Implementation of virtual reality in healthcare: a scoping review on the implementation process of virtual reality in various healthcare settings

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. 2023 Jun 16;4:67. doi: 10.1186/s43058-023-00442-2

Table 6 Study characteristics, characteristics of VR technology, and implementation characteristics per study

Authors, year, country	Study	VR technology	Implementation
Algahtani, Altameem, and Baig, 2021; Saudi Arabia [49]	Goal: The study explores the current state of VR technology adoption, factors that influence such adoption, and the extent of this technology’s efficiency when it is used for vaccinating children Design: Quantitative cross sectional, experimental Participants: Workers in vaccination clinics (n = 186) survey—and pediatric patients (n = 6) experiment Data collection: Survey and experiment	VR technology and goal: VR eyewear that shows an amusing video that distracts children during vaccination Target group VR: pediatric patients Setting: Vaccination clinic	Stage: After implementation Target group implementation: Workers in health centers Objective: - Model: UTAUT2 Strategies: N/S Outcomes: Adoption, satisfaction, behavioral intention
Banerjee-Guénette, Bigford, and Glegg, 2020; Canada [60]	Goal: Develop and evaluate the impact of a multifaceted KT intervention (KTI). An overview of (a) the theoretical determinants of occupational therapists’ and physical therapists’ intentions to use a variety of VR and other interactive technologies in practice and (b) their actual technology usage patterns Design: Quantitative Participants: Physical and occupational therapists (n = 11) Data collection: Survey	VR technology and goal: Nintendo Wii, WiiFit, Kinexct for XboX 360; in which the player is represented as an avatar. This system uses motion capture technology to allow full-body movements to control therapy-focused games developed with rehabilitation context in mind Target group VR: Rehabilitation patients Setting: Rehabilitation clinic	Stage: After implementation Target group implementation: Therapists Objective: N/S Model: Decomposed Theory of Planned Behavior + elements of Diffusion of Innovation Theory and Technology Acceptance Model (ADOPT-VR) Strategies: One-on-one mentoring sessions; Outcomes: Adoption and Acceptability
Bryant, Bluff, Barnett, Hemsley, Nguyen, Jacobs, Power, Baily, Stubbs, and Lucas, 2020; Australia [45]	Goal: Explore the views of professionals with expertise in health, rehabilitation, and VR technology, on the populations that might benefit from VR-based rehabilitation, and potential barriers and facilitators to their use of VR Design: Qualitative Participants: Health professionals (n = 9) and VR technologist (n = 1) Data collection: Focus group and interview	VR technology and Goal: Immersive VR using a head-mounted display (not specified further—VR technology is developed based on the insights of this study) Target group VR: Rehabilitation patients Setting: Rehabilitation clinic	Stage: Before implementation Target group implementation: Health professionals in rehabilitation Objective: N/S Model: N/S Strategies: N/A Outcomes: -
Cavenett, Baker, Waycott, Carrasco, Robertson, Vetere, and Hampson, 2018; Australia [36]	Goal: Explore factors that influence staff members when deploying new VR technology in residential aged care facilities Design: Qualitative Participants: Workers from Australian residential care facilities (n = 5) Data collection: Interviews	VR technology and goal: Commercial VR system with a headset, 2 3D cameras, 2 hand controllers. Aim is to let participants move things around in VR and stimulate physical activity Target group VR: Elderly at residential aged care facilities Setting: Residential aged care facilities	Stage: After implementation Target group implementation: Workers in residential aged care facilities Objective: N/S Model: N/S Strategies: N/S Outcomes: -
Chung, Robinson, Johnson, Dowling, Chee, Yücel, and Segrave, 2022; Australia [34]	Goal: Explore the perspectives of staff working in the private mental health sector around the use of therapeutic VR, including potential implementation barriers and facilitators Design: Qualitative Participants: Clinicians (n = 14) and managers (n = 5) of a major private mental health hospital Data collection: Interviews	VR technology and goal: A HTC Vive system with a wireless head-mounted display and handheld controllers was utilized. VR scenarios were designed for OCD treatment Target group VR: Patients with Obsessive–compulsive disorder (OCD) Setting: Private mental health hospital	Stage: Before implementation *Use of VR: VR only used as part of study, not in treatment Target group implementation: Clinicians Objective:* N/S Model: Theory of Innovation Diffusion, CFIR and TDF Strategies: Treatment manuals; in-service training days; consultation opportunities with VR developers and early adopter services; Protocols to promote safe and ethical usage of VR Outcomes: -
Dahms, Stamm, and Muller-Werdan, 2019; Germany [54]	Goal: Determine the process-identifying needs of a VR training program for geriatric patients with chronic backpain Design: Qualitative Participants: Experts (n = 4) physiotherapists and psychotherapists in an executive position of a hospital and rehabilitation center Data collection: Interviews	VR technology and goal: ViRST: Personalized and adaptive VR based on immersive interaction sequences and gamification; sensor-based presentation of content with dynamic, adaptive and personalized storytelling for therapeutic recommendations through multimodal interaction with the content (Multimodal Pain Therapy) Target group VR: Chronic back pain patients Setting: Hospital and rehabilitation center	Stage: Before implementation Target group implementation: Experts who care for and have daily contact with geriatric, chronic back pain patients Objective: N/S Model: N/S Strategies: N/A Outcomes: -
Demers, Kong, and Levin, 2019; Canada [57]	Goal: Determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke Design: Mixed-methods convergent parallel design: qualitative and quantitative cross-sectional Participants: Clinicians (n = 9) who are stroke program therapists and patients with a sub-acute stroke undergoing rehabilitation (n = 7) Data collection: Focus group, interviews and survey	VR technology and goal: Unity Pro software and Kineact II camera tracked arm, hand and trunk movements to interact with VR environment without a game controller. Projected on large screen. Participants played games sitting or standing with or without ambulatory aids. One smash blocks task and one shopper’s delight task (interactive grocery shopping) Target group VR: Stroke patients Setting: Rehabilitation clinic	Stage: Before implementation Target group implementation: N/S Objective: N/S Model: N/S Strategies: N/A Outcomes: Perceived usefulness, satisfaction
Demers, Nguyen, Austin Ong, Xin Luo, Thuraisingam, Rubino, Levin, Kaizer, and Archambault, 2019; Canada [35]	Goal: Understand the perspectives of clinicians regarding an exergaming program (VR) to supplement stroke rehabilitation care Design: Qualitative Participants: Occupational and physiotherapists (n = 10) working in the stroke program at a rehabilitation hospital Data collection: Interviews	VR technology and goal: Exergaming program in VR: Jintronix and Meditouch HandTutor to supplement stroke care and address therapeutic goals (e.g., improving upper limb function, sitting balance and endurance) Target group VR: Stroke patients Setting: Rehabilitation hospital	Stage: After implementation Target group implementation: Clinicians Objective: N/S Model: N/S Strategies: Obtaining a dedicated room for VR; approval from hospital administration; establishing the referral process; purchasing equipment; hiring personal for VR Outcomes: -
