{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:22Z","timestamp":1785545062446,"version":"3.56.0"},"reference-count":105,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR XR Spatial Comput"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The growing global mental health (MH) burden, especially in underresourced communities, calls for innovative, scalable, and culturally responsive training approaches to expand care access and improve outcomes. Task-sharing has shown promise in addressing workforce shortages but is limited by training and supervision challenges. Traditional methods, such as role-playing and standardized patients, are resource-intensive and less scalable. Virtual simulations, including augmented reality (AR), present novel opportunities for immersive and interactive training. An AR-assisted training tool can enable culturally sensitive training while fostering empathy, communication skills, and confidence in handling nuanced MH scenarios. However, AR\u2019s usability and effectiveness for MH task-sharing training remain underexplored.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to assess the usability of an AR-assisted MH task-sharing training tool that uses virtual patient (VP) simulation and evaluate its potential to enhance training. Additionally, we developed design recommendations for future related XR-assisted clinical training tools.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a formative, explorative sequential mixed-methods usability study. A convenience sample of 5 MH trainees or workers (ages 18\u201060 years; female: n=3, male: n=2; identifying as African American, Asian, and Hispanic) participated. Participants were recruited through a university-affiliated MH training program. The usability testing protocol included a semistructured prestudy interview, orientation to the AR headset (Magic Leap 2), a think-aloud user testing session, and a poststudy quantitative questionnaire and qualitative interview. Usability was assessed using a modified Post-Study System Usability Questionnaire (PSSUQ), which measures system usefulness, information quality, and interface quality. Data were analyzed using descriptive statistics and thematic analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The AR simulation was positively received by participants, demonstrating above-average usability. The overall mean PSSUQ score was 3.46 (SD 1.71), with subscale scores for system usefulness (mean 3.46, SD 1.77), information quality (mean 3.76, SD 1.73), and interface quality (mean 2.83, SD 1.59). Thematic analysis highlighted high realism fostered trainees\u2019 empathy toward the VP, while increasing immersion and interaction quality. Despite some hardware limitations and user discomfort that broke immersion, participants recognized the tool\u2019s potential and usefulness for training in various MH scenarios. Based on these findings, we proposed design recommendations across environmental context, training structure, VP behavioral realism (body language, voice, eye movement, and technical hardware considerations).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This pilot study is among the first to evaluate AR-based VP simulation for training lay MH task-sharers, filling the technology and population gaps of prior VR- and desktop-focused simulation research. Preliminary empirical usability evidence from a validated instrument (PSSUQ) demonstrates above-average usability, and findings informed design recommendations for future research. These findings suggest AR-based training could provide a less resource-intensive solution for realistic MH training practice in underresourced settings. Further research includes larger sample sizes for inferential analysis, comparison studies with traditional methods, and generalizing to other MH conditions.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/80711","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T15:20:06Z","timestamp":1773760806000},"page":"e80711-e80711","source":"Crossref","is-referenced-by-count":0,"title":["Augmented Reality\u2013Assisted Training Tool for Mental Health Task-Sharers: Pilot Mixed Methods Usability Study"],"prefix":"10.2196","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9468-5136","authenticated-orcid":false,"given":"Ling Li Vivian","family":"Ngiam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6157-1108","authenticated-orcid":false,"given":"Lucas Piotr","family":"Wozniak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7885-6536","authenticated-orcid":false,"given":"Catherine","family":"Dinh-Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2656-4897","authenticated-orcid":false,"given":"Ayanna