI":"10.2307\/41410412","volume":"36","author":"V Venkatesh","year":"2012","unstructured":"Venkatesh V, Thong J, Xu X (2012) Consumer acceptance and use of information technology: extending the unified theory of acceptance and use of technology. MIS Q 36(1):157\u2013178. https:\/\/doi.org\/10.2307\/41410412","journal-title":"MIS Q"},{"issue":"11","key":"1144_CR60","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1111\/j.1553-2712.2008.00191.x","volume":"15","author":"DS Vincent","year":"2008","unstructured":"Vincent DS, Sherstyuk A, Burgess L, Connolly KK (2008) Teaching mass casualty triage skills using immersive three-dimensional virtual reality. Acad Emerg Med 15(11):1160\u20131165. https:\/\/doi.org\/10.1111\/j.1553-2712.2008.00191.x","journal-title":"Acad Emerg Med"},{"key":"1144_CR61","doi-asserted-by":"crossref","unstructured":"Vogt P, Boer R, de Boer M, Prins H, Smit J, Tuinstra D, Paans W (2023) Designing and evaluating a virtual reality training for paramedics to practice triage in complex situations. In: Chen JYC, Fragomeni G (eds) Virtual, augmented and mixed reality. Springer, Cham, pp 503\u2013522","DOI":"10.1007\/978-3-031-35634-6_36"},{"issue":"4","key":"1144_CR62","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1007\/s10055-022-00656-0","volume":"26","author":"T Xie","year":"2022","unstructured":"Xie T, Zheng L, Liu G, Liu L (2022) Exploring structural relations among computer self-efficacy, perceived immersion, and intention to use virtual reality training systems. Virtual Real 26(4):1725\u20131744. https:\/\/doi.org\/10.1007\/s10055-022-00656-0","journal-title":"Virtual Real"},{"issue":"5","key":"1144_CR63","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1002\/cne.920180503","volume":"18","author":"RM Yerkes","year":"1908","unstructured":"Yerkes RM, Dodson JD (1908) The relation of strength of stimulus to rapidity of habit-formation. J Comp Neurol Psychol 18(5):459\u2013482. https:\/\/doi.org\/10.1002\/cne.920180503","journal-title":"J Comp Neurol Psychol"},{"key":"1144_CR64","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1007\/s10055-020-00434-w","volume":"24","author":"M Zahabi","year":"2020","unstructured":"Zahabi M, Razak A (2020) Adaptive virtual reality-based training: a systematic literature review and framework. Virtual Real 24:725\u2013752. https:\/\/doi.org\/10.1007\/s10055-020-00434-w","journal-title":"Virtual Real"},{"issue":"12","key":"1144_CR65","doi-asserted-by":"publisher","first-page":"66","DOI":"10.3390\/mti7120113","volume":"7","author":"O Zechner","year":"2023","unstructured":"Zechner O, Garc\u00eda Guirao D, Schrom-Feiertag H, Regal G, Uhl JC, Gyllencreutz L, Tscheligi M (2023a) Nextgen training for medical first responders: advancing mass-casualty incident preparedness through mixed reality technology. Multimodal Technol Interact 7(12):66. https:\/\/doi.org\/10.3390\/mti7120113","journal-title":"Multimodal Technol Interact"},{"issue":"2","key":"1144_CR66","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3390\/mti7020014","volume":"7","author":"O Zechner","year":"2023","unstructured":"Zechner O, Kleygrewe L, Jaspaert E, Schrom-Feiertag H, Hutter RIV, Tscheligi M (2023b) Enhancing operational police training in high stress situations with virtual reality: experiences, tools and guidelines. Multimodal Technol Interact 7(2):90. https:\/\/doi.org\/10.3390\/mti7020014","journal-title":"Multimodal Technol Interact"},{"key":"1144_CR67","doi-asserted-by":"crossref","unstructured":"Zechner O, Schrom-Feiertag H, Uhl J, Nguyen Q, Kleygrewe L, Tscheligi M (2023c) Mind the heart: designing a stress dashboard based on physiological data for training highly stressful situations in virtual reality. In: Abdelnour\u00a0Nocera J, Krist\u00edn\u00a0L\u00e1rusd\u00f3ttir M, Petrie H, Piccinno A, Winckler M (eds) Human\u2013computer interaction\u2014interact 2023. Springer, Cham, pp 209\u2013230","DOI":"10.1007\/978-3-031-42293-5_16"}],"container-title":["Virtual Reality"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10055-025-01144-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10055-025-01144-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10055-025-01144-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T05:59:08Z","timestamp":1750485548000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10055-025-01144-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,24]]},"references-count":67,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["1144"],"URL":"https:\/\/doi.org\/10.1007\/s10055-025-01144-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4383276\/v1","asserted-by":"object"}]},"ISSN":["1434-9957"],"issn-type":[{"value":"1434-9957","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,24]]},"assertion":[{"value":"7 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"69"}}