Easterlin, Berdahl, Rabizadeh, Spiegel, Agoratus, Hoover, and Dudovitz, 2020; USA [62]	Goal: Examining the acceptability of hypothetically using VR during an infusion appointment to help reduce medical trauma Design: Qualitative Participants: Patient-guardian dyads (n = 18) (pediatric IBD patients and parents) Data collection: Interviews	VR technology and goal: VR wear goggles to help reduce medical trauma (content not specified) Target group VR: Pediatric IBD patients Setting: Pediatric clinic	Stage: Before implementation Target group implementation: N/S Objective: N/S Model: N/S Strategies: N/A Outcomes: -
Ford, Mangegold, Randall, Aballay, and Duncan, 2018; USA [56]	Goal: Evaluate key stakeholder (i.e., patients, providers) perceptions of feasibility, acceptability, and effectiveness for the use of low-cost VR technology during routine burn care with adult patients Design: Quantitative cross sectional and qualitative Participants: patients (n = 10) within burn care and providers (n = 8) who delivered the burn care Data collection: Survey and interviews	VR technology and goal: VR is used as a distraction during burn care. An iPod Touch was used to deliver the VR videos: choice of 8 VR applications (Table Mountain sunset, reindeer race, scuba diving, exploring Amsterdam, roller coaster, playing soccer, swinging through a city, or riding motocross) Target group VR: Burn patients Setting: Burn care clinic	Stage: Before implementation Target group implementation: Care providers of burn patients Objective: N/S Model: N/S Strategies: N/A Outcomes: Acceptability and Feasibility
Glegg, Holsti, Stanton, Hanna, Velikonja, Ansley, Sartor, and Brum, 2017; Canada [43]	Goal: Evaluate the impact of knowledge translation (KT) on factors influencing virtual reality adoption and to identify support needs of therapists Design: Quantitative cross-sectional Participants: Physical, occupational, and rehabilitation therapists (n = 37) Data collection: Survey	VR technology and goal: A variety of VR and other interactive technology systems were already available to participants (not specified) Target group VR: Rehabilitation patients Setting: Brain injury rehabilitation centers	Stage: After implementation Target group implementation: Physical, occupational, and rehabilitation therapists Objective: Knowledge translation (KT) on factors influencing VR adoption and identify support needs of therapists Model: DTPB: Decomposed Theory of Planned Behavior (ADOPT-VR2 instrument) Strategies: Interactive education; clinical manual with goal setting, measuring client progress, developing client progress and evidence; Evidence synthesis; Sample goals; Overview of games and how to select goal-appropriate ones for clients; Information on isolating desired skills or grading VR activities for therapy Outcomes: Adoption and behavioral intention
Høeg, Scully, Bruun-Pedersen, and Serafin, 2020; Denmark [50]	Goal: Determine the circumstances in which physiotherapists and occupational therapists would decide to use VR as part of the therapy. Additionally, evaluate the challenges faced with the implementation, including pain points related to the use of VR Design: Qualitative Participants: Physiotherapists (n = 4) Data collection: Interviews and observations	VR technology and goal: VR-based treatment tool for biking-based rehabilitation: Oculus Rift Consumer Version headset. Software is a set of 4 unique, digitally generated virtual landscapes; measuring the angular velocity of the foot-pedals on the training bike. Stimulating movement Target group VR: Rehabilitation patients Setting: Outpatient health center	Stage: After implementation Target group implementation: Physiotherapists in outpatients health centers Objective: N/S Model: N/S Strategies: N/S Outcomes: -
Kramer, Jeffrey, Pyne, Timoty, Kimbrell, Savary, Jeffrey, Smith, and Jegley, 2010; USA [46]	Goal: Determine critical factors in the successful implementation of a VR intervention among veterans Design: Qualitative Participants: Clinicians (n = 18) from a Veterans Health Administration hospital Data collection: Focus groups	VR technology and goal: VR that offers an assessment method for OEF-OIF veterans by allowing for controlled immersion in a simulated combat environment while monitoring psychophysiological reactivity. The technology has also been used as an adjunct to exposure therapy and aims to improve PTSD symptoms among veterans Target group VR: Veterans Setting: Veterans Health Administration hospital (PTSD clinic, substance abuse treatment service residential program, and mental health clinic)	Stage: After implementation Target group implementation: Clinicians from a Veterans Health Administration hospital Objective: N/S Model: N/S Strategies: N/S Outcomes: -
Langlet, Odegi, Zandian, Nolstam, Södersten, and Bergh, 2021; Sweden [42]	Goal: Evaluate the feasibility and usability of an immersive virtual reality technology administered through an app for use of patients with eating disorders Design: Quantitative cross sectional Participants: Eating disorder personnel (n = 19) and information technology personnel (n = 5) Data collection: Usability tests and survey	VR technology and goal: Participants handled virtual food and utensils on an app using immersive virtual reality technology comprising a headset and two hand controllers. The challenge consisted of a meal type (meatballs, potatoes, sauce, and lingonberries) that is typically difficult for patients with anorexia nervosa to eat in real life. Participants were instructed, via visual feedback from the app, to eat at a healthy rate, which is also a challenge for patients Target group VR: Anorexia Nervosa patients Setting: Eating disorder clinic	Stage: Before implementation Target group implementation: Eating disorder clinic personnel Objective: N/S Model: N/S Strategies: N/A Outcomes: Feasibility (and usability)
Levac, Glegg, Pradhan, Foc, Espy, Chicklis, and Deutsch, 2019; USA [48]	Goal: Undertake a cross-country comparison of VR/AVG uptake to inform the content of educational interventions designed to promote implementation of these technologies into practice Design: Quantitative cross-sectional Participants: Physical- and occupational therapists in Canada and VS (n = 1490) Data collection: Survey	VR technology and goal: VR/AVG (active video gaming) in general healthcare (not specified) Target group VR: N/S Setting: General healthcare	Stage: After implementation Target group implementation: Physical- and occupational therapists Objective: N/S Model: Decomposed Theory of Planned Behavior (ADOPT-VR2 instrument) Strategies: N/S Outcomes: Uptake
