Vestibular dysfunction is common in people with multiple sclerosis (PwMS), but responses to optokinetic stimulation (OKS) across different vestibular conditions remain unclear. This study examined the immediate effects of VR-based OKS on balance and motion sickness in PwMS.

Forty-one PwMS and 23 matched healthy controls were included. Participants were classified by videonystagmography into MS with central vestibular involvement (n = 20, Group 1), MS without vestibular involvement (n = 21, Group 2) and healthy controls (n = 23, Group 3). Postural control was assessed with the FreeMED forceplate and VR sickness with the VR Sickness Questionnaire. Individually tailored OKS was delivered using Oculus Quest 2, with assessments immediately before and after stimulation.

Significant group × time interactions were found for sway length (open eyes [OE] monopodal left p = 0.024, closed eyes [CE] monopodal left p = 0.012, CE monopodal right p = 0.009), average speed (OE bipodal p = 0.004, OE monopodal left p = 0.017, CE monopodal right p = 0.026), mediolateral sway (CE bipodal p = 0.014, OE monopodal right p = 0.038) and anteroposterior sway (OE monopodal left p = 0.013). Post hoc analyses showed reduced sway length in G2 (p = 0.047), reduced average speed in G1 (p = 0.002), increased mediolateral sway in G1, G3 and G2 (p = 0.031, p = 0.026, p = 0.010) and opposite anteroposterior responses, decreasing in G1/G2 but increasing in G3, with differences between G1–G2 and G2–G3 (p = 0.007, p = 0.004). VR sickness scores did not differ between groups (p > 0.05).

VR-based OKS induced immediate, well-tolerated balance changes in PwMS, with group-specific responses across conditions. Greater destabilization was seen in those with central vestibular involvement. Individualized OKS may promote vestibular adaptation and improve postural control in MS rehabilitation.

There is increasing demand for high-quality anatomy teaching for medical undergraduates. This study investigates medical students’ perspectives on using virtual reality to learn laryngeal anatomy.

Thirty-six Year 4 university teaching hospital medical students participated in a virtual reality laryngeal anatomy learning experience (Oculus Quest 2® headsets). Students interacted with a VR model and completed a confidential feedback survey assessing their virtual reality exposure, learning environment, perceived usefulness and willingness to use virtual reality in future training.

A total of 75 per cent of students had minimal prior virtual reality exposure. Despite this, 69.5 per cent agreed that virtual reality helped them learn the anatomy better than traditional lectures; 76.1 per cent believed virtual reality enhanced their learning; and 80 per cent expressed willingness to use virtual reality in their training. High satisfaction was reported regarding the learning environment, with 97.2 per cent feeling comfortable and engaged.

Virtual reality is a useful adjunct to laryngeal anatomy education, providing an interactive, engaging and resource-efficient adjunct to traditional methods.

Auditory verbal hallucinations (AVHs) are common and distressing symptoms across a range of psychiatric disorders, including schizophrenia spectrum disorders. Audio Visual Assisted Therapy Aid for Refractory Auditory Hallucinations (AVATAR) is an innovative therapeutic approach that facilitates dialogue with a digital avatar representing the voices that patients hear.

This systematic review and meta-analysis aimed to assess the efficacy, tolerability and acceptability of AVATAR therapy in reducing voice-related symptoms.

Following preregistration, we conducted a systematic review and meta-analysis of controlled trials of AVATAR therapy in samples primarily diagnosed with schizophrenia spectrum disorders. PubMed, CINAHL, Embase, PsycInfo, ClinicalTrials.gov, ISRCTN and Web of Science were searched in March 2025. We assessed bias and certainty with the Cochrane Risk-of-Bias 2 tool and the GRADE approach. Random-effects models were used to synthesise outcomes.

