Cybersickness and discomfort from head-mounted displays delivering fully immersive virtual reality: A systematic review

Aim To synthesize existing knowledge on the phenomenon of cybersickness and discomfort associated with the use of HMDs in delivering fully immersive VR experiences within educational contexts. Background Virtual reality (VR) plays an increasingly important role in education; however, head-mounted displays (HMDs) may trigger cybersickness and discomfort. Design A systematic review (PROSPERO: CRD42024583656) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methods The PubMed, CINAHL, Cochrane Library and Scopus databases were searched to identify primary studies in English or Italian, published from 2013 to 2024. Results Twenty-five studies were included. Ad hoc questionnaires followed by the Simulator Sickness Questionnaire and the Motion Sickness Assessment Questionnaire were mainly used to detect cybersickness. In 12 studies, inconsistent or very low scores of cybersickness were reported. Oculomotor disturbances were the most frequently documented negative effects, followed by disorientation. Discomfort was assessed in eight studies, mainly with ad hoc questionnaires, with five of them reporting inconsistent or minimal discomfort. Conclusions Students and professionals should be informed about the possibility of some adverse effects, especially if they undertake daily activities after the educational sessions (e.g. oculomotor issues and driving).