Levac and Miller, 2013; Canada [13]	Goal: Explore observations and insights from a sample of physical therapists working with children with acquired brain injury regarding practical implications of using the Wii as a physical therapy intervention Design: Qualitative Participants: Physical therapists (n = 6) at a children’s rehabilitation center Data collection: Interviews	VR technology and goal: Wii virtual reality (VR) interactive video gaming console: movement-based games to target motor impairments in a variety of patient populations Target group VR: Variety of patient populations (sample: children with acquired brain injury) Setting: Clinical rehabilitation practice and at home	Stage: After implementation Target group implementation: Physical therapists at children’s rehabilitation center Objective: N/S Model: N/S Strategies: Making time to reflect and understand how to use VR; Spend time considering the potential and added value of VR into practice; Time and effort to set up and maintain system, find treatment location and maintenance issues; Getting familiar with the technology to instruct patients in its use Outcomes: -
Levac, Glegg, Sveistrup, Colquhoun, Miller, Finestone, DePaul, Harris, and Velikonja, 2016; USA [58]	Goal: (1) evaluate the impact of the intervention on therapists’ confidence related to VR knowledge and skills and perceptions of facilitators and barriers related to VR use; (2) assess the usability of the VR system; (3) obtain therapists’ perspectives about the KT intervention and VR use in practice; and finally, (4) measure the frequency of continued VR use following the KT intervention Design: Qualitative and quantitative cross-sectional Participants: Physical and occupational therapists (n = 11) Data collection: Focus groups and survey	VR technology and goal: Motion-capture technology enables players to view their mirror image in the virtual environment of the GestureTek Interactive Rehabilitation Exercise (IREX) software platform. Interaction with the virtual environment is through body movements to participate with games that address multiple upper extremity or full body movement goals, while motivating clients to participate Target group VR: Stroke rehabilitation patients Setting: Stroke rehabilitation units	Stage: After implementation Target group implementation: Physical- and occupational therapists Objective: The KT intervention designed to translate knowledge about use of the VR system to therapists in two stroke rehabilitation units Model: ADOPT-VR Strategies: E-learning modules (3 online modules provided foundational knowledge about clinical VR use); Hands-on learning (VR experience, training sessions, case scenarios); Experiential learning (use and reflect); Didactic reminders (weekly e-mails with “tips”for VR use); Mentorship (mentors to contact with questions or support needs) Outcomes: Uptake
Lindner, Miloff, Zetterlund, Reuterskiöld, Andersson, and Carlbring, 2019; Sweden [51]	Goal: Survey attitudes toward and familiarity with VR and VRET among practicing cognitive behavior therapists attending a conference Design: Quantitative cross-sectional Participants: Psychologists, psychiatrists, social workers, nurses, and counselors (n = 185) Data collection: Survey	VR technology and goal: Virtual reality exposure therapy (VRET) for fear and anxiety on VR headset Target group VR: Therapists Setting: Used during a conference (normally used during treatment)	Stage: Before implementation Target group implementation: N/S Objective: N/S Model: N/S Strategies: N/A Outcomes: -
Ma, Mor, Anderson, Baños, Botella, and Bouchard, 2021; Sweden [41]	Goal: Present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders Design: Quantitative cross-sectional Participants: Experts on VR and MR technology within psychotherapies (n = 14) Data collection: Survey	VR technology and goal: VR and MR technology use in treatment of anxiety and stress-related disorders (not specified) Target group VR: Patients with anxiety or stress-related disorders Setting: Clinics and within research projects	Stage: Before implementation Target group implementation: N/S Objective: N/S Model: N/S Strategies: N/A Outcomes: -
Nguyen, Ong, Luo, Thuraisingam, Rubino, Levin, Kaizer, and Archambault, 2019; Canada [37]	Goal: Identify the facilitators and barriers perceived by clinicians to using an Exergaming Room as adjunct to conventional therapy Design: Qualitative Participants: Clinicians (n = 10); physical therapists and occupational therapists Data collection: Interviews	VR technology and goal: The Exergames Room contains two systems. The Jintronix is a VR rehabilitation software and it elicits purposeful movements that can be done in sitting or standing. The Meditouch HandTutor allows the repetition of functional movements within a game context, while providing augmented motion biofeedback Target group VR: Rehabilitation patients Setting: The Exergames Room in a hospital	Stage: After implementation Target group implementation: Rehabilitation patients Objective: N/S Model: N/S Strategies: N/S Outcomes: -
Nwosu, Mills, Roughneen, Stanley, Chapman, and Rason, 2021; UK [52]	Goal: 1) explore the feasibility of implementing VR therapy, for patients and healthcare providers, in a hospital specialist inpatient palliative care unit and a hospice, and (2) to identify questions for organizations, to support VR adoption in palliative care Design: Quantitative cross-sectional Participants: Patients (n = 12) and healthcare providers (n = 3) Data collection: Survey	VR technology and goal: The Samsung Gear VR system was used in a hospital specialist palliative inpatient unit and a hospice. Patients and healthcare providers received VR distraction therapy Target group VR: Palliative patients Setting: Palliative inpatient unit	Stage: After implementation Target group implementation: Healthcare providers in palliative care units Objective: N/S Model: N/S Strategies: N/S Outcomes: Feasibility
Ogourtsova, Archambault, and Lamontagne, 2019; Canada [38]	Goal: Explore the barriers and facilitators perceived by clinicians in the use of virtual reality for hemineglect assessment; and to identify features of an optimal virtual assessment Design: Qualitative and quantitative cross-sectional Participants: Clinicians (n = 11) and research experts in the field (n = 3) Data collection: Focus groups, interviews, and survey	VR technology and goal: VR for post-stroke unilateral spatial neglect assessment: VR-based USN assessment that could be implemented and used by clinicians in the management of post-stroke unilateral spatial neglect Target group VR: Post-stroke patients Setting: Healthcare clinic	Stage: After implementation Target group implementation: Clinicians Objective: N/S Model: N/S Strategies: N/S Outcomes: -
Proffitt, Glegg, Levac, and Lange, 2019; USA [59]	Goal: Review four case examples from the authors’ collective experience of including end users in VR/AVG research to identify common benefits, challenges, and lessons learned Design: Quantitative cross-sectional and qualitative Participants: (1) therapists and clients with stroke; (2) OT students; (3) Clients and therapists; (4) Clients and therapists Data collection: Survey, interviews, observations, focus groups, and usability testing	VR technology and goal: Gesturetek IREX (interactive rehabilitation exercise system); Rapael SmartGlove; Adapted PlayStation2 controller; All VR systems related to rehabilitation Target group VR: Individuals with stroke, pro-bono clinic clients, adolescents and adults with hemiparesis, individuals with stroke/brain injury/amputations/older adults at risk for falls Setting: Inpatient stroke rehabilitation, pro-bono student-run outpatient clinic, home-based rehabilitation, outpatient clinic/hospital/home	Stage: After implementation Target group implementation: Therapists and clients Objective: N/S Model: N/S Strategies: N/S Outcomes: -