Elon","family":"Seals","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8564-7695","authenticated-orcid":false,"given":"Victoria K","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9083-0195","authenticated-orcid":false,"given":"Jose Fernando","family":"Florez-Arango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796019000180","article-title":"The excess costs of depression: a systematic review and meta-analysis","volume":"29","author":"K\u00f6nig","journal-title":"Epidemiol Psychiatr Sci"},{"issue":"5","key":"R2","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/S2215-0366(16)30024-4","article-title":"Scaling-up treatment of depression and anxiety: a global return on investment analysis","volume":"3","author":"Chisholm","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-08964-3","article-title":"Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis","volume":"20","author":"Eylem","journal-title":"BMC Public Health"},{"issue":"9","key":"R4","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1176\/ps.2009.60.9.1190","article-title":"Low socioeconomic status and mental health care use among respondents with anxiety and depression in the NCS-R","volume":"60","author":"Roy-Byrne","journal-title":"Psychiatr Serv"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1377\/hlthaff.27.2.393","article-title":"New evidence regarding racial and ethnic disparities in mental health: policy implications","volume":"27","author":"McGuire","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1176\/appi.focus.20190027","article-title":"Trauma-informed care and cultural humility in the mental health care of people from minoritized communities","volume":"18","author":"Ranjbar","journal-title":"Focus (Am Psychiatr Publ)"},{"issue":"179","key":"R7","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2018.00179","article-title":"Cultural diversity and mental health: considerations for policy and practice","volume":"6","author":"Gopalkrishnan","journal-title":"Front Public Health"},{"issue":"11","key":"R8","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/S2215-0366(21)00285-6","article-title":"Racial and ethnic differences in perception of provider cultural competence among patients with depression and anxiety symptoms: a retrospective, population-based, cross-sectional analysis","volume":"8","author":"Eken","journal-title":"Lancet Psychiatry"},{"issue":"3","key":"R9","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1891\/0889-8391.28.3.156","article-title":"The Vietnam Multicomponent Collaborative Care for Depression Program: development of depression care for low- and middle-income nations","volume":"28","author":"Ngo","journal-title":"Journal of Cognitive Psychotherapy"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01179-z","article-title":"Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks","volume":"17","author":"Le","journal-title":"Implement Sci"},{"issue":"2","key":"R11","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1001\/jama.283.2.212","article-title":"Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial","volume":"283","author":"Wells","journal-title":"JAMA"},{"issue":"10","key":"R12","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.2105\/AJPH.2016.303304","article-title":"Community engagement compared with technical assistance to disseminate depression care among low-income, minority women: a randomized controlled effectiveness study","volume":"106","author":"Ngo","journal-title":"Am J Public Health"},{"key":"R13","unstructured":"World Health Organization. Education and Training. World Health Organization; 2016. URL: https:\/\/iris.who.int\/handle\/10665\/252271 [Accessed 05-02-2025] ISBN: 978-92-4-151160-5"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024059","article-title":"WHO guidance on mental health training: a systematic review of the progress for non-specialist health workers","volume":"9","author":"Caulfield","journal-title":"BMJ Open"},{"issue":"10047","key":"R15","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1016\/S0140-6736(16)31140-0","article-title":"Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a randomised, controlled, non-inferiority trial","volume":"388","author":"Richards","journal-title":"Lancet"},{"issue":"6","key":"R16","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1007\/s10597-020-00734-0","article-title":"Task sharing or task dumping: counsellors experiences of delivering a psychosocial intervention for mental health problems in South Africa","volume":"57","author":"Jacobs","journal-title":"Community Ment Health J"},{"issue":"11\u201312","key":"R17","first-page":"18","volume":"14","author":"Harvey","journal-title":"Innov Clin Neurosci"},{"issue":"6","key":"R18","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1097\/00001888-199306000-00002","article-title":"An