Effect of immersive virtual reality-based cognitive remediation in patients with mood or psychosis spectrum disorders: study protocol for a randomized, controlled, double-blinded trial.

BACKGROUND: Cognitive impairments are prevalent across mood disorders and psychosis spectrum disorders, but there is a lack of real-life-like cognitive training programmes. Fully immersive virtual reality has the potential to ensure motivating and engaging cognitive training directly relevant to patients' daily lives. We will examine the effect of a 4-week, intensive virtual reality-based cognitive remediation programme involving daily life challenges on cognition and daily life functioning in patients with mood disorders or psychosis spectrum disorders and explore the neuronal underpinnings of potential treatment efficacy. METHODS: The trial has a randomized, controlled, double-blinded, parallel-group design. We will include 66 symptomatically stable outpatients with mood disorders or psychosis spectrum disorders aged 18-55 years with objective and subjective cognitive impairment. Assessments encompassing a virtual reality test of daily life cognitive skills, neuropsychological testing, measures of daily life functioning, symptom ratings, questionnaires on subjective cognitive complaints, and quality of life are carried out at baseline, after the end of 4 weeks of treatment and at a 3-month follow-up after treatment completion. Functional magnetic resonance imaging scans are performed at baseline and at the end of treatment. The primary outcome is a broad cognitive composite score comprising five subtasks on a novel ecologically valid virtual reality test of daily life cognitive functions. Two complete data sets for 54 patients will provide a power of 80% to detect a clinically relevant between-group difference in the primary outcome. Behavioural data will be analysed using linear mixed models in SPSS, while MRI data will be analysed with the FMRIB Expert Analysis Tool (FEAT). Treatment-related changes in neural activity from baseline to end of treatment will be investigated for the dorsal prefrontal cortex and hippocampus as the regions of interest. DISCUSSION: The results will provide insight into whether virtual reality-based cognitive remediation has beneficial effects on cognition and functioning in symptomatically stable patients with mood disorders or psychosis spectrum disorders, which can aid future treatment development. TRIAL REGISTRATION: ClinicalTrials.gov NCT06038955. Registered on September 15, 2023.

Experiencing herd immunity in virtual reality increases COVID-19 vaccination intention: Evidence from a large-scale field intervention study.

This study investigates the impact of an immersive virtual reality (VR) simulation of herd immunity on vaccination intentions and its potential underlying mechanisms. In this preregistered field study, N = 654 participants were randomly assigned to one of the three VR conditions: (1) Gamified Herd Immunity; (2) Gamified Herd Immunity + Empathy (with additional narrative elements); (3) Control (gamified with no vaccination-related content). In the Gamified Herd Immunity simulation, participants embodied a vulnerable person and navigated a wedding venue trying to avoid getting infected. A total of 455 participants with below maximum intentions to take a novel vaccine and without severe cybersickness were analyzed. The Gamified Herd Immunity + Empathy and the Gamified Herd Immunity conditions increased vaccination intentions by 6.68 and 7.06 points on a 0-100 scale, respectively, compared to 1.91 for the Control condition. The Gamified Herd Immunity + Empathy condition enhanced empathy significantly more than the Gamified Herd Immunity condition but did not result in higher vaccination intentions. Experienced presence was related to the change in vaccination intentions. The results suggest that VR vaccination communication can effectively increase vaccination intentions; the effect is not solely due to the technological novelty and does not depend on empathy.

A randomized trial testing the effectiveness of virtual reality as a tool for pro-environmental dietary change.

This study investigates the impact of an efficacy-focused virtual reality (VR) intervention designed according to instructional design principles on eating behavior. In the preregistered intervention study, psychology students were randomly assigned to nine seminar blocks. Employing parallel design, they were allocated to either a VR intervention to experience the environmental impact of food behavior (1) and alter the future by revising food choices (2) or to a passive control condition. The data from 123 participants (78% female, mean age 25.03, SD = 6.4) were analyzed to investigate the effect of the VR intervention on dietary footprint measured from 1 week before to 1 week after the intervention. The VR intervention decreased individual dietary footprints (d = 0.4) significantly more than the control condition. Similarly, the VR condition increased response efficacy and knowledge to a larger extent compared to the control. For knowledge, the effect persisted for 1 week. The VR intervention had no impact on intentions, self-efficacy, or psychological distance. Additional manipulation of normative feedback enhanced self-efficacy; however, manipulation of geographical framing did not influence psychological distance. This research received no financial support from any funding agency and was registered on 15/09/2021 at Open Science Foundation with the number https://doi.org/10.17605/OSF.IO/2AXF3 .

