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This introduction to the volume explains the origin of these essays, which began as papers given at a workshop to support the development of the Virtual Reality Oracle, which created a virtual reality experience of visiting the ancient Greek oracle of Dodona. An ancient Greek oracular site comprised an encounter with ‘unknowing’: the sanctuary was a space to which visitors brought questions concerned with many different areas of their lives. In that respect, we also drew a parallel with the experience of those who ‘visit’, as researchers, an oracle about which little is certain. The essay then reflects on this process of research, to consider how in examining the way our historical subjects engage with the affordances of their environments, we, in turn, as historians, ourselves engage with the affordances of our historical evidence, using Bakhtin’s theory of the chronotope.
This Element explores online harms experienced by children in the metaverse and considers the implications through a criminological lens. Drawing on research from the VIRRAC project, funded by REPHRAIN, it includes insights from industry experts, practitioners, and young people. The Element examines how criminological theories help us understand children's experiences online, while highlighting gaps in knowledge, resources, and training among professionals responsible for safeguarding against online harms, particularly child sexual exploitation and abuse in metaverse spaces. It explores complexities faced by those trying to detect, prevent, and respond to online harms in immersive environments, revealing the challenges of professional practice in this field. By amplifying children's voices, the Element offers critical findings on their needs for support and safety. Combining research and practical perspectives, it informs future policy and interventions to better protect vulnerable children in virtual reality platforms. This title is also available as Open Access on Cambridge Core.
This chapter positions immersive digital technologies — particularly AI, social media, and VR — as emerging mind-altering forces that rival traditional substances in their capacity to reshape attention, emotion, and identity. It outlines how platforms exploit neurochemical pathways related to novelty, reward, and social validation, fostering dependence and cognitive distortion. The design principles behind addictive digital systems, such as infinite scroll, algorithmic reinforcement, and emotional simulation, are critically examined. The chapter argues that digital environments can produce states analogous to intoxication, including dissociation, flow, and affective deregulation. Special attention is given to the implications for youth development, mental health, and the structure of public discourse. In conclusion, the chapter suggests that digital systems may soon become the dominant agents of altered consciousness, with broad implications for society and governance.
The ’Introduction’ lays the intellectual foundation for the book by situating mind-altering substances within the broader arc of human cultural, neurological, and technological evolution. It argues that altered states of consciousness — whether chemically, behaviourally, or digitally induced — are not peripheral but central to the human experience. The chapter outlines how the search for transcendence, novelty, and meaning has driven innovations in medicine, ritual, and technology across millennia. It introduces the concept of ’experiential adaptation’ to describe how societies continually modify consciousness in response to environmental, social, and symbolic pressures. The introduction also maps out the interdisciplinary methodology of the book, drawing from anthropology, neuroscience, history, digital media studies, and future forecasting. It prepares the reader to navigate a narrative that stretches from Palaeolithic natural and artificial, healthy and pathological, sacred and simulated.
This paper investigates the emergence, development and creative potential of three-dimensional musical scores, examining their transformation from physical layered media to contemporary mixed reality implementations. Through analysis of key historical works and recent technological innovations, it explores how depth and spatial materiality in musical notation create new possibilities for compositional organisation, performance practice and aesthetic expression. The study examines pioneering works utilising transparent overlays and physical depth by composers such as Cage and Takemitsu, before analysing contemporary applications in augmented and virtual reality environments that enable dynamic, interactive score generation and networked performance possibilities. Drawing on phenomenological perspectives and spatial theory, the research demonstrates how three-dimensional scores challenge traditional temporal-spatial relationships in musical notation while suggesting new frameworks for understanding musical structure and interpretation. Technical affordances and limitations of current mixed reality platforms are evaluated, alongside consideration of their implications for future developments in notation and composition. The paper argues that while three-dimensional scores offer compelling new creative possibilities, their successful implementation requires both technological expertise and collaborative approaches that may reshape traditional models of compositional practice.
Chapter 2 shows how when the emperor of innovation isn’t wearing any clothes, upgraders can still see the naked truth of the situation. Zuckerberg promised a metaverse, a new digital reality, that would transform human connection, interaction, and commerce. But this handwavy conception of the future lacked any clear vision, let alone consumer demand. Upgraders were able to spot the folly long before it became one of the largest corporate boondoggles in modern commerce, a shorthand for corporate disfunction. In contrast to the unbridled enthusiasm of innovators, upgraders would have started with the question of why the public would ever want this product in the first place. Instead, Meta tried to sway public opinion with overly rosy futuristic promises, trying to move the market to meet their innovation, rather than solving problems that actually mattered to the public. Like other innovations, the metaverse shows how tech companies ignore the fundamentals of human behavior and social change, dooming their grand visions.
