Usability Analysis of Virtual Reality (VR) Learning Concept-based Dental and Medical Examinations: A Preliminary Study in Indonesia

Usability Analysis of Virtual Reality (VR) Learning Concept-based Dental and Medical Examinations: A Preliminary Study in Indonesia | 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 Usability Analysis of Virtual Reality (VR) Learning Concept-based Dental and Medical Examinations: A Preliminary Study in Indonesia Benso Sulijaya, Luthfi Saiful Arif, La Ode Abd Rahman, Muhammad Hidayat Sahid, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7551610/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 The integration of virtual reality (VR) into medical and dental education has created new opportunities for simulating clinical environments, providing an immersive and interactive platform for training in skills such as general physical examinations. Aim This study aims to analyze medical, dental, and nursing students’ perception of the usability and effectiveness of VR-based training for dental and physical examinations. Methods A quantitative approach was employed using questionnaires on user experience, cybersickness in virtual reality (CSQ-VR), and the System Usability Scale (SUS). Respondents, including dental, medical, and nursing students, were recruited through convenience sampling. The VR-based dental and general physical examinations were carried out for a maximum of 20 minutes, followed by surveys. Results A total of 41 respondents participated in the training. The findings indicated high satisfaction, with 51.22% reporting good usability ratings. No significant differences were observed among the students regarding user experience, usability, or motion sickness. Additionally, no significant correlation was found between satisfaction, game duration, or motion sickness. Conclusion VR-based dental and general physical examination training is perceived positively by different groups. Future studies must address several issues to ensure a smooth data collection process. virtual reality dental medical nursing examination education Figures Figure 1 Figure 2 Introduction Throughout the evolution of healthcare education, particularly in dentistry and medicine, emerging technologies have consistently been embraced to enhance learning experiences and improve student outcomes. Among these advancements, virtual reality (VR) has gained considerable attention for its ability to simulate realistic clinical environments and provide immersive, interactive training platforms. Traditional lecture-based teaching methods often lack engagement and fail to offer standardized, realistic models, leading to the suboptimal acquisition of practical skills among students (Izard et al., 2018). These challenges have driven the exploration of VR as a complementary tool in dental and medical education. VR enables learners to engage in realistic, three-dimensional environments, where they can practice complex skills without being physically present in a clinical setting. This unique capability gives VR considerable potential in both theoretical and practical aspects of dental and medical education (Zhao et al., 2021 ). Additionally, VR allows for repeated practice, immediate feedback, and standardized learning experiences, effectively addressing some of the limitations inherent in traditional teaching methods (Yeung et al., 2021 ). Evidence shows that VR provides a promising way for students to practice skills in a realistic environment, allowing them to improve their abilities in a well-controlled setting before working with real patients (Liebermann et al., 2022). Moreover, VR can simulate rare and dangerous clinical scenarios, enhancing students’ preparedness for emergency situations (Jung, 2022 ). In terms of student assessment, VR can support pedagogy across different disciplines and facilitate debriefing, ultimately enhancing the learning experience (Coyne et al., 2021 ). These benefits make VR a valuable tool for Indonesian dental and medical education. Given that Indonesia has numerous dental and medical colleges, improving the education system through VR integration could help enhance educational quality and address challenges in both preclinical and clinical settings (Haryanvi et al., 2021; Mayasari et al., 2021; Kanschik, 2023). Despite its advantages, the implementation of VR in education faces several challenges, including limited perceptions of and experience with the technology. A previous study revealed that, although more than 80% of medical students and lecturers in Indonesia expressed interest in using VR, fewer than 50% had hands-on experience with it (Arif et al., 2024 ). Limited experience and expertise with complex technology can influence users’ perceptions and their willingness to adopt sophisticated tools (Goeke, 2016), including VR, which remains uncommon in Indonesia. Furthermore, although VR technology has matured, the development and successful adoption of VR modules depend heavily on careful alignment with educational goals (Ryani, 2022), particularly in accordance with the national curricula for dental and medical education in Indonesia. Furthermore, concerns about cybersickness, as noted by Weech et al. ( 2019 ), also underscore the importance of optimizing VR systems to minimize discomfort and enhance usability. Through the adaptation of VR, numerous opportunities have emerged that could significantly transform the way dental and medical education is delivered. However, despite its growing global popularity, the use of VR in dental and medical education in Indonesia remains underexplored, with conventional teaching methods still widely employed. The development and implementation of VR-based training should be guided by the Technology Acceptance Model (TAM), which highlights that the perceived ease of use and usefulness are closely linked to the intention to use (Fussell, 2022 ). To ensure the benefits and sustained adoption of VR-based training, in this study, we aim to analyze the perceptions of medical, dental, and nursing students regarding the usability and effectiveness of VR for dental and physical examination training. Additionally, in this preliminary study, we seek to identify potential challenges that may arise in a larger-scale investigation. By examining these factors, we aim to contribute to the growing body of knowledge on the application of VR in dental and medical education and to identify areas for future improvement in order to optimize its integration into clinical training. Material and Methods Ethical Approval This study was conducted in accordance with the Declaration of Helsinki and received ethical clearance from the Ethics Committee of the Faculty of Medicine, Universitas Indonesia (No. KET-1545/UN2.F1/ETIK/PPM.00.02/2024) under protocol number 24-09-1486. All participants provided informed consent before participating in the study. Study design and Ethics This cross-sectional study employed a quantitative approach to assess the usability, perceptions, and feasibility of VR-based dental and general exams. The VR-based training used in this study was developed by a team from Universitas Indonesia to help students improve their general and dental examination competence. The learning module was designed in accordance with Indonesia's national dental and medical curriculum. Participants were recruited using convenience sampling. Following a rule of thumb, a minimum sample size of 30 was used