overview of the uses of standardized patients for teaching and evaluating clinical skills. AAMC","volume":"68","author":"Barrows","journal-title":"Acad Med"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2016.12.011","article-title":"Effect of simulation training on the development of nurses and nursing students\u2019 critical thinking: a systematic literature review","volume":"50","author":"Adib-Hajbaghery","journal-title":"Nurse Educ Today"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s41077-016-0035-9","article-title":"Simulation and mental health outcomes: a scoping review","volume":"2","author":"Williams","journal-title":"Adv Simul"},{"key":"R21","doi-asserted-by":"crossref","unstructured":"Talbot T Rizzo A . Virtual human standardized patients for clinical training. In: Rizzo A Bouchard S , editors. Virtual Reality for Psychological and Neurocognitive Interventions. Springer; 2019:387-405. [doi: 10.1007\/978-1-4939-9482-3_17] ISBN: 978-1-4939-9482-3","DOI":"10.1007\/978-1-4939-9482-3_17"},{"key":"R22","doi-asserted-by":"crossref","unstructured":"Milgram P Takemura H Utsumi A Kishino F . Augmented reality: a class of displays on the reality-virtuality continuum. Presented at: Proc SPIE 2351, Telemanipulator and Telepresence Technologies; Oct 31 to Nov 1, 1994:282-292; Boston, MA. 1995.[doi: 10.1117\/12.197321]","DOI":"10.1117\/12.197321"},{"issue":"10","key":"R23","doi-asserted-by":"publisher","first-page":"4174","DOI":"10.1007\/s00464-016-4800-6","article-title":"Systematic review on the effectiveness of augmented reality applications in medical training","volume":"30","author":"Barsom","journal-title":"Surg Endosc"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s00779-010-0306-8","article-title":"Using presence to evaluate an augmented reality location aware game","volume":"15","author":"McCall","journal-title":"Pers Ubiquit Comput"},{"key":"R25","doi-asserted-by":"crossref","unstructured":"Otono R Genay A Perusquia-Hernandez M et al. Studying \u201cavatar transitions\u201d in augmented reality: influence on sense of embodiment and physiological activity. Presented at: 2022 IEEE International Symposium on Mixed and Augmented Reality Adjunct (ISMAR-Adjunct); Oct 17-21, 2022:503-504; Singapore. 2022.[doi: 10.1109\/ISMAR-Adjunct57072.2022.00106]","DOI":"10.1109\/ISMAR-Adjunct57072.2022.00106"},{"key":"R26","doi-asserted-by":"crossref","unstructured":"Jacobs R Schn\u00e4delbach H J\u00e4ger N et al. The performative mirror space. Presented at: CHI \u201919: Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems; May 4-9, 2019:1-14; Glasgow, Scotland. May 2, 2019.URL: https:\/\/dl.acm.org\/doi\/proceedings\/10.1145\/3290605 [doi: 10.1145\/3290605.3300630]","DOI":"10.1145\/3290605.3300630"},{"key":"R27","doi-asserted-by":"crossref","unstructured":"Hoang TN Ferdous HS Vetere F Reinoso M . Body as a canvas: an exploration on the role of the body as display of digital information. Presented at: DIS \u201918: Designing Interactive Systems Conference 2018; Jun 9-13, 2018:253-263; Hong Kong, China. 2018.[doi: 10.1145\/3196709.3196724]","DOI":"10.1145\/3196709.3196724"},{"issue":"6669","key":"R28","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1038\/35784","article-title":"Rubber hands \u2018feel\u2019 touch that eyes see","volume":"391","author":"Botvinick","journal-title":"Nature New Biol"},{"issue":"4","key":"R29","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1162\/pres.15.4.455","article-title":"Is this my hand I see before me? the rubber hand illusion in reality, virtual reality, and mixed reality","volume":"15","author":"IJsselsteijn","journal-title":"Presence: Teleoperators and Virtual Environments"},{"key":"R30","doi-asserted-by":"crossref","unstructured":"Yuan Y Steed A . Is the rubber hand illusion induced by immersive virtual reality? Presented at: VR \u201910: Proceedings of the 2010 IEEE Virtual Reality Conference; Mar 20-24, 2010; Waltham, MA. [doi: 10.1109\/VR.2010.5444807]","DOI":"10.1109\/VR.2010.5444807"},{"key":"R31","doi-asserted-by":"crossref","unstructured":"Javornik A Rogers Y Gander D Moutinho A . MagicFace: stepping into character through an augmented reality mirror. Presented at: CHI \u201917: CHI Conference on Human Factors in Computing Systems; May 6-11, 2017:4838-4849; Denver, CO. 2017.