Empathy is essential for designers to obtain a deep understanding of user experiences. It encompasses emotional and cognitive dimensions, combining the ability to resonate with others’ feelings emotionally, and to intellectually grasp their perspective, known respectively as affective and cognitive empathy. While empathy has been recognized as vital in a human-centered design process, empathic interactions with users depend on designers’ innate empathic tendencies, referred to as dispositional empathy, making the interactions prone to bias. This nuanced distinction between designers’ dispositional empathy and the resulting automatic responses to a context-specific user circumstance, known as situational empathy, remains underexplored. This research aims to establish the influence of designers’ dispositional empathy on the resulting situated outcome, thereby determining how empathy is triggered. Through an empirical evaluation using immersive virtual reality (VR) technology, participants embody the perspective of a user with vision impairment. This research reveals a statistically significant relationship between dispositional empathic concern and situational affective responses, and between situational cognitive and situational affective empathy. The findings highlight situational affective empathy as inherently linked to humans’ empathic tendencies, underscoring the significance of contextual elements to elicit cognitive empathy, and the potential for emotional responses to drive further cognitive thinking. Through a deepened understanding of empathy’s nuanced nature, the outcomes establish methods and tools for eliciting and measuring situational cognitive and affective empathy when experienced from a first-person perspective in VR. This research contributes to a broader understanding of the practical implications of constructing and experiencing VR experiences for enhanced designer empathy, facilitating future design innovation through digital contexts.
Virtual reality (VR) can boost charitable attitudes and behavior. In an experiment with 100 participants viewing the content in VR vs. desktop computer, the VR group exhibited significantly higher levels of spatial presence (MD = 1.24, p < .001), attention allocation (MD = . 58, p < .001), spatial situation model building (MD = .47, p = .01), and empathy (MD = .46, p = .049). Donation behavior did not differ between the two groups (p = .36). Both computer and VR viewers shared similar emotions, but VR users felt greater immersion and emotional intensity, perceiving themselves as active participants, while computer viewers took a more passive role. This study generated insights for nonprofits considering VR in their marketing strategies, shedding light on the potential of VR storytelling and its effects on charitable giving.
The article analyses 360° video production in international humanitarian aid nonprofit organizations from 2015 to 2019 as 360° video storytelling is one of the latest innovations in organizational digital communication. Through a content analysis and interviews, a specific use of the 360° video format for particular issues or campaigns in order to bring a distant reality to the organization’s audience has been detected. Thus, putting the users in the shoes of “the other” seems to be the objective pursued. NGOs may soon begin to understand long-term interactivity and engagement not just as action and reaction between organization and receiver (almost non-existent to date), but above all as the receiver’s behaviour, which they may strive to orient towards one of the organization’s end goals, depending on the communication strategy set by the organization’s director. With this objective, common to entities from other sectors, they could be moving towards an innovative conceptualization of engagement.
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.
Methods
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.
Results
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.
Conclusion
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.
Methods
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.
Results
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.
Conclusion
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.
Methods
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.
Results
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.
Conclusions
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.
This chapter considers the impact of digital technologies on Australian poetry, in both its production and its circulation. It charts Australian endeavours in electronic poetry, pointing out its internationalisation of Australian poetry, exploration of tensions between the global and the local, and caution regarding the dangers of increased surveillance. The chapter then discusses the experimentation with hypertext, interactivity, animation and computer coding, including the creation of a new language by mez (Mary-Anne Breeze). It considers the digital manipulation of words and voice and the poetic use of computerised text generation. It traces developments occurring between literature and game, including the use of virtual reality and 3D environments. The chapter also outlines the impact of machine learning on text generation, including the destabilisation of distinctions between human and machine creativity. After discussing the prevalence of multimedia work, it considers Indigenous digitality before turning to digital publishing such as online journals, databases and ebook publications. The chapter concludes with a reflection on the paucity of attention given to digital works in funding and prize culture.
This paper aims to theorise how virtual reality (VR) can contribute to the development of contextual architecture. We start by considering how an architectural context may translate into a virtual domain, introducing preliminary definitions of what a virtual design context (VDC) could entail. We then discuss a proposed taxonomy that guides the creation of such a VDC, anchored in principles drawn from virtual realism in art philosophy and contextualism within architecture. This taxonomy is envisioned as a preliminary framework for developing VR-driven design environments with a focus on context. Next, we conducted expert user-testing with 24 architects using two VDCs developed according to the taxonomy. The goal of this step was to gain insights regarding the cognitive load of designers and their user experience while engaged in different types of VDCs. Results suggest that designing in these virtual environments enhanced contextual learning, supported conceptual and creative insight and helped maintain manageable cognitive load. The paper concludes by underscoring the real-world applicability of this taxonomy, highlighting how VR can breathe new life into contextual design, not by reducing context into a digital replica, but by opening new dimensions through which its richness can be explored, interpreted and reimagined.
This paper presents the design and implementation of Jaeger UTFPR, an open-source, low-cost, remote-controlled tiny humanoid robot measuring just 12 cm in height. Developed with a focus on accessibility and affordability, the robot integrates 3D-printed components, cost-effective electronics, embedded systems, and wireless communication to provide real-time audio and video feedback through a virtual reality (VR) interface. Operators control Jaeger UTFPR using a VR headset and motion controllers, enabling immersive telepresence and direct manipulation of the robot’s movements. With a total cost of just a few tens of dollars, this innovative solution offers broad applications in education, entertainment, research, and remote inspection, serving as an accessible platform for robotics enthusiasts and developers. Experimental evaluations demonstrate the system’s effectiveness in balancing performance and cost, validating its potential as a tool for immersive robotics experiences.