in this study (Browne, 1995; Whitehead, 2015). The eligibility criteria required participants to be currently enrolled in a dental, medical, or nursing program and to agree to follow the instructions. Subjects with a history of severe motion sickness or those unable to use virtual reality due to severe audiovisual impairments were excluded. All participants provided informed consent before taking part in the study. VR-based Dental and General Examination Training The VR-based training is part of a larger project platform called Immersive Hub for Healthcare Education. The training platform was developed to provide an immersive training space for students, including those in medicine, dentistry, nursing, vocational studies, midwifery, and other healthcare fields. In the early phase, two modules were developed: the general examination module for medical students and the dental examination module for dental students. However, these applications were not limited to specific professions and could be used by others to enhance interprofessional education. The general examination module covered several aspects, including history taking, anthropometry, inspection, palpation, percussion, and auscultation, while the dental examination module included peripheral examination, dental inspection, and odontogram filling. Figure 1 illustrates the modules used in the VR-based training. This study was conducted at the Healthcare Cluster, Universitas Indonesia. After the participants were recruited, the research team explained the procedure through a brief tutorial video and obtained informed consent. The participants were then given a head-mounted display (Meta Quest 2) to wear and prepared to enter the simulation. The dental students utilized the dental examination module, while the medical and nursing students utilized the general examination module. The duration of the VR-based training was limited to 20 minutes to prevent severe side effects. The participants could ask for the simulation to be terminated if they felt discomfort. The research team stood near the participants to ensure their safety and provided guidance when technical issues occurred. After the participants completed the VR-based training, they were asked to complete a questionnaire. All data were recorded on a cloud-based platform. Questionnaire This study employed three types of instruments to assess the participants’ satisfaction, perception of usability, and cybersickness. The participants’ satisfaction was assessed using a self-developed questionnaire, containing seven questions with a 6-point scale numbered from 1 (strongly disagree) to 5 (strongly agree). Using 30 samples, validity and reliability testing was conducted to ensure that the questionnaire targeted the constructs accurately and was consistent. Testing showed that each question had a value of r>0.361, with a Cronbach’s alpha of 0.727, indicating that the questionnaire was valid and reliable. The participants' perception of the VR-based training was recorded using the Indonesian adapted version of the System Usability Scale (SUS) questionnaire, which was validated by Sharfina and Santoso, with a Cronbach's alpha of 0.841 (Sharfina et al, 2016). The SUS questionnaire consists of 10 items, with odd numbers corresponding to positive items and even numbers corresponding to negative items. The participants were asked to rate the questions using a 5-point scale numbered from 1 (strongly disagree) to 5 (strongly agree). For positive items, the score contribution is calculated by subtracting 1 from the scale position, while for negative items, it is determined by subtracting the scale position from 5. The overall SUS score is obtained by summing the item score contributions and multiplying the result by 2.5, yielding a range from 0 to 100. An SUS score of 85-100 indicates “The best imaginable”, 73 to 84 indicates “Excellent”, 53-72 indicates “Good”, 38-52 indicates “OK/Fair”, 24-37 indicates “Poor”, and 0-25 indicates “The worst possible” (Shidende, 2023). The Cybersickness Questionnaire-VR (CSQ-VR) was used to assess cybersickness during the session. This instrument was developed and validated by Kourtesis et al. in 2023. Six questions, divided into 3 sub-scores, with a 7-point scale numbered from 1 (absent feeling) to 7 (extreme feeling), were presented to the participants. Each sub-score is calculated by adding together the results of two different questions, resulting in a score that describes different symptoms (nausea, vestibular, and oculomotor symptoms). The total score is the sum of the three sub-scores (Kourtesis, et al., 2023). At the end, one open-ended question was added to address opinions and issues related to the application and user experience. The results of this question will be used to revise and enhance the VR-based training. Moreover, all research teams were responsible for taking note of every issue that arose during the experiment. Data Analysis The data were analyzed using IBM SPSS Statistics Version 26 (SPSS Inc., Chicago, IL, USA). Demographic information and questionnaire responses are summarized using descriptive statistics. The characteristics of the respondents are presented using sample size, and categorical variables are presented as percentages. Numerical data are presented as the mean and standard deviation. Categorical variables were compared using the Chi-square test. If the data were normally distributed, comparisons of numerical variables were conducted using independent t-tests; otherwise, a non-parametric test was used. The association between cybersickness, satisfaction, and game duration was evaluated using Pearson correlation analysis for normally distributed variables, while Spearman’s test was used for non-normally distributed variables. A p-value < 0.05 was considered statistically significant. Result We recruited 41 participants during this study (dental vs. medical vs. nursing students, 46.34 vs. 31.71 vs. 21.95%, respectively). A total of 19 students took part in VR-based dental training, while 22 students took part in VR-based general examination training. Table 1 shows that female participants (60.98) predominated over male participants (39.02). Among all the participants, second-year students were the most represented group (36.59), followed by first-year (21.95) and fourth-year students (19.51). The majority of the participants had no prior VR experience (48.78) and did not own a VR device (95.12). Most of the participants reported a high satisfaction level (4 out of 5) and perceived VR-based training as “good” (51.22). Meanwhile, cybersickness symptoms were minimal across all aspects. The mean duration of VR practice was 970.80 ± 654.59 seconds (Table 1). Table 1. Respondents' demographic data. Respondents (n=41) n (%) Gender, n (%) Male 16 (39.02) Female 25 (60.98) Faculty, n (%) Dental 19 (46.34) Medicine 13 (31.71) Nursing 9 (21.95) Education year, n (%) 1 9 (21.95) 2 15 (36.59) 3 1 (2.44) 4 8 (19.51) 5 7 (17.07) 6 1 (2.44) Prior VR experience, n (%) Never 20 (48.78) Yes, 1x 8 (19.51) Yes, >1x 13 (31.71) Own a VR device, n (%) Yes 2 (4.88) No 39 (95.12) Satisfaction, mean (±SD) 4.48 0.46 Usability perception, n (%) The best imaginable 5 (12,20) Excellent 4 (9.76) Good 21 (51.22) Ok/Fair 11 (26.83) Cybersickness, mean (SD) Nausea 2.83 (1.43) Vestibular 2.68 (1.60) Oculomotor 2.78 (1.41) Total 8.29 (3.79) Game duration in seconds, mean (±SD) 970.80 ±654.59 Figure 2 presents the participants' responses