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NCT Number: NCT07650019

EDA-Based Adaptive Support in VR ALS Training

This randomized controlled study aims to investigate the effects of an electrodermal activity (EDA)-based adaptive support system on performance during virtual reality (VR)-based advanced life support (ALS) training. Participants' stress levels will be continuously monitored through EDA during the simulation. When stress exceeds a predefined threshold, the adaptive system will automatically activate a support mode that provides additional guidance and time. The performance outcomes of participants receiving adaptive support will be compared with those receiving standard VR training. The study will also examine the role of presence, anxiety, social anxiety, and personality traits in the relationship between stress and performance.

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Key information

Age range

18 year–25 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

This study is a randomized controlled trial designed to evaluate whether an electrodermal activity (EDA)-based adaptive support system can improve performance in VR-based advanced life support (ALS) training. The research focuses on integrating physiological stress monitoring into automated VR simulation systems to create a more responsive and individualized learning environment.

Simulation-based education is widely used in medical training because it enables learners to practice high-risk clinical procedures in a safe and controlled environment. However, most automated VR training systems currently provide standardized instruction regardless of participants' stress levels or individual needs. Since acute stress may negatively influence cognitive and psychomotor performance during complex medical tasks, adaptive systems that dynamically respond to learners' stress may improve educational outcomes.

The study will recruit 72 volunteer second-year anesthesia technician students from Acıbadem Mehmet Ali Aydınlar University. Participants will be randomly assigned to either an adaptive-support condition or a standard-training control condition. Before the experimental phase, all participants will complete a standardized ALS preparatory training and competency assessment to ensure comparable baseline knowledge levels across groups.

During VR-based ALS training, participants' EDA levels will be continuously recorded using a non-invasive physiological monitoring system. Baseline EDA measurements will first be collected during a resting period. In the adaptive-support condition, when a participant's EDA exceeds a predefined threshold indicating elevated stress, the system will automatically activate a support mode. This mode will provide additional guidance, more frequent instructions, and extended response time during the simulation. Participants in the control group will continue the simulation under standard conditions without adaptive modifications.

After completing the training, all participants will undergo the same VR-based performance examination without guidance. Performance will be automatically evaluated by the simulation system. In addition to performance outcomes, participants will complete self-report measures assessing presence, state and trait anxiety, social anxiety, and personality traits. These measures will allow the researchers to investigate how individual differences influence stress responses, presence experiences, and training outcomes in adaptive VR environments.

The findings of this study are expected to contribute to the development of more flexible, personalized, and physiologically responsive VR-based medical training systems. The project may also provide empirical evidence for integrating real-time psychophysiological monitoring into automated simulation-based education.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Being older than 18

Exclusion criteria

  • prior completion of ALS training
  • history of virtual reality (VR)-induced motion sickness
  • medical conditions such as vertigo or the use of medications known to cause vertigo-like symptoms

Treatment and study plan

EDA-Based Adaptive Support System

Other

Participants receive VR-based advanced life support training with an electrodermal activity (EDA)-based adaptive support system that automatically provides additional guidance, more frequent instructions, and extended response time when stress levels exceed a predefined threshold.

Standard VR-Based Training

Other

Participants receive standard VR-based advanced life support training without adaptive support. Although electrodermal activity (EDA) is monitored during the simulation, the training flow remains unchanged regardless of stress levels.

Primary outcomes

  1. Advanced Life Support Performance Score

    Time frame: Up to 4 weeks

    Participants' performance during the post-training VR-based advanced life support examination will be automatically evaluated by the simulation system. The score will reflect the accuracy and completeness of advanced life support procedures performed without guidance. Scores will range from 0 to 100 with higher scores indicating better success.

Secondary outcomes

  1. Electrodermal Activity (EDA) Level

    Time frame: Up to 4 weeks

    Description:

    Participants' physiological stress responses during the VR simulation will be continuously measured using electrodermal activity recordings. Baseline and training-phase EDA values will be analyzed. Higher EDA levels will suggest higher stress levels.

  2. Presence Score

    Time frame: Up to 4 weeks

    Participants' sense of presence in the VR environment will be assessed using the Turkish adaptation of the Presence Questionnaire developed by Witmer and Singer (1998). Higher scores indicate a stronger sense of immersion and realism in the virtual environment.

  3. State Anxiety Score

    Time frame: Up to 4 weeks

    articipants' situational anxiety levels following the VR training will be assessed using the State Anxiety subscale of the State-Trait Anxiety Inventory (STAI). Scores will range from 1 to 4 and higher scores will indicate higher anxiety levels.

  4. Trait Anxiety Score

    Time frame: Up to 4 weeks

    Participants' general tendency toward anxiety will be assessed using the Trait Anxiety subscale of the State-Trait Anxiety Inventory (STAI). Scores will range from 1 to 4 and higher scores will indicate higher anxiety levels.

  5. Social Anxiety Score

    Time frame: Up to 4 weeks

    Participants' social anxiety levels will be assessed using the Liebowitz Social Anxiety Scale, which evaluates anxiety and avoidance in social and performance situations. Scores will range from 1 to 4 and higher scores will indicate higher anxiety levels.

  6. Personality Traits

    Time frame: Up to 4 weeks

    Participants' personality characteristics will be assessed using the Ten-Item Personality Inventory, which measures extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience. Scores will range from 1 to 7, with higher scoes indicating closeness to the assesed personality trait.

Sponsors and collaborators

Lead sponsor

Acibadem University

Other

Registry information

Official study title

Effects of Electrodermal Activity-Based Adaptive Support Systems on Performance in VR-Based Advanced Life Support Training: A Randomized Controlled Study

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 16, 2026
Registry last updated
Jul 2, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.