[doi: 10.1145\/3025453.3025722]","DOI":"10.1145\/3025453.3025722"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s10055-020-00444-8","article-title":"Virtual reality and augmented reality in social learning spaces: a literature review","volume":"25","author":"Scavarelli","journal-title":"Virtual Real"},{"key":"R33","unstructured":"Kolb DA . Experiential Learning: Experience as the Source of Learning and Development. Pearson Education; 2014. URL: https:\/\/books.google.com\/books?id=jpbeBQAAQBAJ ISBN: 978-0-13-389250-5"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2018.05.007","article-title":"Virtual gaming simulation of a mental health assessment: a usability study","volume":"31","author":"Verkuyl","journal-title":"Nurse Educ Pract"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2021\/7061623","article-title":"Virtual reality as pedagogical tool to enhance experiential learning: a systematic literature review","volume":"2021","author":"Asad","journal-title":"Education Research International"},{"key":"R36","unstructured":"Li Y Luo H Zhang C . Presented at: Hawaii International Conference on System Sciences; Jan 5-8, 2021; Kauai, HI. 2021.URL: http:\/\/hdl.handle.net\/10125\/71104"},{"key":"R37","doi-asserted-by":"crossref","unstructured":"Lohr DJ Johnson S Aziz S Komogortsev O . Demonstrating eye movement biometrics in virtual reality. Presented at: Proceedings of the 2023 Symposium on Eye Tracking Research and Applications (ETRA '23); May 30 to Jun 2, 2023; T\u00fcbingen, Germany. [doi: 10.1145\/3588015.3590109]","DOI":"10.1145\/3588015.3590109"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.3389\/feduc.2019.00080","article-title":"Head-mounted display virtual reality in post-secondary education and skill training","volume":"4","author":"Concannon","journal-title":"Front Educ"},{"issue":"5","key":"R39","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.1016\/j.wneu.2012.08.022","article-title":"Fundamentals of neurosurgery: virtual reality tasks for training and evaluation of technical skills","volume":"80","author":"Choudhury","journal-title":"World Neurosurg"},{"issue":"2","key":"R40","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1097\/01.sla.0000151982.85062.80","article-title":"Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training","volume":"241","author":"Gallagher","journal-title":"Ann Surg"},{"key":"R41","author":"Verkuyl","journal-title":"Research & Reviews: Journal of Nursing and Health Sciences"},{"key":"R42","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2016.06.014","article-title":"Teaching clinical reasoning and decision-making skills to nursing students: design, development, and usability evaluation of a serious game","volume":"94","author":"Johnsen","journal-title":"Int J Med Inform"},{"issue":"6","key":"R43","doi-asserted-by":"publisher","first-page":"1991","DOI":"10.1111\/bjet.13023","article-title":"Effectiveness of immersive virtual reality using head\u2010mounted displays on learning performance: a meta\u2010analysis","volume":"51","author":"Wu","journal-title":"Brit J Educational Tech"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1016\/j.learninstruc.2016.01.007","article-title":"Mind wandering, control failures, and social media distractions in online learning","volume":"42","author":"Hollis","journal-title":"Learn Instr"},{"key":"R45","doi-asserted-by":"crossref","unstructured":"Dede CJ Jacobson J Richards J . Introduction: virtual, augmented, and mixed realities in education. In: Richards J Dede C Huang R Richards J , editors. Virtual, Augmented, and Mixed Realities in Education. Springer; 2017:1-16. [doi: 10.1007\/978-981-10-5490-7_1] ISBN: 978-981-10-5490-7","DOI":"10.1007\/978-981-10-5490-7_1"},{"issue":"1535","key":"R46","doi-asserted-by":"publisher","first-page":"3549","DOI":"10.1098\/rstb.2009.0138","article-title":"Place illusion and plausibility can lead to realistic behaviour in immersive virtual environments","volume":"364","author":"Slater","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2014.07.025","article-title":"Short- and long-term effects of embodied experiences in immersive virtual environments on environmental locus of control and behavior","volume":"39","author":"Ahn","journal-title":"Comput Human Behav"},{"issue":"4","key":"R48","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1177\/0018720816644364","article-title":"Human\u2013robot interaction","volume":"58","author":"Sheridan","journal-title":"Hum Factors"},{"issue":"9","key":"R49","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238437","article-title":"Usability of mental illness simulation involving scenarios with patients with schizophrenia via immersive virtual reality: a mixed methods study","volume":"15","author":"Lee","journal-title":"PLoS One"},{"issue":"2","key":"R50","doi-asserted-by":"publisher","DOI":"10.2196\/29518","article-title":"A virtual reality resident training curriculum on behavioral health anticipatory guidance: development and usability study","volume":"4","author":"Herbst","journal-title":"JMIR Pediatr Parent"},{"key":"R51","doi-asserted-by":"publisher","DOI":"10.3389\/frvir.2021.759682","article-title":"Editorial: cybersickness