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Using devices such as headsets and motion sensors, users are immersed in a simulated world. Augmented reality (AR) is an interactive overlay of the real environment that provides an additional wrapper over the environment, and the user experiences an immersive and interactive environment. In Mixed reality (MR), VR and AR elements are combined; computer graphics interplay with real objects, allowing users to interact with virtual and physical objects at the same time.<\/jats:p>\n                    <jats:p>VR and MR are effective training tools in different healthcare settings. These tools are useful for preparing emergency health personnel to respond to disasters by providing them with an immersive reality since real practices are very difficult to implement in mass casualty incidents.<\/jats:p>\n                    <jats:p>Given the usefulness of this approach, assessing the optimal training times associated with this method and the side effects that may influence learning is helpful. One of the most common side effects is fatigue. We developed a questionnaire to assess fatigue in terms of various dimensions, that can affect a person while training in the context of VR and MR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We designed a questionnaire to assess the fatigue levels perceived by professionals and validated this measure after VR training experience. We analyzed ratings of visual, mental, physical, and general fatigue. This questionnaire was applied to emergency professionals (Sample size\u2009=\u2009101).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The reliability and validity of the questionnaire were assessed in terms of the following factors: general, social, emotional, visual, and motivational fatigue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of this research suggest that fatigue is an element of VR and MR training. Educators should take these effects into account to optimize learning in the context of VR and MR. According to user feedback, the optimal length of time for mixed reality training is around 20\u00a0min, especially when the user has little or no experience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-026-08641-w","type":"journal-article","created":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T23:06:09Z","timestamp":1769987169000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Virtual &amp; mixed reality fatigue questionnaire"],"prefix":"10.1186","volume":"26","author":[{"given":"Ana Mar\u00eda","family":"Cintora-Sanz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"Mu\u00f1oz-Romo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Schrom-Feiertag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Blanco-Lara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Vazqu\u00e9z-Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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