regarding user satisfaction of VR-based training. Overall, the study indicates a high level of satisfaction, with more than 50% of the participants strongly agreeing with the statements, except for the ability to control the learning process (36.59%). Notably, regarding the ability to perform the dental/general patient examination properly using VR, 9.76% of the participants disagreed, and 2.44% strongly disagreed. The highest satisfaction score (73.17%) was observed for the clarity and completeness of the information provided by the VR-based training, followed by overall satisfaction with the training. To expand the analysis, we compared satisfaction, usability perception, and cybersickness between genders, as shown in Table 2. The analysis revealed that the female participants reported higher satisfaction than the male participants (p=0.021). Similar to the overall results of all the participants, most of the male and female participants rated the VR-based training as “good” (male vs. female, 21.95 vs. 29.27), with no significant difference (p=0.568). No significant difference in cybersickness symptoms was found in both groups (p=0.534). Table 2. Students’ satisfaction and usability perception, compared between gender. Gender P-value Male (n=16) Female (n=25) Satisfaction, mean (±SD) 4.24 (0.54) 4.64 (0.34) 0.021* a Usability perception, n (%) The best imaginable 3 (7.32) 2 (4.88) 0.568 b Excellent 1 (2.44) 3 (7.32) Good 9 (21.95) 12 (29.27) Ok/Fair 3 (7.32) 8 (19.51) Cybersickness, mean (±SD) Nausea 2.81 (1.22) 2.84 (1,57) 0.864 a Vestibular 2.75 (1.73) 2.64 (1,55) 0.947 a Oculomotor 2.75 (1.34) 2.80 (1,47) 0.989 a Total 8.31 (2.77) 8.28 (4,37) 0.534 a SUS (System Usability Scale); CSQ-VR (Cybersickness Questionnaire-VR); a: Mann–Whitney test; b: Chi-square. P value < 0.05 considered significant. Table 3 shows the correlation between cybersickness, satisfaction, and game duration. The correlation coefficient for cybersickness was -0.132, with a p-value of 0.410, while satisfaction had a correlation coefficient of -0.141, with a p-value of 0.380. This study results indicate no significant correlation between cybersickness, satisfaction, and game duration (p>0.05). Table 3. Correlation between cybersickness and game duration. Game duration in seconds Correlation coefficient p-value Cybersickness (total) -0.132 0.410 Satisfaction -0.141 0.380 Spearman test, P value < 0.05 considered significant. Discussion Virtual reality (VR) innovation in dentistry and medical education benefits multiple disciplines. Integrating VR advancements into the educational system requires diverse approaches and procedures tailored to each field. Several studies have demonstrated the effectiveness of VR in dental and medical education. For example, VR supports dental education in crown cementation (Tubelo, 2016) and tooth arrangement assessment (Mansoory, 2020). Similarly, VR has proven to be a valuable tool for simulating clinical scenarios, allowing students to practice in a controlled and reproducible environment (Freina & Ott, 2015). These findings highlight the transformative potential of VR, yet they also call for a balanced discussion of its limitations and challenges, such as accessibility and associated disadvantages. As VR's potential remains largely unexplored in Indonesia, the results of this study could provide valuable insights into its usability in Indonesian dental and medical training contexts. The present study shows that all subjects reported high satisfaction levels, with the largest proportion of participants, in both the male and female groups, rating VR-based training as “good”. These findings indicate that the participants had positive perceptions of the use of VR-based training in dental and medical education. More than half of the participants in this study also showed strong agreement with statements regarding the training’s high perceived usefulness, ease of use, and enjoyability. Such perceptions correlate significantly with intentions/attitudes toward use, as shown in a study conducted by Fussell and Trong in 2021. Additionally, Bandura’s self-efficacy or personal belief research supports the findings regarding the perceived ease of use. This perception is important for stimulating a student’s thoughts, actions, and motivation and improving the effectiveness of their learning (Davis, 1989; Bandura, 1991). Stimulating the intention to regularly use VR during learning could pave the way for incorporating VR into the curriculum. This study also considered gender differences in the perception and experience of VR-based training. Significantly higher satisfaction was found among female participants. The impact of gender differences on VR-based training is rarely discussed, particularly in the context of dental and medical education. However, a study on environmental education featuring videos of human bodies found that female participants demonstrated better performance in both empathy and actual behaviors (Chiang, 2021). Similarly, Moraes et al. (2023) reported that female students performed better in VR learning. This may explain the higher satisfaction levels among female students, as student satisfaction is often influenced by their perceived achievement (Liu, 2024). In terms of cybersickness, this study evaluated oculomotor, vestibular, and nausea symptoms as potential consequences of using VR. Visual fatigue may be one of the negative effects of frequent and repeated exposure to VR (Ran et al., 2021; Felemban et al., 2021; Wang et al., 2014). The analysis revealed a low incidence of cybersickness in both the male and female groups, which differs from previous studies showing that female participants tend to experience more cybersickness after using VR (Kelly, 2023). This discrepancy may be due to the relatively short exposure time to the VR environment in our study, which was under 20 minutes. Furthermore, our correlation analysis found no association between cybersickness and gameplay duration. This result aligns with that of a previous study suggesting that VR use can be sustained for up to 70 minutes (Kourtesis, 2021). However, a 10–15-minute break every hour is recommended for extended VR use to reduce the risk of VR sickness (Yao, 2014; Woo, 2023). This study has several strengths. It included students from various healthcare professions, which may support the promotion of interprofessional education in the future. The VR-based training was developed by an interdisciplinary team, thus enhancing its generalizability and applicability. However, several limitations must also be acknowledged. As a preliminary study, one of the aims was to identify and address technical issues during data collection to inform future research. To enable more robust comparisons based on gender or faculty background regarding usability and satisfaction, a more rigorous study design, such as a randomized controlled trial with a larger and more balanced sample, is recommended. In this study, cybersickness was assessed only once, at the end of the session. Future studies should evaluate cybersickness both before and after VR exposure to allow for pre- and post-intervention comparisons. Additionally, a knowledge assessment should be incorporated using Kirkpatrick’s model of training evaluation, which includes reaction, learning, behavior, and results, to better understand the effectiveness of VR-based training (Strojny, 2023). The feasibility of conducting multiple