in virtual reality and augmented reality","volume":"2","author":"Lawson","journal-title":"Front Virtual Real"},{"key":"R52","doi-asserted-by":"publisher","DOI":"10.1016\/j.compedu.2012.10.024","article-title":"Current status, opportunities and challenges of augmented reality in education","volume":"62","author":"Wu","journal-title":"Comput Educ"},{"issue":"1","key":"R53","doi-asserted-by":"publisher","first-page":"e81","DOI":"10.36834\/cmej.61705","article-title":"Augmented reality in medical education: a systematic review","volume":"11","author":"Tang","journal-title":"Can Med Educ J"},{"issue":"17","key":"R54","doi-asserted-by":"publisher","first-page":"3556","DOI":"10.3390\/app9173556","article-title":"Potential of augmented reality and virtual reality technologies to promote wellbeing in older adults","volume":"9","author":"Lee","journal-title":"Appl Sci (Basel)"},{"issue":"2","key":"R55","doi-asserted-by":"publisher","DOI":"10.2196\/25499","article-title":"Virtual and augmented reality applications in medicine: analysis of the scientific literature","volume":"23","author":"Yeung","journal-title":"J Med Internet Res"},{"key":"R56","unstructured":"Juanes-M\u00e9ndez JA Marcos-Pablos S Velasco-Marcos MA Izard SG . Medical learning through simulations with immersive virtual reality and augmented reality devices. In: Technological Adoption and Trends in Health Sciences Teaching, Learning, and Practice. IGI Global; 2022. URL: https:\/\/www.semanticscholar.org\/paper\/Medical-Learning-Through-Simulations-With-Immersive-Juanes-M%C3%A9ndez-Marcos-Pablos\/e1925e4c95506b85378038989334818402a79b4b [Accessed 06-02-2025]"},{"issue":"4","key":"R57","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1007\/s40037-013-0107-7","article-title":"Augmented reality in medical education?","volume":"3","author":"Kamphuis","journal-title":"Perspect Med Educ"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.469","article-title":"Augmented reality in healthcare education: an integrative review","volume":"2","author":"Zhu","journal-title":"PeerJ"},{"issue":"8","key":"R59","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2497","article-title":"Effects of mobile augmented reality learning compared to textbook learning on medical students: randomized controlled pilot study","volume":"15","author":"Albrecht","journal-title":"J Med Internet Res"},{"issue":"5","key":"R60","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7379","article-title":"Adherence to AHA guidelines when adapted for augmented reality glasses for assisted pediatric cardiopulmonary resuscitation: a randomized controlled trial","volume":"19","author":"Siebert","journal-title":"J Med Internet Res"},{"issue":"1","key":"R61","doi-asserted-by":"publisher","DOI":"10.2196\/23963","article-title":"Augmented reality technology as a teaching strategy for learning pediatric asthma management: mixed methods study","volume":"3","author":"Kotcherlakota","journal-title":"JMIR Nurs"},{"issue":"5","key":"R62","doi-asserted-by":"publisher","DOI":"10.2196\/14910","article-title":"Augmented reality learning environment for basic life support and defibrillation training: usability study","volume":"22","author":"Ingrassia","journal-title":"J Med Internet Res"},{"issue":"3","key":"R63","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1097\/SIH.0000000000000486","article-title":"Development and implementation of augmented reality enhanced high-fidelity simulation for recognition of patient decompensation","volume":"16","author":"Zackoff","journal-title":"Simul Healthc"},{"issue":"3","key":"R64","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1097\/SIH.0000000000000347","article-title":"Virtual reality simulation in nontechnical skills training for healthcare professionals: a systematic review","volume":"14","author":"Bracq","journal-title":"Simul Healthc"},{"issue":"1","key":"R65","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.jarmac.2018.01.009","article-title":"Adaptive skill as the conditio sine qua non of expertise","volume":"7","author":"Ward","journal-title":"J Appl Res Mem Cogn"},{"key":"R66","unstructured":"Nielsen J . Usability Engineering. Morgan Kaufmann Publishers Inc; 1994. ISBN: 978-0-08-052029-2"},{"key":"R67","unstructured":"Strengthening community mental health resilience in Harlem. Harlem Strong. URL: https:\/\/harlem-strong.org\/ [Accessed 06-02-2025]"},{"key":"R68","unstructured":"Center for innovation in mental health at the CUNY graduate school of public health and health policy. Center for Innovation in Mental Health. URL: https:\/\/cimh.sph.cuny.edu\/ [Accessed 06-02-2025]"},{"key":"R69","unstructured":"Ericsson KA Simon HA . Protocol analysis: verbal reports as data (revised edition). MIT Press Direct. URL: https:\/\/direct.mit.edu\/books\/monograph\/4763\/Protocol-AnalysisVerbal-Reports-as-Data [Accessed 05-02-2025]"},{"issue":"1","key":"R70","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1080\/10447319509526110","article-title":"IBM computer usability satisfaction questionnaires: psychometric evaluation and instructions for use","volume":"7","author":"Lewis","journal-title":"Int J Hum Comput Interact"},{"issue":"6","key":"R71","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1016\/S0033-3182(09)70864-3","article-title":"An ultra-brief screening scale for anxiety and depression: the PHQ\u20134","volume":"50","author":"Kroenke","journal-title":"Psychosomatics"},{"key":"R72","unstructured":"Care. Magic Leap 2. URL: https:\/\/www.magicleap.com\/magic-leap-2 [Accessed 05-02-2025]"},{"key":"R73","unstructured":"WAI site usability testing questions. Web Accessibility Initiative (WAI). URL: https:\/\/www.w3.org\/WAI\/EO\/Drafts\/UCD\/questions.html [Accessed 05-02-2025]"},{"issue":"2","key":"R74","doi-asserted-by":"publisher","DOI":"10.2196\/mental.5801","article-title":"Feasibility of an immersive virtual reality intervention for hospitalized patients: an observational cohort study","volume":"3","author":"Mosadeghi","journal-title":"JMIR Ment Health"},{"key":"R75","unstructured":"Writing your user test plan: open-ended vs. specific tasks and questions. User Testing. URL: https:\/\/www.usertesting.com\/blog\/open-ended-vs-specific-tasks-and-questions [Accessed 05-02-2025]"},{"key":"R76","unstructured":"Unity: develop, deploy, and grow | the world\u2019s leading 3D game engine. Unity. URL: https:\/\/unity.com\/ [Accessed 12-03-2024]"},{"key":"R77","unstructured":"Integrate an avatar creator into your game in days [archived version]. Ready Player Me. URL: https:\/\/web.archive.org\/web\/20251222042725\/https:\/\/readyplayer.me\/ [Accessed 12-03-2024]"},{"key":"R78","unstructured":"SALSA lipsync suite. Unity Asset Store. URL: https:\/\/assetstore.unity.com\/packages\/tools\/animation\/salsa-lipsync-suite-148442 [Accessed 12-03-2024]"},{"key":"R79","unstructured":"Animate 3D characters for games, film, and more. Mixamo. URL: https:\/\/www.mixamo.com\/#\/ [Accessed 12-03-2024]"},{"key":"R80","unstructured":"One platform to connect. Zoom. URL: https:\/\/www.zoom.com [Accessed 05-02-2025]"},{"key":"R81","unstructured":"A brief history of ATLAS.ti. ATLAS.ti. URL: https:\/\/atlasti.com\/about-atlas-ti [Accessed 05-02-2025]"},{"issue":"4","key":"R82","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/0147-1767(85)90062-8","article-title":"Naturalistic inquiry","volume":"9","author":"Lincoln","journal-title":"Int J Intercult Relat"},{"issue":"9","key":"R83","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","journal-title":"Qual Health Res"},{"issue":"4","key":"R84","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","journal-title":"Qual Res Sport Exerc Health"},{"issue":"2","key":"R85","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","journal-title":"Qual Res Psychol"},{"issue":"5","key":"R86","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1007\/s40670-022-01598-7","article-title":"Communication skills training using remote augmented reality medical simulation: a feasibility and acceptability qualitative study","volume":"32","author":"Hess","journal-title":"Med Sci Educ"},{"key":"R87","doi-asserted-by":"crossref","unstructured":"Ayer L Schultz D Abbott M et al. Mental health task-shifting in community-based organizations: implementation, impact, and cost \u2014 evaluation of the connections to care program. RAND Corporation; 2020. [doi: 10.7249\/RR3083]","DOI":"10.7249\/RR3083"},{"issue":"3","key":"R88","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s10880-016-9464-9","article-title":"Primary care behavioral health provider training: systematic development and implementation in a large medical system","volume":"23","author":"Dobmeyer","journal-title":"J Clin Psychol Med Settings"},{"issue":"4","key":"R89","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/j.ijnss.2019.09.008","article-title":"Exploring the barriers of utilizing theoretical knowledge in clinical settings: a qualitative study","volume":"6","author":"Hashemiparast","journal-title":"Int J Nurs Sci"},{"issue":"3-4","key":"R90","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1002\/ajcp.12516","article-title":"Systematic review of cultural aspects of stigma and mental illness among racial and ethnic minority groups in the United States: implications for interventions","volume":"68","author":"Misra","journal-title":"Am J Community Psychol"},{"issue":"2","key":"R91","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.eurpsy.2014.01.001","article-title":"EPA guidance on building trust in mental health