Rimer, Husby, and Solem, 2021; Norway [40]	Goal: Testing whether modern, wireless, commercially available VR equipment with controller-free hand tracking could induce and reduce discomfort using scenarios designed for fear of heights. Also, the study tested if clinicians’ attitudes toward using VR in therapy changed after trying it themselves Design: Quantitative cross-sectional Participants: Clinicians (n = 74) and psychology students (n = 54) with clinical experience Data collection: Survey	VR technology and goal: VRET software: The program utilized the VR hardware Oculus Quest, which is a wireless head-mounted display (HMD). It included a controller-free hand-tracking feature, which enabled the use of hands as an input method to control the program. The software consisted of two different scenarios, which will be referred to as the “Lift” and the “Plank.” Target group VR: Patients with anxiety/phobia treatment Setting: Private and public health clinics	Stage: After implementation Target group implementation: Clinicians from private and public health clinics Objective: N/S Model: N/S Strategies: N/S Outcomes: -
Sarkar, Lee, Nguyen, Lisker, and Lyles, 2021; USA [44]	Goal: Assess the readiness for VR in safety-net settings with a qualitative, theory-informed implementation science study Design: Qualitative Participants: Current VR users and non-users in safety-net health systems (n = 15) Data collection: Interviews	VR technology and goal: AppliedVR platform for pain treatment. A commercially available, previously validated VR technology platform (Not further specified) Target group VR: Chronic pain patients Setting: Safety-net sites—clinics	Stage: After implementation Target group implementation: Health care providers Objective: N/S Model: Consolidated Framework for Implementation Research (CFIR) Strategies: Specific orientation from staff in order to initiate VR use; Staff support for coaching and troubleshooting; Champions among clinicians who can share both evidence for VR and successful treatment experiences Outcomes: -
Stamou, Gracia-Palacios, and Botella, 2019; Spain [39]	Goal: Assess the level of feasibility, acceptance, and practical parameters of the combination of VR and traditional CBT for PND Design: Pilot study – quantitative cross-sectional and qualitative Participants: Patients (n = 6) with depression, anxiety, post-natal depression or recurrent depression Data collection: Survey and interviews	VR technology and goal: VR system where they were exposed to a series of virtual stressors, while at the same time, they were asked to tidy up the virtual house. VR stressors can be manipulated by the therapist in terms of intensity (from 0 to 6), frequency, duration, and applied individually or simultaneously. They are divided into three main categories and include amongst others: loud music, telephone ringing, newborn baby crying, toddler reaching for medication, power outage, fire in the kitchen, next door neighbors arguing, and next-door party Target group VR: Depression and anxiety-related patient groups Setting: General Practice clinics	Stage: Before implementation Target group implementation: N/S Objective: N/S Model: N/S Strategies: N/A Outcomes: Feasibility and Acceptability
Tennant, McGillivray, Youssef, McCarthy, and Clark, 2020; Australia [55]	Goal: 1. To evaluate the acceptability and feasibility of implementing an Immersive VR therapeutic intervention in an inpatient pediatric oncology setting, from the perspective of key stakeholders (i.e., oncology HCPs, patients, and parent healthcare providers); (2) to examine factors influencing VR adoption by HCPs, including barriers/facilitators to VR use with children who are seriously ill; (3) to explore user perspectives regarding the potential clinical utility of VR as an intervention to support psychological adjustment to hospitalization, including child VR content preferences Design: Quantitative Participants: Multidisciplinary oncology healthcare professionals (n = 30) and oncology inpatients (n = 90) Data collection: Survey	VR technology and goal: Immersive VR experiences were provided using a smartphone and VR headset and headphones. The intervention content involved original 360° video content. Participants viewed one of three virtual simulation experiences, including simulated travel to Australian national parks (i.e., nature experience), Australian zoos (i.e., animal experience), or global city tourist spots (i.e., travel experience). The goal is to support children’s needs during active cancer treatment, including to help regulate strong emotion, alleviate boredom, enhance mood, and provide a sense of escape from hospital, the experience of play, distraction from feared medical procedures, and physical symptom reduction Target group VR: Oncology inpatients (7–19 years) Setting: Children’s hospital and cancer center	Stage: Before implementation Target group implementation: Health care providers in children’s oncology care Objective: N/S Model: N/S Strategies: N/A Outcomes: Acceptability, adoption and feasibility
Üstel, Smith, Blajeski, Johnson, Butler, Nicola-Adkins et al., 2021; USA [47]	Goal: Understand peer specialist beliefs about potential barriers and facilitators influencing peer-delivered VR-JIT Design: Qualitative Participants: Peer specialists (n = 34) Data collection: Focus groups	VR technology and goal: Virtual Reality Job Interview Training (VR-JIT) which is a computerized job interview simulator delivered via the Internet. VR-JIT was designed to improve interview skills. VR-JIT enables trainees to review an e-learning curriculum about job interview strategies and tips; complete an online job application for a fictional company called “Wondersmart,” and then repeatedly practice interviews with a virtual hiring manager named “Molly Porter.” Trainees choose their responses from scripted options that range from highly effective to highly ineffective and then speak them aloud to “Molly Porter” using the website’s speech recognition function Target group VR: Individuals with serious illness Setting: Peer specialist workspaces	Stage: Before implementation Target group implementation: Peer specialists Objective: N/S Model: Consolidated Framework for Implementation Research (CFIR) Strategies: N/A Outcomes: Acceptability and Feasibility
Vincent, Eberts, Naik, Gulick, and O’Hayer, 2021, USA [53]	Goal: Explore the provider perception of the value of VR and identify barriers to Implementation among healthcare providers Design: Qualitative, cross-sectional Participants: Providers (n = 17) who have used VR as a therapeutic tool in the past year Data collection: Survey	VR technology and goal: VR as a treatment tool in psychiatry and pain management (not specified) Target group VR: Patients with psychiatric disorders or treated with pain management Setting: Community practice; medical clinic; research setting	Stage: After implementation Target group implementation: Healthcare providers Objective: N/S Model: N/S Strategies: Training about VR content in treatment and how to use VR (in person and online—about half a day); self-directed research Outcomes: -