VR sessions on the same day could also be explored to evaluate the potential of longer and repeated use. Conclusion The use of VR-based dental and physical examination training is perceived positively and can be effectively utilized by all groups. The results of the SUS and CSQ-VR analyses in this preliminary study emphasize that the application of VR in Indonesia is feasible and can provide a learning experience in accordance with the national curricula. However, future studies must address several issues to ensure a smooth data collection process. Declarations Acknowledgments The authors thank Universitas Indonesia and Medimedi Indonesia for supporting this research. Author contributions Conceptualization, B.S., L.S.A., L.O.A.R., M.H.S., C.H.S., U.N.S., and M.S.R.; methodology, B.S., L.S.A., L.O.A.R., M.H.S., C.H.S., and U.N.S.; software, C.H.S., U.N.S., and M.S.R.; validation, L.O.A.R. and M.H.S.; formal analysis, C.H.S.; investigation, B.S., L.S.A., and L.O.A.R.; data curation, B.S. and L.S.A.; writing—original draft preparation, B.S., L.S.A., and C.H.S; writing—review and editing, L.O.A.R., M.H.S., C.H.S., and U.N.S. All authors have read and agreed to the published version of the manuscript. Funding Universitas Indonesia. Institutional Review Board Statement The Ethics Committee of the Faculty of Medicine, Universitas Indonesia, granted ethical clearance (No: KET-1545/UN2.F1/ETIK/PPM.00.02/2024) with protocol number 24-09-1486. Informed Consent Statement This study was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2013. The subject was thoroughly explained during the course of the research, and the participants understood, agreed to participate, and signed informed consent. Data Availability Statement The data presented in this study are available on request from the corresponding author. Conflicts of Interest The authors declare no conflicts of interest. Clinical trial number: not applicable Consent for publication: Not applicable. No identifying images or other personal or clinical details of participants are presented in the manuscript. References Koolivand, H., Shooreshi, M.M., Safari-Faramani, R. et al. 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The perceived coolness of using virtual reality technology in blended learning performance can improve learning motivation and learning satisfaction. InFrontiers in Education 2024 Apr 8 (Vol. 9, p. 1346467). Frontiers Media SA. 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-7551610","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":531589925,"identity":"b638322e-b634-4d4a-9077-dd9cf6fc2948","order_by":0,"name":"Benso 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06:16:49","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":102289,"visible":true,"origin":"","legend":"","description":"","filename":"f0e65ed2ee8042f8ac34da247073d75f1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7551610/v1/c63d61206ea63de068881557.xml"},{"id":93993715,"identity":"ecbbc39c-ad4a-44e4-b896-f411e7ec4479","added_by":"auto","created_at":"2025-10-21 06:24:49","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":115332,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7551610/v1/ec0e01f59ed99648f6edc1d5.html"},{"id":93993713,"identity":"741e8528-ce60-4533-b275-d448f0526429","added_by":"auto","created_at":"2025-10-21 06:24:49","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1680806,"visible":true,"origin":"","legend":"\u003cp\u003eVR-based training. (A) Weight measurement and (B) abdominal percussion were included in general examination module. (C) Peripheral examination and (D) odontogram filling were included in dental examination module.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7551610/v1/a5d65981fa8fa864c0461190.png"},{"id":93992923,"identity":"97a4dcf8-3ee6-42bd-81cd-05c1ac3de168","added_by":"auto","created_at":"2025-10-21 06:16:48","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":147089,"visible":true,"origin":"","legend":"\u003cp\u003eUser satisfaction of VR-based training.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7551610/v1/96b64ed0c05444a0e648e4d8.png"},{"id":104397491,"identity":"6f530d73-c7ab-44c2-8df1-55e21cf2a9b8","added_by":"auto","created_at":"2026-03-11 11:49:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2797871,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7551610/v1/eeab5a9e-da0e-4dd1-959f-dab5cb488aeb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Usability Analysis of Virtual Reality (VR) Learning Concept-based Dental and Medical Examinations: A Preliminary Study in Indonesia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThroughout the evolution of healthcare education, particularly in dentistry and medicine, emerging technologies have consistently been embraced to enhance learning experiences and improve student outcomes. Among these advancements, virtual reality (VR) has gained considerable attention for its ability to simulate realistic clinical environments and provide immersive, interactive training platforms. Traditional lecture-based teaching methods often lack engagement and fail to offer standardized, realistic models, leading to the suboptimal acquisition of practical skills among students (Izard et al., 2018). These challenges have driven the exploration of VR as a complementary tool in dental and medical education. VR enables learners to engage in realistic, three-dimensional environments, where they can practice complex skills without being physically present in a clinical setting. This unique capability gives VR considerable potential in both theoretical and practical aspects of dental and medical education (Zhao et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Additionally, VR allows for repeated practice, immediate feedback, and standardized learning experiences, effectively addressing some of the limitations inherent in traditional teaching methods (Yeung et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eEvidence shows that VR provides a promising way for students to practice skills in a realistic environment, allowing them to improve their abilities in a well-controlled setting before working with real patients (Liebermann et al., 2022). Moreover, VR can simulate rare and dangerous clinical scenarios, enhancing students\u0026rsquo; preparedness for emergency situations (Jung, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In terms of student assessment, VR can support pedagogy across different disciplines and facilitate debriefing, ultimately enhancing the learning experience (Coyne et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). These benefits make VR a valuable tool for Indonesian dental and medical education. Given that Indonesia has numerous dental and medical colleges, improving the education system through VR integration could help enhance educational quality and address challenges in both preclinical and clinical settings (Haryanvi et al., 2021; Mayasari et al., 2021; Kanschik, 2023).