services","volume":"29","author":"Gaebel","journal-title":"Eur psychiatr"},{"key":"R92","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2023.101459","article-title":"The educational value of mental health simulation in undergraduate bachelor of nursing education: an integrative review","volume":"84","author":"Alexander","journal-title":"Clin Simul Nurs"},{"key":"R93","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2021.01.009","article-title":"Simulations with standardized patients for nursing students in preparation for clinical placements in mental health care","volume":"54","author":"Knutson de Presno","journal-title":"Clin Simul Nurs"},{"issue":"1","key":"R94","doi-asserted-by":"publisher","DOI":"10.2196\/31644","article-title":"How, for whom, and in which contexts or conditions augmented and virtual reality training works in upskilling health care workers: realist synthesis","volume":"10","author":"Gasteiger","journal-title":"JMIR Serious Games"},{"issue":"6","key":"R95","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3533377","article-title":"Systematic review of comparative studies of the impact of realism in immersive virtual experiences","volume":"55","author":"Gon\u00e7alves","journal-title":"ACM Comput Surv"},{"key":"R96","doi-asserted-by":"crossref","unstructured":"Kasapakis V Dzardanova E Nikolakopoulou V Vosinakis S Xenakis I Gavalas D . Social virtual reality: implementing non-verbal cues in remote synchronous communication. In: Bourdot P Alca\u00f1iz Raya M Figueroa P Interrante V Kuhlen TW Reiners D , editors. Virtual Real Mix Real Cham. Springer International Publishing; 2021:152-157. [doi: 10.1007\/978-3-030-90739-6_10]","DOI":"10.1007\/978-3-030-90739-6_10"},{"issue":"2-3","key":"R97","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1177\/15553434211019234","article-title":"Use of augmented reality to train sensemaking in high-stakes medical environments","volume":"15","author":"Sushereba","journal-title":"J Cogn Eng Decis Mak"},{"issue":"8","key":"R98","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1080\/10503307.2021.1874069","article-title":"Therapeutic distance in client-therapist narratives: client attachment, therapist attachment, and dyadic effects","volume":"31","author":"Egozi","journal-title":"Psychother Res"},{"issue":"2","key":"R99","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1109\/MRA.2012.2192811","article-title":"The uncanny valley [from the field]","volume":"19","author":"Mori","journal-title":"IEEE Robot Automat Mag"},{"issue":"3","key":"R100","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1075\/is.7.3.03mac","article-title":"The uncanny advantage of using androids in cognitive and social science research","volume":"7","author":"MacDorman","journal-title":"IS"},{"issue":"s12","key":"R101","doi-asserted-by":"publisher","first-page":"65","DOI":"10.47836\/mjmhs.19.s12.9","article-title":"The applications of augmented reality (AR) and virtual reality (VR) in teaching medical and dentistry students: a review on advantages and disadvantages","volume":"19","author":"Mohamad Zainal","journal-title":"MJMHS"},{"issue":"2","key":"R102","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1037\/0882-7974.21.2.333","article-title":"Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE)","volume":"21","author":"Czaja","journal-title":"Psychol Aging"},{"issue":"11","key":"R103","doi-asserted-by":"publisher","first-page":"1895","DOI":"10.1007\/s11548-020-02236-6","article-title":"Ultrasound in augmented reality: a mixed-methods evaluation of head-mounted displays in image-guided interventions","volume":"15","author":"R\u00fcger","journal-title":"Int J CARS"},{"issue":"3","key":"R104","doi-asserted-by":"publisher","DOI":"10.2196\/32715","article-title":"Effectiveness of using augmented reality for training in the medical professions: meta-analysis","volume":"10","author":"Baashar","journal-title":"JMIR Serious Games"},{"issue":"3","key":"R105","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1080\/00461520.2022.2079128","article-title":"Design-based research: what it is and why it matters to studying online learning","volume":"57","author":"Hoadley","journal-title":"Educ Psychol"}],"container-title":["JMIR XR and Spatial Computing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/xr.jmir.org\/2026\/1\/e80711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:26:38Z","timestamp":1785536798000},"score":1,"resource":{"primary":{"URL":"https:\/\/xr.jmir.org\/2026\/1\/e80711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":105,"URL":"https:\/\/doi.org\/10.2196\/80711","relation":{},"ISSN":["2818-3045"],"issn-type":[{"value":"2818-3045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"article-number":"v3i5e80711"}}