Digital innovation has the potential to be transformative to both clinical practice and academic research related to mental health. Recent advances in research and consumer-grade technology, combined with society’s rapid and widespread adoption of digital technology, has created an emerging and dynamic field attracting the interest of clinicians, researchers, and service-users alike. In this chapter we summarise potential applications of digital technology to mental health research and clinical practice, including digital phenotyping, smartphone applications, virtual reality, and teletherapy. We summarise how digital technologies might be applied to enhance psychiatric assessment and treatment, as well as in research settings. In particular, we outline the potential benefits of digital technology as clinical and research tools. We also explore the challenges associated with digital innovation in mental health, including ethical concerns, methodological considerations when critiquing research in this field, and considerations from the service-user perspective.
Obstetric emergencies are frequently encountered on labour wards and in maternity units across the world. To manage these emergencies safely, a maternity team is required to demonstrate excellent collaboration to care for mothers, birthing people and babies in challenging circumstances. Such skills can be learnt and developed through simulation training. Yet, improvements in team working, and the need to transform the working culture of maternity organisations have been recurrently recommended following several high-profile inquiries and national reviews of care (Saving Babies’ Lives Version Three 2023, Ockenden Report 2022, Kirkup Report 2015). In this chapter, we explore the benefits of maternity training, and consider how to establish and ensure the success of a training programme. We reflect on the limitations of current simulation training in the UK, then look ahead to an exciting future of innovation in the field which aims to make birth safer for mothers, birthing people and babies globally.
The chapter highlights the importance of AI literacy. Opportunities and challenges that AI creates in the educational context, such as strategies for technology use, and what AI tools like ChatGPT can enable and hinder in the learning process.
Although virtual reality (VR) programs are being developed by marginalized groups’, a systemic power imbalance still exists. Marginalized groups have a place in digital wellbeing and can lead initiatives to access resources that they desire. To better support these efforts and mobilize knowledge among marginalized stakeholders, we conducted a scoping review of the use of VR for wellbeing. Adopting an equity lens that considers the experiences of intersectional marginalization, our aim was to identify VR programs, their targets, outcomes and equity-related facilitators and barriers. In May 2023, we conducted a comprehensive literature search of MEDLINE, PsycINFO, Embase and Web of Science databases and grey literature for virtual reality and marginalized populations. Eligible research articles since the inception of the databases were those that met our predefined criteria of VR, marginalized populations and wellbeing. We included 38 studies and charted preregistered variables using narrative synthesis, descriptive statistics, and a logic model. The populations were often intersectionally marginalized--primarily individuals with disabilities, underrepresented sexualities and genders, and marginalized older individuals in high-income countries on Turtle Island (North America). The most common race categories were Black or African American (26%) and European or White (53%), but other sociodemographic characteristics were underreported. VR offered diverse support, including social, mental, physical and cultural. We report program outcomes for several subgroups; though heterogeneous, most studies reported improved wellbeing outcomes. VR’s flexibility created informal, flexible spaces, with peer support that contributed to mental and social wellbeing. Several factors could hinder marginalized groups’ ability to access and participate, such as the lack of free programs, data and program ownership, and intersectional data analyses. This topic reflects a growing literature, with half of the publications being in 2022 or 2023. Many of these studies have limitations like small sample sizes and a lack of mixed-methods or practical significance analyses. Moving forward, researchers should apply more open-access and inclusive practices in their designs and recruitment processes to widen equitable access to marginalized stakeholders. Nevertheless, many marginalized populations created VR programs and benefited from them, contributing to a rebalancing of power over wellbeing.
This article examines the effectiveness of using virtual reality training environments for procedural training in fourth generation airliners. It is based on a study that assessed whether the training outcomes from a current recurrent training course for FAA certificated airframe and power plant technicians, which used a full flight simulator (FFS) to deliver and assess training, differed from the same training delivered using a virtual reality (VR) device. The study used an experimental design with three groups, and two within-group measures of training effectiveness. The control group followed the current training programme and was assessed in the FFS, while the second group was trained using a VR device and was subsequently assessed in the FFS. Training effectiveness was assessed using a modified Global Evaluative Assessment of Robotic Skills (GEARS) tool that measured both cognitive and psychomotor aspects of learning alongside the time to successful completion of the assessed task was also measured. The population sampled for the study were all Federal Aviation Administration (FAA) certificated airframe and power plant technicians who were engine-run qualified; a total sample of 100 was used to achieve a 95% confidence interval (p < 0.05). The hypothesis under test was that there is no difference in test performance between the three groups. A multivariate analysis of covariance (MANCOVA) analysis was performed using the GEARS scores and time to completion as variables, and the null hypothesis was retained. The VR system, as tested, was found to provide equivalent task performance to the traditional training method. Recommendations for future research and ongoing application of the specific experimental methodology were provided.