\u003c/p\u003e\u003cp\u003eDespite its advantages, the implementation of VR in education faces several challenges, including limited perceptions of and experience with the technology. A previous study revealed that, although more than 80% of medical students and lecturers in Indonesia expressed interest in using VR, fewer than 50% had hands-on experience with it (Arif et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Limited experience and expertise with complex technology can influence users\u0026rsquo; perceptions and their willingness to adopt sophisticated tools (Goeke, 2016), including VR, which remains uncommon in Indonesia. Furthermore, although VR technology has matured, the development and successful adoption of VR modules depend heavily on careful alignment with educational goals (Ryani, 2022), particularly in accordance with the national curricula for dental and medical education in Indonesia. Furthermore, concerns about cybersickness, as noted by Weech et al. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), also underscore the importance of optimizing VR systems to minimize discomfort and enhance usability.\u003c/p\u003e\u003cp\u003eThrough the adaptation of VR, numerous opportunities have emerged that could significantly transform the way dental and medical education is delivered. However, despite its growing global popularity, the use of VR in dental and medical education in Indonesia remains underexplored, with conventional teaching methods still widely employed. The development and implementation of VR-based training should be guided by the Technology Acceptance Model (TAM), which highlights that the perceived ease of use and usefulness are closely linked to the intention to use (Fussell, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). To ensure the benefits and sustained adoption of VR-based training, in this study, we aim to analyze the perceptions of medical, dental, and nursing students regarding the usability and effectiveness of VR for dental and physical examination training. Additionally, in this preliminary study, we seek to identify potential challenges that may arise in a larger-scale investigation. By examining these factors, we aim to contribute to the growing body of knowledge on the application of VR in dental and medical education and to identify areas for future improvement in order to optimize its integration into clinical training.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki and received ethical clearance from the Ethics Committee of the Faculty of Medicine, Universitas Indonesia (No. KET-1545/UN2.F1/ETIK/PPM.00.02/2024) under protocol number 24-09-1486. All participants provided informed consent before participating in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy design and Ethics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study employed a quantitative approach to assess the usability, perceptions, and feasibility of VR-based dental and general exams. The VR-based training used in this study was developed by a team from Universitas Indonesia to help students improve their general and dental examination competence. The learning module was designed in accordance with Indonesia's national dental and medical curriculum.\u003c/p\u003e\n\u003cp\u003eParticipants were recruited using convenience sampling. Following a rule of thumb, a minimum sample size of 30 was used in this study (Browne, 1995; Whitehead, 2015). The eligibility criteria required participants to be currently enrolled in a dental, medical, or nursing program and to agree to follow the instructions. Subjects with a history of severe motion sickness or those unable to use virtual reality due to severe audiovisual impairments were excluded. All participants provided informed consent before taking part in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVR-based Dental and General Examination Training\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe VR-based training is part of a larger project platform called Immersive Hub for Healthcare Education. The training platform was developed to provide an immersive training space for students, including those in medicine, dentistry, nursing, vocational studies, midwifery, and other healthcare fields. In the early phase, two modules were developed: the general examination module for medical students and the dental examination module for dental students. However, these applications were not limited to specific professions and could be used by others to enhance interprofessional education. The general examination module covered several aspects, including history taking, anthropometry, inspection, palpation, percussion, and auscultation, while the dental examination module included peripheral examination, dental inspection, and odontogram filling. Figure 1 illustrates the modules used in the VR-based training.\u003c/p\u003e\n\u003cp\u003eThis study was conducted at the Healthcare Cluster, Universitas Indonesia. After the participants were recruited, the research team explained the procedure through a brief tutorial video and obtained informed consent. The participants were then given a head-mounted display (Meta Quest 2) to wear and prepared to enter the simulation. The dental students utilized the dental examination module, while the medical and nursing students utilized the general examination module. The duration of the VR-based training was limited to 20 minutes to prevent severe side effects. The participants could ask for the simulation to be terminated if they felt discomfort. The research team stood near the participants to ensure their safety and provided guidance when technical issues occurred. After the participants completed the VR-based training, they were asked to complete a questionnaire. All data were recorded on a cloud-based platform.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuestionnaire\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study employed three types of instruments to assess the participants’ satisfaction, perception of usability, and cybersickness. The participants’ satisfaction was assessed using a self-developed questionnaire, containing seven questions with a 6-point scale numbered from 1 (strongly disagree) to 5 (strongly agree). Using 30 samples, validity and reliability testing was conducted to ensure that the questionnaire targeted the constructs accurately and was consistent. Testing showed that each question had a value of r\u0026gt;0.361, with a Cronbach’s alpha of 0.727, indicating that the questionnaire was valid and reliable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe participants' perception of the VR-based training was recorded using the Indonesian adapted version of the System Usability Scale (SUS) questionnaire, which was validated by Sharfina and Santoso, with a Cronbach's alpha of 0.841 (Sharfina et al, 2016). The SUS questionnaire consists of 10 items, with odd numbers corresponding to positive items and even numbers corresponding to negative items. The participants were asked to rate the questions using a 5-point scale numbered from 1 (strongly disagree) to 5 (strongly agree). For positive items, the score contribution is calculated by subtracting 1 from the scale position, while for negative items, it is determined by subtracting the scale position from 5. The overall SUS score is obtained by summing the item score contributions and multiplying the result by 2.5, yielding a range from 0 to 100. An SUS score of 85-100 indicates “The best imaginable”, 73 to 84 indicates “Excellent”, 53-72 indicates “Good”, 38-52 indicates “OK/Fair”, 24-37 indicates “Poor”, and 0-25 indicates “The worst possible” (Shidende, 2023).