Authors, year, country

Study

VR technology

Implementation

Study goal, design, and participants

VR technology, goal, target group, and setting

Implementation stage, strategies, target group, objectives, and outcomes

Algahtani, Altameem, and Baig, 2021; Saudi Arabia [49]

Goal: The study explores the current state of VR technology adoption, factors that influence such adoption, and the extent of this technology’s efficiency when it is used for vaccinating children

Design: Quantitative cross sectional, experimental

Participants: Workers in vaccination clinics (n = 186) survey—and pediatric patients (n = 6) experiment

Data collection: Survey and experiment

VR technology and goal: VR eyewear that shows an amusing video that distracts children during vaccination

Target group VR: pediatric patients

Setting: Vaccination clinic

Stage: After implementation

Target group implementation: Workers in health centers

Objective: -

Model: UTAUT2

Strategies: N/S

Outcomes: Adoption, satisfaction, behavioral intention

Banerjee-Guénette, Bigford, and Glegg, 2020; Canada [60]

Goal: Develop and evaluate the impact of a multifaceted KT intervention (KTI). An overview of (a) the theoretical determinants of occupational therapists’ and physical therapists’ intentions to use a variety of VR and other interactive technologies in practice and (b) their actual technology usage patterns

Design: Quantitative

Participants: Physical and occupational therapists (n = 11)

Data collection: Survey

VR technology and goal: Nintendo Wii, WiiFit, Kinexct for XboX 360; in which the player is represented as an avatar. This system uses motion capture technology to allow full-body movements to control therapy-focused games developed with rehabilitation context in mind

Target group VR: Rehabilitation patients

Setting: Rehabilitation clinic

Stage: After implementation

Target group implementation: Therapists

Objective: N/S

Model: Decomposed Theory of Planned Behavior + elements of Diffusion of Innovation Theory and Technology Acceptance Model (ADOPT-VR)

Strategies: One-on-one mentoring sessions;

Outcomes: Adoption and Acceptability

Bryant, Bluff, Barnett, Hemsley, Nguyen, Jacobs, Power, Baily, Stubbs, and Lucas, 2020; Australia [45]

Goal: Explore the views of professionals with expertise in health, rehabilitation, and VR technology, on the populations that might benefit from VR-based rehabilitation, and potential barriers and facilitators to their use of VR

Design: Qualitative

Participants: Health professionals (n = 9) and VR technologist (n = 1)

Data collection: Focus group and interview

VR technology and Goal: Immersive VR using a head-mounted display (not specified further—VR technology is developed based on the insights of this study)

Target group VR: Rehabilitation patients

Setting: Rehabilitation clinic

Stage: Before implementation

Target group implementation: Health professionals in rehabilitation

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: -

Cavenett, Baker, Waycott, Carrasco, Robertson, Vetere, and Hampson, 2018; Australia [36]

Goal: Explore factors that influence staff members when deploying new VR technology in residential aged care facilities

Design: Qualitative

Participants: Workers from Australian residential care facilities (n = 5)

Data collection: Interviews

VR technology and goal: Commercial VR system with a headset, 2 3D cameras, 2 hand controllers. Aim is to let participants move things around in VR and stimulate physical activity

Target group VR: Elderly at residential aged care facilities

Setting: Residential aged care facilities

Stage: After implementation

Target group implementation: Workers in residential aged care facilities

Objective: N/S

Model: N/S

Strategies: N/S

Outcomes: -

Chung, Robinson, Johnson, Dowling, Chee, Yücel, and Segrave, 2022; Australia [34]

Goal: Explore the perspectives of staff working in the private mental health sector around the use of therapeutic VR, including potential implementation barriers and facilitators

Design: Qualitative

Participants: Clinicians (n = 14) and managers (n = 5) of a major private mental health hospital

Data collection: Interviews

VR technology and goal: A HTC Vive system with a wireless head-mounted display and handheld controllers was utilized. VR scenarios were designed for OCD treatment

Target group VR: Patients with Obsessive–compulsive disorder (OCD)

Setting: Private mental health hospital

Stage: Before implementation

Use of VR: VR only used as part of study, not in treatment

Target group implementation: Clinicians

Objective: N/S

Model: Theory of Innovation Diffusion, CFIR and TDF

Strategies: Treatment manuals; in-service training days; consultation opportunities with VR developers and early adopter services; Protocols to promote safe and ethical usage of VR

Outcomes: -

Dahms, Stamm, and Muller-Werdan, 2019; Germany [54]

Goal: Determine the process-identifying needs of a VR training program for geriatric patients with chronic backpain

Design: Qualitative

Participants: Experts (n = 4) physiotherapists and psychotherapists in an executive position of a hospital and rehabilitation center

Data collection: Interviews

VR technology and goal: ViRST: Personalized and adaptive VR based on immersive interaction sequences and gamification; sensor-based presentation of content with dynamic, adaptive and personalized storytelling for therapeutic recommendations through multimodal interaction with the content (Multimodal Pain Therapy)

Target group VR: Chronic back pain patients

Setting: Hospital and rehabilitation center

Stage: Before implementation

Target group implementation: Experts who care for and have daily contact with geriatric, chronic back pain patients

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: -

Demers, Kong, and Levin, 2019; Canada [57]

Goal: Determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke

Design: Mixed-methods convergent parallel design: qualitative and quantitative cross-sectional

Participants: Clinicians (n = 9) who are stroke program therapists and patients with a sub-acute stroke undergoing rehabilitation (n = 7)

Data collection: Focus group, interviews and survey

VR technology and goal: Unity Pro software and Kineact II camera tracked arm, hand and trunk movements to interact with VR environment without a game controller. Projected on large screen. Participants played games sitting or standing with or without ambulatory aids. One smash blocks task and one shopper’s delight task (interactive grocery shopping)

Target group VR: Stroke patients

Setting: Rehabilitation clinic

Stage: Before implementation

Target group implementation: N/S

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: Perceived usefulness, satisfaction

Demers, Nguyen, Austin Ong, Xin Luo, Thuraisingam, Rubino, Levin, Kaizer, and Archambault, 2019; Canada [35]

Goal: Understand the perspectives of clinicians regarding an exergaming program (VR) to supplement stroke rehabilitation care

Design: Qualitative

Participants: Occupational and physiotherapists (n = 10) working in the stroke program at a rehabilitation hospital

Data collection: Interviews

VR technology and goal: Exergaming program in VR: Jintronix and Meditouch HandTutor to supplement stroke care and address therapeutic goals (e.g., improving upper limb function, sitting balance and endurance)

