{"paper_id":"34e1f034-1917-47e3-9133-97b6e0aebbe4","body_text":"Using virtual reality to investigate bias and discrimination in clinical decision making: A proof of concept study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Using virtual reality to investigate bias and discrimination in clinical decision making: A proof of concept study Zoe Chui, Helen Welsh, Rebecca Rhead, Lucia Valmaggia, Juliana Onwumere, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7849122/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Biases held by healthcare practitioners can shape clinical interactions, leading to discrimination and poor patient outcomes. Traditional methods, such as vignettes or self-report measures, often lack ecological validity. Objective We evaluated a novel VR simulation designed to explore bias and discrimination in clinical decisionmaking. Methods Thirty-five healthcare practitioners across 14 NHS trusts completed an in-person VR simulation and provided feedback on realism, immersion, and usability via surveys and open-ended responses. Patients in the simulation had intersecting sociodemographic characteristics (race, gender, migration status). Results Most participants rated the VR environment as at least moderately realistic (88.6%), with 42.9% rating it very or extremely realistic. Nearly half (45.7%) reported consistency with real-world experience. Open-text feedback highlighted strengths in realism, immersion, and educational potential, with suggestions to improve dialogue flexibility. Conclusions VR is a feasible, immersive, and scalable tool for investigating bias in clinical decision-making. Virtual reality bias discrimination healthcare intersectionality clinical decision-making treatment recommendations Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-7849122\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":549801053,\"identity\":\"2da8320e-dcc5-4945-8c94-61fbb1a679ab\",\"order_by\":0,\"name\":\"Zoe Chui\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"King's College London\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Zoe\",\"middleName\":\"\",\"lastName\":\"Chui\",\"suffix\":\"\"},{\"id\":549801054,\"identity\":\"00a2548f-4016-40f1-9c0d-2acdc1849fb1\",\"order_by\":1,\"name\":\"Helen 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Traditional methods, such as vignettes or self-report measures, often lack ecological validity.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eObjective We evaluated a novel VR simulation designed to explore bias and discrimination in clinical decisionmaking.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eMethods Thirty-five healthcare practitioners across 14 NHS trusts completed an in-person VR simulation and provided feedback on realism, immersion, and usability via surveys and open-ended responses. Patients in the simulation had intersecting sociodemographic characteristics (race, gender, migration status).\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eResults Most participants rated the VR environment as at least moderately realistic (88.6%), with 42.9% rating it very or extremely realistic. Nearly half (45.7%) reported consistency with real-world experience. 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