Effects of Image Realism on the Stress Response in Virtual Reality

Safety critical situations, as they occur in professions such as medicine, nursing, and aviation, are often trained in simulators to prevent damages to personnel and material. These jobs often come with a high amount of stress, to which prolonged exposure can have devastating effects. Over the past years, stress inoculation training in conjunction with Virtual Reality has become focus of the research community and software companies. Especially the nursing profession can benefit from it, since stress-related illnesses are often the reason for an early exit from the workforce. However, since training facilities often need to compromise on their simulations due to monetary reasons, trade-offs must be made in the degree of detail of such simulations in order to keep development and acquisition costs low. One such possibility is in using low graphical fidelity. We present a psycho-physiological study on the influence of image realism of virtual environments on the stress response. In a within subject design study, we ask participants to complete nursing related, virtually recreated tasks in an artificial intensive care unit, whilst exposed to different stress factors. We provide our findings in the form of objective and subjective measures. Results show that one can elicit different stress responses by manipulating image realism in a sufficiently drastic manner. However, a life-like reaction does not seem to depend on a highly realistic environment.