\u003c/p\u003e\n\u003cp\u003eThe Cybersickness Questionnaire-VR (CSQ-VR) was used to assess cybersickness during the session. This instrument was developed and validated by Kourtesis et al. in 2023. Six questions, divided into 3 sub-scores, with a 7-point scale numbered from 1 (absent feeling) to 7 (extreme feeling), were presented to the participants. Each sub-score is calculated by adding together the results of two different questions, resulting in a score that describes different symptoms (nausea, vestibular, and oculomotor symptoms). The total score is the sum of the three sub-scores (Kourtesis, et al., 2023).\u003c/p\u003e\n\u003cp\u003eAt the end, one open-ended question was added to address opinions and issues related to the application and user experience. The results of this question will be used to revise and enhance the VR-based training. Moreover, all research teams were responsible for taking note of every issue that arose during the experiment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were analyzed using IBM SPSS Statistics Version 26 (SPSS Inc., Chicago, IL, USA). Demographic information and questionnaire responses are summarized using descriptive statistics. The characteristics of the respondents are presented using sample size, and categorical variables are presented as percentages. Numerical data are presented as the mean and standard deviation.\u003c/p\u003e\n\u003cp\u003eCategorical variables were compared using the Chi-square test. If the data were normally distributed, comparisons of numerical variables were conducted using independent t-tests; otherwise, a non-parametric test was used. The association between cybersickness, satisfaction, and game duration was evaluated using Pearson correlation analysis for normally distributed variables, while Spearman’s test was used for non-normally distributed variables. A p-value \u0026lt; 0.05 was considered statistically significant.\u0026nbsp;\u003c/p\u003e"},{"header":"Result","content":"\u003cp\u003eWe recruited 41 participants during this study (dental vs. medical vs. nursing students, 46.34 vs. 31.71 vs. 21.95%, respectively). A total of 19 students took part in VR-based dental training, while 22 students took part in VR-based general examination training. Table 1 shows that female participants (60.98) predominated over male participants (39.02). Among all the participants, second-year students were the most represented group (36.59), followed by first-year (21.95) and fourth-year students (19.51). The majority of the participants had no prior VR experience (48.78) and did not own a VR device (95.12). Most of the participants reported a high satisfaction level (4 out of 5) and perceived VR-based training as \u0026ldquo;good\u0026rdquo; (51.22). Meanwhile, cybersickness symptoms were minimal across all aspects. The mean duration of VR practice was 970.80 \u0026plusmn; 654.59 seconds (Table 1).\u003c/p\u003e\n\u003cp\u003eTable 1. Respondents\u0026apos; demographic data.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 312px;\"\u003e\n \u003cp\u003eRespondents (n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eGender, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(39.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(60.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eFaculty, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eDental\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(46.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eMedicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(31.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(21.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eEducation year, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(21.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(36.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(2.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(19.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(17.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(2.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003ePrior VR experience, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(48.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eYes, 1x\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(19.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eYes, \u0026gt;1x\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(31.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eOwn a VR device, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(4.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(95.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eSatisfaction, mean (\u0026plusmn;SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eUsability perception, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eThe best imaginable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(12,20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(9.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(51.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eOk/Fair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(26.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eCybersickness, mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNausea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(1.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eVestibular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(1.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eOculomotor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(1.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e8.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eGame duration in seconds, mean (\u0026plusmn;SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e970.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026plusmn;654.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFigure 2 presents the participants\u0026apos; responses regarding user satisfaction of VR-based training. Overall, the study indicates a high level of satisfaction, with more than 50% of the participants strongly agreeing with the statements, except for the ability to control the learning process (36.59%). Notably, regarding the ability to perform the dental/general patient examination properly using VR, 9.76% of the participants disagreed, and 2.44% strongly disagreed. The highest satisfaction score (73.17%) was observed for the clarity and completeness of the information provided by the VR-based training, followed by overall satisfaction with the training.\u003c/p\u003e\n\u003cp\u003eTo expand the analysis, we compared satisfaction, usability perception, and cybersickness between genders, as shown in Table 2. The analysis revealed that the female participants reported higher satisfaction than the male participants (p=0.021). Similar to the overall results of all the participants, most of the male and female participants rated the VR-based training as \u0026ldquo;good\u0026rdquo; (male vs. female, 21.95 vs. 29.27), with no significant difference (p=0.568). No significant difference in cybersickness symptoms was found in both groups (p=0.534).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2. Students\u0026rsquo; satisfaction and usability perception, compared between gender.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 85px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003cp\u003e(n=16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003cp\u003e(n=25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eSatisfaction, mean (\u0026plusmn;SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(0.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(0.