Virtual reality for stress therapy has been shown to be effective in reducing stress. However, the majority of the existing studies have only focused on investigating the effectiveness of virtual reality application as a stress reduction tool. Limited information was communicated on how the virtual environments used were designed. Existing design frameworks which may potentially be used as a reference turned out to be providing general guidelines and were not specifically developed for designing a virtual environment for stress therapy. The frameworks were also found to focus on either improving psychological well-being or virtual reality design respectively. To address the identified gap, this study proposed a framework for designing virtual environments for stress therapy. The framework incorporates design requirements from a psychological and information technology point of view. In addition, the framework also highlights the design elements that were specifically needed to design a virtual environment to reduce stress. This paper hence describes the framework and discusses the framework evaluation. Four methods, including (i) questionnaire, (ii) physiological measures, (iii) experiment and (iv) interview were used to evaluate the (i) effectiveness, (ii) usability, (iii) ease of use and (iv) usefulness of the system that implemented the concept of the framework in reducing stress. In addition, the methods were also used to assess the usefulness of the design elements listed in the framework to reduce stress. The results of the evaluation indicated that the system was (i) effective, (ii) usable, (iii) useful and (iv) easy to use to reduce stress. The results also showed that the proposed design elements were useful in aiding the stress-reduction process. As all the results returned positive findings, the framework was thus considered appropriate and suitable to be used as a guideline for designing virtual environments for stress therapy.

Introduction: Virtual reality (VR) has been widely used in medical and health sciences education since the late twentieth century. VR complements the conventional teaching and learning (T&L) approach by providing an engaging and immersive 3D spatial learning environment, especially for understanding the orientation of anatomical structures. Despite these advantages, the usability and student preference of highly immersive head-mounted display-based (HMD) and less immersive desktop-based (DB) VR in human anatomy courses have yet to be determined. Methods: In a cross-sectional study, 49 Year-2 medical students were recruited through a convenient sampling. The participants were asked to identify 15 skeletal system components using the HMD and DB platform with human anatomy VR application. Both applications’ System Usability Scale (SUS) and preference scores were obtained via a self-administered questionnaire. The data were expressed as median [IQR] and statistically analysed using MATLAB R2022b. Results: Most participants preferred the HMD over the DB platform (p=0.04), especially the male participants (p=0.01). There was no significant difference in overall SUS scores between both platforms (p=0.14). However, when compared within and between genders, females scored significantly higher in the DB than HMD (p=0.02) and higher than males’ DB SUS scores (p=0.03). Conclusion: The overall usability of HMD was comparable with the DB platform for learning human anatomy. Although most participants prefer to use the HMD, further exploration of why females prefer the DB is needed. Subsequently, VR application developers must consider gender-related adaptions to promote the equitability and inclusivity of the technology for all users. Keywords: Human Anatomy, Virtual Reality, Head-mounted Display, Desktop-based Application, Usability, Preference