Immersive virtual reality in STEM: is IVR an effective learning medium and does adding self-explanation after a lesson improve learning outcomes?

The goal of the current study was to investigate the effects of an immersive virtual reality (IVR) science simulation on learning in a higher educational setting, and to assess whether using self-explanation has benefits for knowledge gain. A sample of 79 undergraduate biology students (40 females, 37 males, 2 non-binary) learned about next-generation sequencing using an IVR simulation that lasted approximately 45 min. Students were randomly assigned to one of two instructional conditions: self-explanation (n = 41) or control (n = 38). The self-explanation group engaged in a 10 min written self-explanation task after the IVR biology lesson, while the control group rested. The results revealed that the IVR simulation led to a significant increase in knowledge from the pre- to post-test (ß Posterior = 3.29). There were no differences between the self-explanation and control groups on knowledge gain, procedural, or conceptual transfer. Finally, the results indicate that the self-explanation group reported significantly higher intrinsic cognitive load (ß Posterior = .35), and extraneous cognitive load (ß Posterior = .37), and significantly lower germane load (ß Posterior = - .38) than the control group. The results suggest that the IVR lesson was effective for learning, but adding a written self-explanation task did not increase learning after a long IVR lesson.

Factors influencing UK residents' preferences in how psychologists present themselves online: a conjoint analysis during the early months of the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has led to a surge in mental health issues in the UK and worldwide, yet many UK residents have not received the help they have needed. Earlier research has indicated that accommodating client preferences leads to better therapeutic outcomes, however, little is known about preferences in how psychologists present themselves online and what might facilitate or slow help-seeking individuals' decision about whom to seek help from. Based on literature suggesting personal branding as an effective way for clients to choose between psychologists, we sought to investigate UK residents' preferences for specialization and self-disclosure in online presentations of psychologists based on level of fear of COVID-19 and diagnostic status. METHODS: A sample of 187 UK residents were surveyed mid-April 2020 and analyzed using a rating-based conjoint analysis with a fractional factorial design consisting of 22 profiles. Each profile consisted of six attributes (Years of experience, area of expertise, gender, self-disclosure, training institution and facial trustworthiness). Analyses of variance (ANOVA) were used to explore preferences for area of expertise and self-disclosure depending on fear of COVID-19. An independent sample t-test was done to explore preference for self-disclosure among diagnosed residents. RESULTS: The conjoint model yielded a good fit (Kendall's tau = .90, p < .001). Relative importance scores (RI) were highest for years of experience (RI = 28.84) and area of expertise (RI = 22.78). Residents with a high fear of COVID-19 preferred psychologists specialized in anxiety disorders and fear (also fear of COVID-19) more than residents with a low fear of COVID-19 (MD = .92, 95% CI = [.198, 1.64], p = .013). Residents with a high fear of COVID-19 also preferred self-disclosing psychologists more than residents with a low fear of COVID-19 (MD = 1.05, 95% CI = [.184, 1.92], p = .013). Diagnostic status was not associated with preference for self-disclosure. CONCLUSIONS: Listing de facto specialization in psychologist profiles might facilitate prospective clients' decision-making process. Self-disclosure appears to be important for some clients, but more research is warranted.

Benefits of Taking a Virtual Field Trip in Immersive Virtual Reality: Evidence for the Immersion Principle in Multimedia Learning.