Target group VR: Stroke patients

Setting: Rehabilitation hospital

Stage: After implementation

Target group implementation: Clinicians

Objective: N/S

Model: N/S

Strategies: Obtaining a dedicated room for VR; approval from hospital administration; establishing the referral process; purchasing equipment; hiring personal for VR

Outcomes: -

Easterlin, Berdahl, Rabizadeh, Spiegel, Agoratus, Hoover, and Dudovitz, 2020; USA [62]

Goal: Examining the acceptability of hypothetically using VR during an infusion appointment to help reduce medical trauma

Design: Qualitative

Participants: Patient-guardian dyads (n = 18) (pediatric IBD patients and parents)

Data collection: Interviews

VR technology and goal: VR wear goggles to help reduce medical trauma (content not specified)

Target group VR: Pediatric IBD patients

Setting: Pediatric clinic

Stage: Before implementation

Target group implementation: N/S

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: -

Ford, Mangegold, Randall, Aballay, and Duncan, 2018; USA [56]

Goal: Evaluate key stakeholder (i.e., patients, providers) perceptions of feasibility, acceptability, and effectiveness for the use of low-cost VR technology during routine burn care with adult patients

Design: Quantitative cross sectional and qualitative

Participants: patients (n = 10) within burn care and providers (n = 8) who delivered the burn care

Data collection: Survey and interviews

VR technology and goal: VR is used as a distraction during burn care. An iPod Touch was used to deliver the VR videos: choice of 8 VR applications (Table Mountain sunset, reindeer race, scuba diving, exploring Amsterdam, roller coaster, playing soccer, swinging through a city, or riding motocross)

Target group VR: Burn patients

Setting: Burn care clinic

Stage: Before implementation

Target group implementation: Care providers of burn patients

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: Acceptability and Feasibility

Glegg, Holsti, Stanton, Hanna, Velikonja, Ansley, Sartor, and Brum, 2017; Canada [43]

Goal: Evaluate the impact of knowledge translation (KT) on factors influencing virtual reality adoption and to identify support needs of therapists

Design: Quantitative cross-sectional

Participants: Physical, occupational, and rehabilitation therapists (n = 37)

Data collection: Survey

VR technology and goal: A variety of VR and other interactive technology systems were already available to participants (not specified)

Target group VR: Rehabilitation patients

Setting: Brain injury rehabilitation centers

Stage: After implementation

Target group implementation: Physical, occupational, and rehabilitation therapists

Objective: Knowledge translation (KT) on factors influencing VR adoption and identify support needs of therapists

Model: DTPB: Decomposed Theory of Planned Behavior (ADOPT-VR2 instrument)

Strategies: Interactive education; clinical manual with goal setting, measuring client progress, developing client progress and evidence; Evidence synthesis; Sample goals; Overview of games and how to select goal-appropriate ones for clients; Information on isolating desired skills or grading VR activities for therapy

Outcomes: Adoption and behavioral intention

Høeg, Scully, Bruun-Pedersen, and Serafin, 2020; Denmark [50]

Goal: Determine the circumstances in which physiotherapists and occupational therapists would decide to use VR as part of the therapy. Additionally, evaluate the challenges faced with the implementation, including pain points related to the use of VR

Design: Qualitative

Participants: Physiotherapists (n = 4)

Data collection: Interviews and observations

VR technology and goal: VR-based treatment tool for biking-based rehabilitation: Oculus Rift Consumer Version headset. Software is a set of 4 unique, digitally generated virtual landscapes; measuring the angular velocity of the foot-pedals on the training bike. Stimulating movement

Target group VR: Rehabilitation patients

Setting: Outpatient health center

Stage: After implementation

Target group implementation: Physiotherapists in outpatients health centers

Objective: N/S

Model: N/S

Strategies: N/S

Outcomes: -

Kramer, Jeffrey, Pyne, Timoty, Kimbrell, Savary, Jeffrey, Smith, and Jegley, 2010; USA [46]

Goal: Determine critical factors in the successful implementation of a VR intervention among veterans

Design: Qualitative

Participants: Clinicians (n = 18) from a Veterans Health Administration hospital

Data collection: Focus groups

VR technology and goal: VR that offers an assessment method for OEF-OIF veterans by allowing for controlled immersion in a simulated combat environment while monitoring psychophysiological reactivity. The technology has also been used as an adjunct to exposure therapy and aims to improve PTSD symptoms among veterans

Target group VR: Veterans

Setting: Veterans Health Administration hospital (PTSD clinic, substance abuse treatment service residential program, and mental health clinic)

Stage: After implementation

Target group implementation: Clinicians from a Veterans Health Administration hospital

Objective: N/S

Model: N/S

Strategies: N/S

Outcomes: -

Langlet, Odegi, Zandian, Nolstam, Södersten, and Bergh, 2021; Sweden [42]

Goal: Evaluate the feasibility and usability of an immersive virtual reality technology administered through an app for use of patients with eating disorders

Design: Quantitative cross sectional

Participants: Eating disorder personnel (n = 19) and information technology personnel (n = 5)

Data collection: Usability tests and survey

VR technology and goal: Participants handled virtual food and utensils on an app using immersive virtual reality technology comprising a headset and two hand controllers. The challenge consisted of a meal type (meatballs, potatoes, sauce, and lingonberries) that is typically difficult for patients with anorexia nervosa to eat in real life. Participants were instructed, via visual feedback from the app, to eat at a healthy rate, which is also a challenge for patients

Target group VR: Anorexia Nervosa patients

Setting: Eating disorder clinic

Stage: Before implementation

Target group implementation: Eating disorder clinic personnel

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: Feasibility (and usability)

Levac, Glegg, Pradhan, Foc, Espy, Chicklis, and Deutsch, 2019; USA [48]

Goal: Undertake a cross-country comparison of VR/AVG uptake to inform the content of educational interventions designed to promote implementation of these technologies into practice

Design: Quantitative cross-sectional

Participants: Physical- and occupational therapists in Canada and VS (n = 1490)

Data collection: Survey

VR technology and goal: VR/AVG (active video gaming) in general healthcare (not specified)

Target group VR: N/S

Setting: General healthcare

Stage: After implementation

Target group implementation: Physical- and occupational therapists

Objective: N/S

Model: Decomposed Theory of Planned Behavior (ADOPT-VR2 instrument)

Strategies: N/S

Outcomes: Uptake

Levac and Miller, 2013; Canada [13]

Goal: Explore observations and insights from a sample of physical therapists working with children with acquired brain injury regarding practical implications of using the Wii as a physical therapy intervention

