Embedding Test Questions in Educational Mobile Virtual Reality: A Study on Hospital Hygiene Procedures

Educational Virtual Environments (EVEs) can enable effective learning experiences on various devices, including smartphones, using non-immersive Virtual Reality (VR). To this purpose, researchers and educators should identify the most appropriate pedagogical techniques, not restarting from scratch but exploring which traditional e-learning and VR techniques can be effectively combined or adapted to EVEs. In this direction, this paper explores if test questions, a typical e-learning technique, can be effectively employed in an EVE through a careful, well-blended design. We also consider the active performance of procedures, a typical VR technique, to evaluate if test questions can be synergic with it or if they can instead break presence and be detrimental to learning. The between-subject study we describe involved 120 participants in four conditions: with/without test questions and active/passive procedure performance. The EVE was run on a smartphone, using non-immersive VR, and taught hand hygiene procedures for infectious disease prevention. Results showed that introducing test questions did not break presence but surprisingly increased it, especially when combined with active procedure performance. Participants' self-efficacy increased after using the EVE regardless of condition, and the different conditions did not significantly change engagement. Moreover, participants who had answered test questions in the EVE showed a reduction in the number of omitted steps in an assessment of learning transfer. Finally, test questions increased participants' satisfaction. Overall, these greater-than-expected benefits support the adoption of the proposed test question design in EVEs based on non-immersive VR.