This study describes and investigates the immersion principle in multimedia learning. A sample of 102 middle school students took a virtual field trip to Greenland via a head mounted display (HMD) or a 2D video as an introductory lesson within a 6-lesson inquiry-based climate change intervention. The HMD group scored significantly higher than the video group on presence (d = 1.43), enjoyment (d = 1.10), interest (d = .57), and retention in an immediate (d = .61) and delayed posttest (d = .70). A structural equation model indicated that enjoyment mediated the pathway from instructional media to immediate posttest, and interest mediated the pathway from instructional media to delayed posttest score, indicating that these factors may play different roles in the learning process with immersive media. This work contributes to the cognitive affective model of immersive learning, and suggests that immersive lessons can have positive longitudinal effects for learning.

Virtual reality reduces COVID-19 vaccine hesitancy in the wild: a randomized trial.

Vaccine hesitancy poses one of the largest threats to global health. Informing people about the collective benefit of vaccination has great potential in increasing vaccination intentions. This research investigates the potential for engaging experiences in immersive virtual reality (VR) to strengthen participants' understanding of community immunity, and therefore, their intention to get vaccinated. In a pre-registered lab-in-the-field intervention study, participants were recruited in a public park (tested: [Formula: see text], analyzed: [Formula: see text]). They were randomly assigned to experience the collective benefit of community immunity in a gamified immersive virtual reality environment ([Formula: see text] of sample), or to receive the same information via text and images ([Formula: see text] of sample). Before and after the intervention, participants indicated their intention to take up a hypothetical vaccine for a new COVID-19 strain (0-100 scale) and belief in vaccination as a collective responsibility (1-7 scale). The study employs a crossover design (participants later received a second treatment), but the primary outcome is the effect of the first treatment on vaccination intention. After the VR treatment, for participants with less-than-maximal vaccination intention, intention increases by 9.3 points (95% CI: 7.0 to [Formula: see text]). The text-and-image treatment raises vaccination intention by 3.3 points (difference in effects: 5.8, 95% CI: 2.0 to [Formula: see text]). The VR treatment also increases collective responsibility by 0.82 points (95% CI: 0.37 to [Formula: see text]). The results suggest that VR interventions are an effective tool for boosting vaccination intention, and that they can be applied "in the wild"-providing a complementary method for vaccine advocacy.

A self-administered virtual reality intervention increases COVID-19 vaccination intention.

Effective interventions for increasing people's intention to get vaccinated are crucial for global health, especially considering COVID-19. We devised a novel intervention using virtual reality (VR) consisting of a consultation with a general practitioner for communicating the benefits of COVID-19 vaccination and, in turn, increasing the intention to get vaccinated against COVID-19. We conducted a preregistered online experiment with a 2×2 between-participant design. People with eligible VR headsets were invited to install our experimental application and complete the ten minute virtual consultation study at their own discretion. Participants were randomly assigned across two age conditions (young or old self-body) and two communication conditions (with provision of personal benefit of vaccination only, or collective and personal benefit). The primary outcome was vaccination intention (score range 1-100) measured three times: immediately before and after the study, as well as one week later. Five-hundred-and-seven adults not vaccinated against COVID-19 were recruited. Among the 282 participants with imperfect vaccination intentions (<100), the VR intervention increased pre-to-post vaccination intentions across intervention conditions (mean difference 8.6, 95% CI 6.1 to 11.1,p<0.0001). The pre-to-post difference significantly correlated with the vaccination intention one week later, ρ=0.20,p<0.0001. The VR intervention was effective in increasing COVID-19 vaccination intentions both when only personal benefits and personal and collective benefits of vaccination were communicated, with significant retention one week after the intervention. Utilizing recent evidence from health psychology and embodiment research to develop immersive environments with customized and salient communication efforts could therefore be an effective tool to complement public health campaigns.

The Validation and Further Development of the Multidimensional Cognitive Load Scale for Physical and Online Lectures (MCLS-POL).

