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. 2026 Sep 30;28:e93549. doi: 10.2196/93549

Table 2.

Means and SEMa for anxiety, self-confidence, motivation, metacognition, and self-efficacy scores in self-rated and observer-rated questionnaires 2 weeks before the intervention (day 0), immediately before the intervention (day 14), during the intervention (day 28), immediately after the intervention (day 42), and 2 weeks later after the intervention (day 56) in the TCRb and control groups, and the interaction effects between the TCR and control groups in both questionnaire types.

Outcome and group Day 0, mean (SEM) Day 14, mean (SEM) Day 28, mean (SEM) Day 42, mean (SEM) Day 56, mean (SEM) Interaction effect






F statistic P value
Self-efficacy score in a self-rated questionnaire 2.886 .03

TCR 3.50 (0.39) 3.60 (0.38) 4.25 (0.46) 4.25 (0.46) 4.50 (0.44)


Control 4.28 (0.46) 4.39 (0.45) 4.22 (0.48) 4.67 (0.46) 4.22 (0.42)

Self-efficacy score in an observer-rated questionnaire 13.014 <.001

TCR 3.90 (0.25) 4.40 (0.25) 4.95 (0.27) 5.33 (0.29) 5.15 (0.27)


Control 4.03 (0.25) 4.25 (0.23) 4.36 (0.22) 4.41 (0.21) 4.56 (0.22)

Anxiety score in a self-rated questionnaire 3.009 .02

TCR 5.80 (0.32) 5.35 (0.36) 4.70 (0.37) 4.50 (0.39) 4.40 (0.37)


Control 4.44 (0.44) 4.17 (0.48) 3.67 (0.45) 4.39 (0.46) 4.56 (0.43)

Anxiety score in an observer-rated questionnaire 5.584 <.001

TCR 5.85 (0.30) 5.33 (0.32) 4.80 (0.30) 4.30 (0.30) 4.38 (0.32)


Control 4.89 (0.33) 4.61 (0.30) 4.44 (0.28) 4.33 (0.28) 4.33 (0.34)

Self-confidence score in a self-rated questionnaire 3.335 .01

TCR 2.80 (0.37) 3.15 (0.41) 4.15 (0.47) 5.15 (0.33) 4.75 (0.29)


Control 3.22 (0.45) 3.67 (0.50) 3.89 (0.48) 4.39 (0.47) 4.11 (0.50)

Self-confidence score in an observer-rated questionnaire 5.575 <.001

TCR 3.35 (0.31) 3.73 (0.30) 4.33 (0.32) 4.63 (0.30) 4.38 (0.30)


Control 3.39 (0.24) 3.61 (0.22) 3.83 (0.21) 3.89 (0.20) 3.75 (0.23)

Motivation score in a self-rated questionnaire 3.631 .008

TCR 3.85 (0.37) 3.80 (0.37) 4.70 (0.34) 5.05 (0.37) 4.35 (0.39)


Control 4.22 (0.46) 4.22 (0.48) 4.06 (0.45) 4.44 (0.44) 4.00 (0.44)

Motivation score in an observer-rated questionnaire 4.448 .002

TCR 4.53 (0.19) 4.70 (0.20) 5.28 (0.20) 5.20 (0.20) 5.13 (0.21)


Control 4.14 (0.26) 4.22 (0.24) 4.14 (0.23) 4.33 (0.24) 4.22 (0.24)

Metacognition score in a self-rated questionnaire 4.303 .003

TCR 3.25 (0.40) 3.85 (0.40) 5.05 (0.29) 4.75 (0.41) 4.65 (0.40)


Control 4.28 (0.25) 4.22 (0.48) 4.11 (0.48) 4.67 (0.49) 4.33 (0.46)

Metacognition score in an observer-rated questionnaire 3.815 <.006

TCR 3.93 (0.19) 3.83 (0.22) 4.40 (0.15) 4.48 (0.19) 4.40 (0.17)


Control 3.72 (0.14) 3.78 (0.18) 3.72 (0.10) 3.92 (0.19) 3.83 (0.20)

aSEM: standard error of the mean.

bTCR: a training system that enables users to perform role-based behaviors using a computer graphics avatar in a real, bustling commercial facility.