Design: Qualitative

Participants: Physical therapists (n = 6) at a children’s rehabilitation center

Data collection: Interviews

VR technology and goal: Wii virtual reality (VR) interactive video gaming console: movement-based games to target motor impairments in a variety of patient populations

Target group VR: Variety of patient populations (sample: children with acquired brain injury)

Setting: Clinical rehabilitation practice and at home

Stage: After implementation

Target group implementation: Physical therapists at children’s rehabilitation center

Objective: N/S

Model: N/S

Strategies: Making time to reflect and understand how to use VR; Spend time considering the potential and added value of VR into practice; Time and effort to set up and maintain system, find treatment location and maintenance issues; Getting familiar with the technology to instruct patients in its use

Outcomes: -

Levac, Glegg, Sveistrup, Colquhoun, Miller, Finestone, DePaul, Harris, and Velikonja, 2016; USA [58]

Goal: (1) evaluate the impact of the intervention on therapists’ confidence related to VR knowledge and skills and perceptions of facilitators and barriers related to VR use; (2) assess the usability of the VR system; (3) obtain therapists’ perspectives about the KT intervention and VR use in practice; and finally, (4) measure the frequency of continued VR use following the KT intervention

Design: Qualitative and quantitative cross-sectional

Participants: Physical and occupational therapists (n = 11)

Data collection: Focus groups and survey

VR technology and goal: Motion-capture technology enables players to view their mirror image in the virtual environment of the GestureTek Interactive Rehabilitation Exercise (IREX) software platform. Interaction with the virtual environment is through body movements to participate with games that address multiple upper extremity or full body movement goals, while motivating clients to participate

Target group VR: Stroke rehabilitation patients

Setting: Stroke rehabilitation units

Stage: After implementation

Target group implementation: Physical- and occupational therapists

Objective: The KT intervention designed to translate knowledge about use of the VR system to therapists in two stroke rehabilitation units

Model: ADOPT-VR

Strategies: E-learning modules (3 online modules provided foundational knowledge about clinical VR use); Hands-on learning (VR experience, training sessions, case scenarios); Experiential learning (use and reflect); Didactic reminders (weekly e-mails with “tips”for VR use); Mentorship (mentors to contact with questions or support needs)

Outcomes: Uptake

Lindner, Miloff, Zetterlund, Reuterskiöld, Andersson, and Carlbring, 2019; Sweden [51]

Goal: Survey attitudes toward and familiarity with VR and VRET among practicing cognitive behavior therapists attending a conference

Design: Quantitative cross-sectional

Participants: Psychologists, psychiatrists, social workers, nurses, and counselors (n = 185)

Data collection: Survey

VR technology and goal: Virtual reality exposure therapy (VRET) for fear and anxiety on VR headset

Target group VR: Therapists

Setting: Used during a conference (normally used during treatment)

Stage: Before implementation

Target group implementation: N/S

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: -

Ma, Mor, Anderson, Baños, Botella, and Bouchard, 2021; Sweden [41]

Goal: Present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders

Design: Quantitative cross-sectional

Participants: Experts on VR and MR technology within psychotherapies (n = 14)

Data collection: Survey

VR technology and goal: VR and MR technology use in treatment of anxiety and stress-related disorders (not specified)

Target group VR: Patients with anxiety or stress-related disorders

Setting: Clinics and within research projects

Stage: Before implementation

Target group implementation: N/S

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: -

Nguyen, Ong, Luo, Thuraisingam, Rubino, Levin, Kaizer, and Archambault, 2019; Canada [37]

Goal: Identify the facilitators and barriers perceived by clinicians to using an Exergaming Room as adjunct to conventional therapy

Design: Qualitative

Participants: Clinicians (n = 10); physical therapists and occupational therapists

Data collection: Interviews

VR technology and goal: The Exergames Room contains two systems. The Jintronix is a VR rehabilitation software and it elicits purposeful movements that can be done in sitting or standing. The Meditouch HandTutor allows the repetition of functional movements within a game context, while providing augmented motion biofeedback

Target group VR: Rehabilitation patients

Setting: The Exergames Room in a hospital

Stage: After implementation

Target group implementation: Rehabilitation patients

Objective: N/S

Model: N/S

Strategies: N/S

Outcomes: -

Nwosu, Mills, Roughneen, Stanley, Chapman, and Rason, 2021; UK [52]

Goal: 1) explore the feasibility of implementing VR therapy, for patients and healthcare providers, in a hospital specialist inpatient palliative care unit and a hospice, and (2) to identify questions for organizations, to support VR adoption in palliative care

Design: Quantitative cross-sectional

Participants: Patients (n = 12) and healthcare providers (n = 3)

Data collection: Survey

VR technology and goal: The Samsung Gear VR system was used in a hospital specialist palliative inpatient unit and a hospice. Patients and healthcare providers received VR distraction therapy

Target group VR: Palliative patients

Setting: Palliative inpatient unit

Stage: After implementation

Target group implementation: Healthcare providers in palliative care units

Objective: N/S

Model: N/S

Strategies: N/S

Outcomes: Feasibility

Ogourtsova, Archambault, and Lamontagne, 2019; Canada [38]

Goal: Explore the barriers and facilitators perceived by clinicians in the use of virtual reality for hemineglect assessment; and to identify features of an optimal virtual assessment

Design: Qualitative and quantitative cross-sectional

Participants: Clinicians (n = 11)

and research experts in the field (n = 3)

Data collection: Focus groups, interviews, and survey

VR technology and goal: VR for post-stroke unilateral spatial neglect assessment: VR-based USN assessment that could be implemented and used by clinicians in the management of post-stroke unilateral spatial neglect

Target group VR: Post-stroke patients

Setting: Healthcare clinic

Stage: After implementation

Target group implementation: Clinicians

Objective: N/S

Model: N/S

Strategies: N/S

Outcomes: -

Proffitt, Glegg, Levac, and Lange, 2019; USA [59]

Goal: Review four case examples from the authors’ collective experience of including end users in VR/AVG research to identify common benefits, challenges, and lessons learned

Design: Quantitative cross-sectional and qualitative

Participants: (1) therapists and clients with stroke; (2) OT students; (3) Clients and therapists; (4) Clients and therapists

Data collection: Survey, interviews, observations, focus groups, and usability testing

VR technology and goal: Gesturetek IREX (interactive rehabilitation exercise system); Rapael SmartGlove; Adapted PlayStation2 controller; All VR systems related to rehabilitation

Target group VR: Individuals with stroke, pro-bono clinic clients, adolescents and adults with hemiparesis, individuals with stroke/brain injury/amputations/older adults at risk for falls