Cognitive load theory (CLT) has been widely used to help understand the process of learning and to design teaching interventions. The Cognitive Load Scale (CLS) developed by Leppink and colleagues has emerged as one of the most validated and widely used self-report measures of intrinsic load (IL), extraneous load (EL), and germane load (GL). In this paper we investigated an expansion of the CLS by using a multidimensional conceptualization of the EL construct that is relevant for physical and online teaching environments. The Multidimensional Cognitive Load Scale for Physical and Online Lectures (MCLS-POL) goes beyond the CLS's operationalization of EL by expanding the EL component which originally included factors related to instructions/explanations with sub-dimensions including EL stemming from noises, and EL stemming from both media and devices within the environment. Through three studies, we investigated the reliability, and internal and external validity of the MCLS-POL using the Partial Credit Model, Confirmatory Factor Analysis, and differences between students either attending a lecture physically or online (Study 2 and 3). The results of Study 1 (N = 250) provide initial evidence for the validity and reliability of the MCLS-POL within a higher education sample, but also highlighted several potential improvements which could be made to the measure. These changes were made before re-evaluating the validity and reliability of the measure in a new sample of higher education psychology students (N = 140, Study 2), and psychological testing students (N = 119, Study 3). Together the studies provide evidence for a multidimensional conceptualization cognitive load and provide evidence of the validity, reliability, and sensitivity of the MCLS-POL and provide suggestions for future research directions.

A Rasch-based validity study of the Harvard Trauma Questionnaire.

BACKGROUND: The Harvard Trauma Questionnaire (HTQ) is the predominant questionnaire for assessing PTSD in trauma-affected refugees. Although the scale is increasingly used for measuring treatment outcomes, it has never been specifically validated for such use. The current study does so by testing the HTQ with the Rasch model. METHODS: The analysis is based on 641 Arabic and Persian speaking refugees, diagnosed with PTSD and undergoing psychiatric treatment in Denmark. The responses were tested against the assumptions of the Rasch model, including unidimensionality, local independence and the absence of differential item function across subgroups. RESULTS: Results reveal two subscales that, when accounting for local dependence and differential item functioning, meet criteria for the Rasch model in the included samples: An arousal/intrusion subscale and an avoidance/numbing subscale. LIMITATIONS: The included sample was highly chronic and suffered from major depressive disorder. Results may not be fully representative of less chronic populations, e.g. recently arrived refugees. CONCLUSIONS: We recommend the use of the arousal/intrusion subscale and the avoidance/numbing subscale as an optimized way of summarizing responses to the HTQ, which remains simple to administer while effectively summarizing all the information available in the scores.

Assessing the Influence of Visual-Taste Congruency on Perceived Sweetness and Product Liking in Immersive VR.

This study was designed to assess whether the combined effect of taste-congruent and incongruent extrinsic visual cues presented in virtual reality (VR) influences the perception of sweetness and product liking. Three VR environments (sweet-congruent, sweet-incongruent, and neutral) were created based on the evidence in existing literature. Participants tasted the same beverage in three VR environments and evaluated the environment and beverage liking, as well as perceived taste intensity (sweetness, sourness, and bitterness), congruency, comfort, and environment vividness. Frontal EEG alpha asymmetry (FAA) was also recorded as a complementary physiological measurement of overall liking. The results showed that the perceived sweetness of the beverage was significantly elevated in a sweet-congruent environment versus the other environments. Visual-taste congruency did not seem to have an effect on beverage liking and overall liking, whereas an increase in environment liking was found in the incongruent environment versus the other environments. These findings confirmed the significant influence of taste-specific visual cues on flavour perception, while the successful use of VR in the study provided insight into future applications of taste-specific VR environment in the modulation of flavour perception and sugar reduction.

Equivalence of using a desktop virtual reality science simulation at home and in class.

The use of virtual laboratories is growing as companies and educational institutions try to expand their reach, cut costs, increase student understanding, and provide more accessible hands on training for future scientists. Many new higher education initiatives outsource lab activities so students now perform them online in a virtual environment rather than in a classroom setting, thereby saving time and money while increasing accessibility. In this paper we explored whether the learning and motivational outcomes of interacting with a desktop virtual reality (VR) science lab simulation on the internet at home are equivalent to interacting with the same simulation in class with teacher supervision. A sample of 112 (76 female) university biology students participated in a between-subjects experimental design, in which participants learned at home or in class from the same virtual laboratory simulation on the topic of microbiology. The home and classroom groups did not differ significantly on post-test learning outcome scores, or on self-report measures of intrinsic motivation or self-efficacy. Furthermore, these conclusions remained after accounting for prior knowledge or goal orientation. In conclusion, the results indicate that virtual simulations are learning activities that students can engage in just as effectively outside of the classroom environment.

