As the healthcare domain faces increasing demands for training and rehabilitation tools, Extended Reality (XR) and Serious Games (SGs) have emerged as promising solutions. This thesis investigates how design elements of XR systems and SGs affect knowledge and skill acquisition as well as user experience across three healthcare subdomains: procedural training for healthcare professionals, object-location spatial memory enhancement in healthy individuals, and executive function training in both healthy and clinical populations. The research proposes prototypes and describes user studies to evaluate both subjective user experience and objective performance metrics. In procedural training, the thesis presents a study exploring the effects of real-time and post-performance feedback. Feedback, combined with refresher sessions, effectively improved the performance of the Basic Life Support with Defibrillator procedure. The thesis also presents qualitative and quantitative evaluations of a multi-user system for STEMI management. While performance improvements relative to a control group did not reach statistical significance, the results highlight a positive user experience. Regarding object-location spatial memory, the thesis compared two versions of a SG: an immersive VR version for VR headsets and a non-immersive VR version for mobile devices. Results indicated that while immersive VR enhanced the sense of presence, the cognitive benefits were comparable to those of the non-immersive version. Furthermore, the thesis investigated the role of haptic interfaces in an object-location spatial memory task, showing that handheld controllers facilitated faster task completion than force-feedback gloves without altering memory performance. In executive function training, the thesis proposes a SG with a sorting task to investigate the effects of adaptive difficulty and multi-user settings. The user study showed that the proposed heuristic-based difficulty adaptation did not result in a significant advantage over linear difficulty increase, and the multi-player setting did not demonstrate clear added value compared to the single-player. A variation of the SG based on the Go/No-Go task is presented and modelled as a Discrete-Time Markov Chain, indicating that the system could serve as a valuable instrument for clinicians to interpret patient performance and assess disease staging. In addition, the thesis presents an enhanced version of the SG that supports both immersive and non-immersive VR devices, along with an evaluation protocol for older patients with mild neurocognitive disorders. Overall, the thesis showed positive effects of XR and SG on procedural and cognitive training in three different subdomains of healthcare. Most findings suggest that greater technological fidelity and some advanced features (e.g., immersive VR, haptic feedback, multi-player) do not necessarily lead to superior training outcomes, whereas other design elements (e.g., feedback, retraining) do. The thesis discusses expected and unexpected outcomes.
As the healthcare domain faces increasing demands for training and rehabilitation tools, Extended Reality (XR) and Serious Games (SGs) have emerged as promising solutions. This thesis investigates how design elements of XR systems and SGs affect knowledge and skill acquisition as well as user experience across three healthcare subdomains: procedural training for healthcare professionals, object-location spatial memory enhancement in healthy individuals, and executive function training in both healthy and clinical populations. The research proposes prototypes and describes user studies to evaluate both subjective user experience and objective performance metrics. In procedural training, the thesis presents a study exploring the effects of real-time and post-performance feedback. Feedback, combined with refresher sessions, effectively improved the performance of the Basic Life Support with Defibrillator procedure. The thesis also presents qualitative and quantitative evaluations of a multi-user system for STEMI management. While performance improvements relative to a control group did not reach statistical significance, the results highlight a positive user experience. Regarding object-location spatial memory, the thesis compared two versions of a SG: an immersive VR version for VR headsets and a non-immersive VR version for mobile devices. Results indicated that while immersive VR enhanced the sense of presence, the cognitive benefits were comparable to those of the non-immersive version. Furthermore, the thesis investigated the role of haptic interfaces in an object-location spatial memory task, showing that handheld controllers facilitated faster task completion than force-feedback gloves without altering memory performance. In executive function training, the thesis proposes a SG with a sorting task to investigate the effects of adaptive difficulty and multi-user settings. The user study showed that the proposed heuristic-based difficulty adaptation did not result in a significant advantage over linear difficulty increase, and the multi-player setting did not demonstrate clear added value compared to the single-player. A variation of the SG based on the Go/No-Go task is presented and modelled as a Discrete-Time Markov Chain, indicating that the system could serve as a valuable instrument for clinicians to interpret patient performance and assess disease staging. In addition, the thesis presents an enhanced version of the SG that supports both immersive and non-immersive VR devices, along with an evaluation protocol for older patients with mild neurocognitive disorders. Overall, the thesis showed positive effects of XR and SG on procedural and cognitive training in three different subdomains of healthcare. Most findings suggest that greater technological fidelity and some advanced features (e.g., immersive VR, haptic feedback, multi-player) do not necessarily lead to superior training outcomes, whereas other design elements (e.g., feedback, retraining) do. The thesis discusses expected and unexpected outcomes.
Extended Reality and Serious Games for Procedural and Cognitive Training in Healthcare / Alessandro Forgiarini , 2026 May 29. 38. ciclo, Anno Accademico 2024/2025.
Extended Reality and Serious Games for Procedural and Cognitive Training in Healthcare
FORGIARINI, ALESSANDRO
2026-05-29
Abstract
As the healthcare domain faces increasing demands for training and rehabilitation tools, Extended Reality (XR) and Serious Games (SGs) have emerged as promising solutions. This thesis investigates how design elements of XR systems and SGs affect knowledge and skill acquisition as well as user experience across three healthcare subdomains: procedural training for healthcare professionals, object-location spatial memory enhancement in healthy individuals, and executive function training in both healthy and clinical populations. The research proposes prototypes and describes user studies to evaluate both subjective user experience and objective performance metrics. In procedural training, the thesis presents a study exploring the effects of real-time and post-performance feedback. Feedback, combined with refresher sessions, effectively improved the performance of the Basic Life Support with Defibrillator procedure. The thesis also presents qualitative and quantitative evaluations of a multi-user system for STEMI management. While performance improvements relative to a control group did not reach statistical significance, the results highlight a positive user experience. Regarding object-location spatial memory, the thesis compared two versions of a SG: an immersive VR version for VR headsets and a non-immersive VR version for mobile devices. Results indicated that while immersive VR enhanced the sense of presence, the cognitive benefits were comparable to those of the non-immersive version. Furthermore, the thesis investigated the role of haptic interfaces in an object-location spatial memory task, showing that handheld controllers facilitated faster task completion than force-feedback gloves without altering memory performance. In executive function training, the thesis proposes a SG with a sorting task to investigate the effects of adaptive difficulty and multi-user settings. The user study showed that the proposed heuristic-based difficulty adaptation did not result in a significant advantage over linear difficulty increase, and the multi-player setting did not demonstrate clear added value compared to the single-player. A variation of the SG based on the Go/No-Go task is presented and modelled as a Discrete-Time Markov Chain, indicating that the system could serve as a valuable instrument for clinicians to interpret patient performance and assess disease staging. In addition, the thesis presents an enhanced version of the SG that supports both immersive and non-immersive VR devices, along with an evaluation protocol for older patients with mild neurocognitive disorders. Overall, the thesis showed positive effects of XR and SG on procedural and cognitive training in three different subdomains of healthcare. Most findings suggest that greater technological fidelity and some advanced features (e.g., immersive VR, haptic feedback, multi-player) do not necessarily lead to superior training outcomes, whereas other design elements (e.g., feedback, retraining) do. The thesis discusses expected and unexpected outcomes.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