Setting: Inpatient stroke rehabilitation, pro-bono student-run outpatient clinic, home-based rehabilitation, outpatient clinic/hospital/home

Stage: After implementation

Target group implementation: Therapists and clients

Objective: N/S

Model: N/S

Strategies: N/S

Outcomes: -

Rimer, Husby, and Solem, 2021; Norway [40]

Goal: Testing whether modern, wireless, commercially available VR equipment with controller-free hand tracking could induce and reduce discomfort using scenarios designed for fear of heights. Also, the study tested if clinicians’ attitudes toward using VR in therapy changed after trying it themselves

Design: Quantitative cross-sectional

Participants: Clinicians (n = 74) and psychology students (n = 54) with clinical experience

Data collection: Survey

VR technology and goal: VRET software: The program utilized the VR hardware Oculus Quest, which is a wireless head-mounted display (HMD). It included a controller-free hand-tracking feature, which enabled the use of hands as an input method to control the program. The software consisted of two different scenarios, which will be referred to as the “Lift” and the “Plank.”

Target group VR: Patients with anxiety/phobia treatment

Setting: Private and public health clinics

Stage: After implementation

Target group implementation: Clinicians from private and public health clinics

Objective: N/S

Model: N/S

Strategies: N/S

Outcomes: -

Sarkar, Lee, Nguyen, Lisker, and Lyles, 2021; USA [44]

Goal: Assess the readiness for VR in safety-net settings with a qualitative, theory-informed implementation science study

Design: Qualitative

Participants: Current VR users and non-users in safety-net health systems (n = 15)

Data collection: Interviews

VR technology and goal: AppliedVR platform for pain treatment. A commercially available, previously validated VR technology platform (Not further specified)

Target group VR: Chronic pain patients

Setting: Safety-net sites—clinics

Stage: After implementation

Target group implementation: Health care providers

Objective: N/S

Model: Consolidated Framework for Implementation Research (CFIR)

Strategies: Specific orientation from staff in order to initiate VR use; Staff support for coaching and troubleshooting; Champions among clinicians who can share both evidence for VR and successful treatment experiences

Outcomes: -

Stamou, Gracia-Palacios, and Botella, 2019; Spain [39]

Goal: Assess the level of feasibility, acceptance, and practical parameters of the combination of VR and traditional CBT for PND

Design: Pilot study – quantitative cross-sectional and qualitative

Participants: Patients (n = 6) with depression, anxiety, post-natal depression or recurrent depression

Data collection: Survey and interviews

VR technology and goal: VR system where they were exposed to a series of virtual stressors, while at the same time, they were asked to tidy up the virtual house. VR stressors can be manipulated by the therapist in terms of intensity (from 0 to 6), frequency, duration, and applied individually or simultaneously. They are divided into three main categories and include amongst others: loud music, telephone ringing, newborn baby crying, toddler reaching for medication, power outage, fire in the kitchen, next door neighbors arguing, and next-door party

Target group VR: Depression and anxiety-related patient groups

Setting: General Practice clinics

Stage: Before implementation

Target group implementation: N/S

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: Feasibility and Acceptability

Tennant, McGillivray, Youssef, McCarthy, and Clark, 2020; Australia [55]

Goal: 1. To evaluate the acceptability and feasibility of implementing an Immersive VR therapeutic intervention in an inpatient pediatric oncology setting, from the perspective of key stakeholders (i.e., oncology HCPs, patients, and parent healthcare providers); (2) to examine factors influencing VR adoption by HCPs, including barriers/facilitators to VR use with children who are seriously ill; (3) to explore user perspectives regarding the potential clinical utility of VR as an intervention to support psychological adjustment to hospitalization, including child VR content preferences

Design: Quantitative

Participants: Multidisciplinary oncology healthcare professionals (n = 30) and oncology inpatients (n = 90)

Data collection: Survey

VR technology and goal: Immersive VR experiences were provided using a smartphone and VR headset and headphones. The intervention content involved original 360° video content. Participants viewed one of three virtual simulation experiences, including simulated travel to Australian national parks (i.e., nature experience), Australian zoos (i.e., animal experience), or global city tourist spots (i.e., travel experience). The goal is to support children’s needs during active cancer treatment, including to help regulate strong emotion, alleviate boredom, enhance mood, and provide a sense of escape from hospital, the experience of play, distraction from feared medical procedures, and physical symptom reduction

Target group VR: Oncology inpatients (7–19 years)

Setting: Children’s hospital and cancer center

Stage: Before implementation

Target group implementation: Health care providers in children’s oncology care

Objective: N/S

Model: N/S

Strategies: N/A

Outcomes: Acceptability, adoption and feasibility

Üstel, Smith, Blajeski, Johnson, Butler, Nicola-Adkins et al., 2021; USA [47]

Goal: Understand peer specialist beliefs about potential barriers and facilitators influencing peer-delivered VR-JIT

Design: Qualitative

Participants: Peer specialists (n = 34)

Data collection: Focus groups

VR technology and goal: Virtual Reality Job Interview Training (VR-JIT) which is a computerized job interview simulator delivered via the Internet. VR-JIT was designed to improve interview skills. VR-JIT enables trainees to review an e-learning curriculum about job interview strategies and tips; complete an online job application for a fictional company called “Wondersmart,” and then repeatedly practice interviews with a virtual hiring manager named “Molly Porter.” Trainees choose their responses from scripted options that range from highly effective to highly ineffective and then speak them aloud to “Molly Porter” using the website’s speech recognition function

Target group VR: Individuals with serious illness

Setting: Peer specialist workspaces

Stage: Before implementation

Target group implementation: Peer specialists

Objective: N/S

Model: Consolidated Framework for Implementation Research (CFIR)

Strategies: N/A

Outcomes: Acceptability and Feasibility

Vincent, Eberts, Naik, Gulick, and O’Hayer, 2021, USA [53]

Goal: Explore the provider perception of the value of VR and identify barriers to Implementation among healthcare providers

Design: Qualitative, cross-sectional

Participants: Providers (n = 17) who have used VR as a therapeutic tool in the past year

Data collection: Survey

VR technology and goal: VR as a treatment tool in psychiatry and pain management (not specified)

Target group VR: Patients with psychiatric disorders or treated with pain management

Setting: Community practice; medical clinic; research setting

Stage: After implementation

Target group implementation: Healthcare providers

Objective: N/S

Model: N/S

Strategies: Training about VR content in treatment and how to use VR (in person and online—about half a day); self-directed research

Outcomes: -