A Multilevel Investigation of Resiliency Scales for Children and Adolescents: The Relationships Between Self-Perceived Emotion Regulation, Vagally Mediated Heart Rate Variability, and Personal Factors Associated With Resilience.

Personal resiliency refers to individual attributes that are related to the process of successfully adapting to the environment in the face of adverse conditions, also known as resilience. Emotion regulation is increasingly found as a core component in mental health and found to modulate individual differences in the management of emotional responses. The Resiliency Scales for Children and Adolescents (RSCA; Prince-Embury, 2006, 2007) were designed to systematically identify and quantify core personal qualities of resiliency in youth, and includes Sense of Mastery scale (MAS), Sense of Relatedness scale (REL), and Emotional Reactivity (REA) scale. The following study was first conducted to confirm the Three-Factor model of Personal Resiliency in a Norwegian student sample using factor analytic procedures. Secondly and the main purpose of the study, was to investigate if personal resiliency is associated with self-reported measures related to emotion regulation, and with resting vagally mediated heart rate variability (vmHRV) as a psychophysiological index of emotion regulation capacity. A revised scale adapted to the Norwegian sample was developed. Results indicate that protective indices related to personal resiliency are associated with both self-reported adaptive emotion regulation and outcome, and partly related to high capacity for emotion regulation indicated by vmHRV. Risk related to personal vulnerability was associated with maladaptive emotion regulation and outcome, but was not associated with emotion regulation capacity. Together the findings provide supporting evidence of both self-reported and psychophysiological correlates between emotion regulatory processes and personal resiliency indicated by RSCA.

Cross-Cultural Psychometric Properties of the Hamilton Depression Rating Scale.

OBJECTIVE: The Hamilton Depression Rating Scale (HDRS) is considered the gold standard measure of depression. The factor structure of the HDRS is generally unstable, but 4 to 8 items appear to form a general depression factor. As transcultural studies of the HDRS have received little attention, and as most of the studies have taken a data-driven approach with a tendency to yield fragmented results, it is not clear if an HDRS general depression factor can also be found in non-Western populations. This is an important issue in deciding on the appropriateness of the scale as a gold standard in transcultural psychiatry. METHOD: A systematic review was carried out to compare previously reported factor structures of the HDRS in non-Western cultures. Overlapping clusters across studies were identified and subsequently tested with confirmatory factor analysis (CFA) of responses from an independent sample. RESULTS: Fourteen relevant studies were identified, 12 of which were obtained. A general depression factor was identified, consisting of the following symptoms: depressed mood, guilt, loss of interests, retardation, suicide, and psychological anxiety. The subsequent CFA analysis supported the fit of this model. CONCLUSIONS: This study indicates that a general depression cluster is manifest in responses to the HDRS across cultures. While psychometric properties of the full-length HDRS are still debated, the general depression cluster appears pertinent to the assessment of depression across cultures. We recommend that cross-cultural clinicians and researchers focus on the use of unidimensional depression scales, which are in agreement with this cluster.

Virtual Learning Simulations in High School: Effects on Cognitive and Non-cognitive Outcomes and Implications on the Development of STEM Academic and Career Choice.

The present study compared the value of using a virtual learning simulation compared to traditional lessons on the topic of evolution, and investigated if the virtual learning simulation could serve as a catalyst for STEM academic and career development, based on social cognitive career theory. The investigation was conducted using a crossover repeated measures design based on a sample of 128 high school biology/biotech students. The results showed that the virtual learning simulation increased knowledge of evolution significantly, compared to the traditional lesson. No significant differences between the simulation and lesson were found in their ability to increase the non-cognitive measures. Both interventions increased self-efficacy significantly, and none of them had a significant effect on motivation. In addition, the results showed that the simulation increased interest in biology related tasks, but not outcome expectations. The findings suggest that virtual learning simulations are at least as efficient in enhancing learning and self-efficacy as traditional lessons, and high schools can thus use them as supplementary educational methods. In addition, the findings indicate that virtual learning simulations may be a useful tool in enhancing student's interest in and goals toward STEM related careers.