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.021*\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eUsability perception, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eThe best imaginable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(7.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(4.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.568\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(2.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(7.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(21.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(29.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eOk/Fair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(7.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(19.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eCybersickness, mean (\u0026plusmn;SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNausea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(1,57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.864\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eVestibular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(1.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(1,55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.947\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eOculomotor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(1.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(1,47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.989\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(2.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(4,37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.534\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSUS (System Usability Scale); CSQ-VR (Cybersickness Questionnaire-VR); a: Mann\u0026ndash;Whitney test; b: Chi-square. P value \u0026lt; 0.05 considered significant.\u003c/p\u003e\n\u003cp\u003eTable 3 shows the correlation between cybersickness, satisfaction, and game duration. The correlation coefficient for cybersickness was -0.132, with a p-value of 0.410, while satisfaction had a correlation coefficient of -0.141, with a p-value of 0.380. This study results indicate no significant correlation between cybersickness, satisfaction, and game duration (p\u0026gt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3. Correlation between cybersickness and game duration.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 331px;\"\u003e\n \u003cp\u003eGame duration in seconds\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eCorrelation coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eCybersickness (total)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e-0.132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.410\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eSatisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e-0.141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.380\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSpearman test, P value \u0026lt; 0.05 considered significant.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eVirtual reality (VR) innovation in dentistry and medical education benefits multiple disciplines. Integrating VR advancements into the educational system requires diverse approaches and procedures tailored to each field. Several studies have demonstrated the effectiveness of VR in dental and medical education. For example, VR supports dental education in crown cementation (Tubelo, 2016) and tooth arrangement assessment (Mansoory, 2020). Similarly, VR has proven to be a valuable tool for simulating clinical scenarios, allowing students to practice in a controlled and reproducible environment (Freina \u0026amp; Ott, 2015). These findings highlight the transformative potential of VR, yet they also call for a balanced discussion of its limitations and challenges, such as accessibility and associated disadvantages. As VR\u0026apos;s potential remains largely unexplored in Indonesia, the results of this study could provide valuable insights into its usability in Indonesian dental and medical training contexts.\u003c/p\u003e\n\u003cp\u003eThe present study shows that all subjects reported high satisfaction levels, with the largest proportion of participants, in both the male and female groups, rating VR-based training as \u0026ldquo;good\u0026rdquo;. These findings indicate that the participants had positive perceptions of the use of VR-based training in dental and medical education. More than half of the participants in this study also showed strong agreement with statements regarding the training\u0026rsquo;s high perceived usefulness, ease of use, and enjoyability. Such perceptions correlate significantly with intentions/attitudes toward use, as shown in a study conducted by Fussell and Trong in 2021. Additionally, Bandura\u0026rsquo;s self-efficacy or personal belief research supports the findings regarding the perceived ease of use. This perception is important for stimulating a student\u0026rsquo;s thoughts, actions, and motivation and improving the effectiveness of their learning (Davis, 1989; Bandura, 1991). Stimulating the intention to regularly use VR during learning could pave the way for incorporating VR into the curriculum.\u003c/p\u003e\n\u003cp\u003eThis study also considered gender differences in the perception and experience of VR-based training. Significantly higher satisfaction was found among female participants. The impact of gender differences on VR-based training is rarely discussed, particularly in the context of dental and medical education. However, a study on environmental education featuring videos of human bodies found that female participants demonstrated better performance in both empathy and actual behaviors (Chiang, 2021). Similarly, Moraes et al. (2023) reported that female students performed better in VR learning. This may explain the higher satisfaction levels among female students, as student satisfaction is often influenced by their perceived achievement (Liu, 2024).\u003c/p\u003e\n\u003cp\u003eIn terms of cybersickness, this study evaluated oculomotor, vestibular, and nausea symptoms as potential consequences of using VR. Visual fatigue may be one of the negative effects of frequent and repeated exposure to VR (Ran et al., 2021; Felemban et al., 2021; Wang et al., 2014). The analysis revealed a low incidence of cybersickness in both the male and female groups, which differs from previous studies showing that female participants tend to experience more cybersickness after using VR (Kelly, 2023). This discrepancy may be due to the relatively short exposure time to the VR environment in our study, which was under 20 minutes. Furthermore, our correlation analysis found no association between cybersickness and gameplay duration. This result aligns with that of a previous study suggesting that VR use can be sustained for up to 70 minutes (Kourtesis, 2021). However, a 10\u0026ndash;15-minute break every hour is recommended for extended VR use to reduce the risk of VR sickness (Yao, 2014; Woo, 2023).