Eight AVATAR trials (N = 978) were included. Compared with usual treatment, waitlist and active control groups, AVATAR therapy decreased the primary outcome of AVH severity at post-treatment (Hedges’ g = −0.40, 95% CI −0.54 to −0.25) and short-term follow-up (Hedges’ g = −0.25, 95% CI −0.40 to −0.10). AVH subscales showed small significant effect sizes at post-treatment (frequency: Hedges’ g = −0.38, 95% CI −0.52 to −0.24; distress: Hedges’ g = −0.32, 95% CI −0.46 to −0.18), which were maintained at short-term follow-up. The certainty of evidence was rated moderate for AVH severity at post-treatment. AVATAR therapy was largely tolerable and acceptable, with adverse events mostly unrelated to the treatment and a comparable drop-out rate to control groups.

Findings suggest that AVATAR therapy is effective at reducing AVH symptoms. Considering heterogeneous control groups and less clear evidence for secondary outcomes and longer follow-ups, further research is warranted.

Mass casualty incidents (MCIs) in high-risk environments pose major challenges for coordinated emergency response. Training is often infrequent, resource-intensive, and lacks interagency consistency. This study explores the use of Virtual Reality (VR) simulation to train responders in the RAMP triage model across emergency services.

An observational qualitative design was used. Sixteen participants from various emergency services engaged in a VR-based MCI scenario involving 26 patients and hazardous conditions. The scenario required rapid RAMP triage based on essential cues (radial pulse and the ability to follow commands). Structured interviews followed, and data were analyzed thematically.

Three themes emerged: (1) Deficiencies in current training, including inconsistent MCI protocols, lack of guideline familiarity, and limited interagency practice; (2) VR as an effective, low-resource training method enabling repeatable and safe practice—RAMP triage was found intuitive and efficient, even for non-medical personnel; and (3) prerequisites for VR implementation, such as realistic design, technical infrastructure, and stakeholder involvement to support shared understanding.

VR-based MCI training is a feasible and effective supplement to traditional drills. It enables scalable and flexible skill-building, though it should complement and not replace live exercises.

This study explored the prevalence and attributes of triage errors made by emergency responders during virtual reality simulations of mass casualty incidents.

The study analyzed errors made by 99 emergency responders during their triage and treatment of a mass casualty incident in virtual reality. Responders received training on the Sort, Assess, Life-saving Intervention, Treatment, Transport (SALT) protocol, then responded to a virtual bombed subway station. Responder accuracy, efficiency, and application of treatments were tracked. Error analysis was performed through the lens of human factors. Accordingly, errors were categorized by their nature: either perception, proficiency, or procedure.

Responders correctly triaged 70% of virtual patients, and 78% demonstrated relative efficiency. Interaction times between responders and patients averaged 20 seconds. The time to assess and treat all patients for life-threatening bleeding injuries across the entire scene averaged six minutes. Most errors were related to proficiency (e.g., competence or experience). However, procedural errors (shortcomings of SALT) and perceptual errors (degraded sensory input from programmed environmental chaos, i.e., virtual smoke/debris and louder sound) were also observed. Most errors were related to patients with either respiratory issues or multiple injuries.

Virtual reality (VR) offered a controlled environment for studying errors made by emergency responders in a mass casualty incident, which will lead to improved training and protocols to better prepare them for these events.

Disaster medicine (DM) prepares health care professionals to manage emergencies caused by significant societal disruptions. Training recent graduates and final-year students is an essential element of disaster preparedness. This review aims to examine the use of Virtual Simulation (VS) in undergraduate students’ DM training.

The research team searched Scopus, PubMed, WOS, and Scielo. The team followed the 6-step approach described by Mak to conduct Scoping Reviews. We identified 262 reports, and 17 articles met the inclusion criteria. We extracted and analyzed data, focusing on educational settings, professions involved, and intervention characteristics. The report followed PRISMA guidelines.

The implementation of VS in DM training has been geographically concentrated, with most studies focused on nursing education. Most programs use virtual reality, with limited augmented or mixed reality integration, principally in nursing students. The training focused primarily on triage, disaster preparedness, evacuation, decontamination, improving knowledge retention, self-confidence, and decision-making.

Although VS has effectively enhanced technical skills and disaster preparedness, its use remains limited in undergraduate health education. Further research is needed to expand its application in interprofessional and non-nursing contexts, with deliberate practice principles to maximize efficiency. Integrating VS into community training can reduce costs and enhance large-scale emergency response.