\u003c/p\u003e\n\u003cp\u003eThis study has several strengths. It included students from various healthcare professions, which may support the promotion of interprofessional education in the future. The VR-based training was developed by an interdisciplinary team, thus enhancing its generalizability and applicability. However, several limitations must also be acknowledged. As a preliminary study, one of the aims was to identify and address technical issues during data collection to inform future research. To enable more robust comparisons based on gender or faculty background regarding usability and satisfaction, a more rigorous study design, such as a randomized controlled trial with a larger and more balanced sample, is recommended. In this study, cybersickness was assessed only once, at the end of the session. Future studies should evaluate cybersickness both before and after VR exposure to allow for pre- and post-intervention comparisons. Additionally, a knowledge assessment should be incorporated using Kirkpatrick\u0026rsquo;s model of training evaluation, which includes reaction, learning, behavior, and results, to better understand the effectiveness of VR-based training (Strojny, 2023). The feasibility of conducting multiple VR sessions on the same day could also be explored to evaluate the potential of longer and repeated use.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe use of VR-based dental and physical examination training is perceived positively and can be effectively utilized by all groups. The results of the SUS and CSQ-VR analyses in this preliminary study emphasize that the application of VR in Indonesia is feasible and can provide a learning experience in accordance with the national curricula. However, future studies must address several issues to ensure a smooth data collection process.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank Universitas Indonesia and Medimedi Indonesia for supporting this research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization, B.S., L.S.A., L.O.A.R., M.H.S., C.H.S., U.N.S., and M.S.R.; methodology, B.S., L.S.A., L.O.A.R., M.H.S., C.H.S., and U.N.S.; software, C.H.S., U.N.S., and M.S.R.; validation, L.O.A.R. and M.H.S.; formal analysis, C.H.S.; investigation, B.S., L.S.A., and L.O.A.R.; data curation, B.S. and L.S.A.; writing—original draft preparation, B.S., L.S.A., and C.H.S; writing—review and editing, L.O.A.R., M.H.S., C.H.S., and U.N.S. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUniversitas Indonesia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Review Board Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Ethics Committee of the Faculty of Medicine, Universitas Indonesia, granted ethical clearance (No: KET-1545/UN2.F1/ETIK/PPM.00.02/2024) with protocol number 24-09-1486.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2013. The subject was thoroughly explained during the course of the research, and the participants understood, agreed to participate, and signed informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data presented in this study are available on request from the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflicts of interest.\u003c/p\u003e\n\u003cp\u003eClinical trial number: not applicable\u003c/p\u003e\n\u003cp\u003eConsent for publication: Not applicable. No identifying images or other personal or clinical details of participants are presented in the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKoolivand, H., Shooreshi, M.M., Safari-Faramani, R. \u003cem\u003eet al.\u003c/em\u003e Comparison of the effectiveness of virtual reality-based education and conventional teaching methods in dental education: a systematic review. \u003cem\u003eBMC Med Educ\u003c/em\u003e 24, 8 (2024). https://doi.org/10.1186/s12909-023-04954-2\u003c/li\u003e\n\u003cli\u003eTubelo RA, Branco VLC, Dahmer A, Samuel SMW, Collares FM. The influence of a learning object with virtual simulation for dentistry: a randomized controlled trial. Int J Med Informatics. 2016;85(1):68\u0026ndash;75.\u003c/li\u003e\n\u003cli\u003eMansoory MS, Azizi SM, Mirhosseini F, Yousefi D, Moradpoor H. A study to investigate the effectiveness of the application of virtual reality technology in dental education. BMC Med Educ. 2022;22(1):457.\u003c/li\u003e\n\u003cli\u003eCasap N, Nadel S, Tarazi E, Weiss EI. Evaluation of a navigation system for dental implantation as a tool to train novice dental practitioners. J Oral Maxillofac Surg. 2011;69(10):2548\u0026ndash;56.\u003c/li\u003e\n\u003cli\u003ePulijala Y, Ma M, Pears M, Peebles D, Ayoub A. Effectiveness of immersive virtual reality in surgical training\u0026mdash;a randomized control trial. J Oral Maxillofac Surg. 2018;76(5):1065\u0026ndash;72.\u003c/li\u003e\n\u003cli\u003eDwisaptarini A, Suebnukarn S, Rhienmora P, Haddawy P, Koontongkaew S. Effectiveness of the multilayered caries model and visuo-tactile virtual reality simulator for minimally invasive caries removal: a randomized controlled trial. Oper Dent. 2018;43(3): E110\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eKoo S, Kim A, Donoff RB, Karimbux NY. An initial assessment of haptics in preclinical operative dentistry training. 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InFrontiers in Education 2024 Apr 8 (Vol. 9, p. 1346467). Frontiers Media SA.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"virtual reality, dental, medical, nursing, examination, education","lastPublishedDoi":"10.21203/rs.3.rs-7551610/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7551610/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe integration of virtual reality (VR) into medical and dental education has created new opportunities for simulating clinical environments, providing an immersive and interactive platform for training in skills such as general physical examinations.\u003c/p\u003e\u003ch2\u003eAim\u003c/h2\u003e\u003cp\u003eThis study aims to analyze medical, dental, and nursing students\u0026rsquo; perception of the usability and effectiveness of VR-based training for dental and physical examinations.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA quantitative approach was employed using questionnaires on user experience, cybersickness in virtual reality (CSQ-VR), and the System Usability Scale (SUS). Respondents, including dental, medical, and nursing students, were recruited through convenience sampling. The VR-based dental and general physical examinations were carried out for a maximum of 20 minutes, followed by surveys.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 41 respondents participated in the training. The findings indicated high satisfaction, with 51.22% reporting good usability ratings. No significant differences were observed among the students regarding user experience, usability, or motion sickness. Additionally, no significant correlation was found between satisfaction, game duration, or motion sickness.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eVR-based dental and general physical examination training is perceived positively by different groups. Future studies must address several issues to ensure a smooth data collection process.\u003c/p\u003e","manuscriptTitle":"Usability Analysis of Virtual Reality (VR) Learning Concept-based Dental and Medical Examinations: A Preliminary Study in Indonesia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-21 06:16:44","doi":"10.21203/rs.3.rs-7551610/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"119c5d70-0c22-46d2-819d-56b4c373015d","owner":[],"postedDate":"October 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-26T18:39:46+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-21 06:16:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7551610","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7551610","identity":"rs-7551610","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}