Critical Values for Yen's Q3: Identification of Local Dependence in the Rasch Model Using Residual Correlations.

The assumption of local independence is central to all item response theory (IRT) models. Violations can lead to inflated estimates of reliability and problems with construct validity. For the most widely used fit statistic Q3, there are currently no well-documented suggestions of the critical values which should be used to indicate local dependence (LD), and for this reason, a variety of arbitrary rules of thumb are used. In this study, an empirical data example and Monte Carlo simulation were used to investigate the different factors that can influence the null distribution of residual correlations, with the objective of proposing guidelines that researchers and practitioners can follow when making decisions about LD during scale development and validation. A parametric bootstrapping procedure should be implemented in each separate situation to obtain the critical value of LD applicable to the data set, and provide example critical values for a number of data structure situations. The results show that for the Q3 fit statistic, no single critical value is appropriate for all situations, as the percentiles in the empirical null distribution are influenced by the number of items, the sample size, and the number of response categories. Furthermore, the results show that LD should be considered relative to the average observed residual correlation, rather than to a uniform value, as this results in more stable percentiles for the null distribution of an adjusted fit statistic.

Psychometric analysis of the Patient Health Questionnaire in Danish patients with an implantable cardioverter defibrillator (The DEFIB-WOMEN study).

OBJECTIVE: To assess the psychometric properties of the Patient Health Questionnaire (PHQ-9), a measure of depressive symptoms, in a large Danish national cohort of patients with heart disease, implanted with an implantable cardioverter defibrillator (ICD), using item response theory. METHODS: A prospective cohort of patients implanted with an ICD (n=1531; 80.4% men) completed the PHQ-9 at the time of implant. Data were analyzed using two item response theory models, the partial credit model and the generalized partial credit model. RESULTS: The analysis showed disordered response thresholds in eight of nine items for the partial credit model and five of nine items for the generalized partial credit model, indicating that respondents have difficulty discriminating between response options. When collapsing response options 2 and 3, the rescored PHQ-9 had a better fit to both models. The unidimensionality and the precision of the rescored PHQ-9 were confirmed. Items did not have any differential functioning (DIF) across educational level, age, indication for ICD implantation, and severity of heart failure that influence depression outcomes in patients with an ICD. One item exhibited DIF by gender. Three items did not fit the partial credit model, but the generalized partial credit model could be fitted to the full item set. CONCLUSION: The unidimensionality and reliability of the Danish version of the PHQ-9 were confirmed. However, the associated consequences of the number of response options (3-point versus 4-point Likert scale) need to be further examined for the PHQ-9 both as a screening tool and outcome measure.

The latent structure of post-traumatic stress disorder among Arabic-speaking refugees receiving psychiatric treatment in Denmark.

BACKGROUND: Refugees are known to have high rates of post-traumatic stress disorder (PTSD). Although recent years have seen an increase in the number of refugees from Arabic speaking countries in the Middle East, no study so far has validated the construct of PTSD in an Arabic speaking sample of refugees. METHODS: Responses to the Harvard Trauma Questionnaire (HTQ) were obtained from 409 Arabic-speaking refugees diagnosed with PTSD and undergoing treatment in Denmark. Confirmatory factor analysis was used to test and compare five alternative models. RESULTS: All four- and five-factor models provided sufficient fit indices. However, a combination of excessively small clusters, and a case of mistranslation in the official Arabic translation of the HTQ, rendered results two of the models inadmissible. A post hoc analysis revealed that a simpler factor structure is supported, once local dependence is addressed. CONCLUSIONS: Overall, the construct of PTSD is supported in this sample of Arabic-speaking refugees. Apart from pursuing maximum fit, future studies may wish to test simpler, potentially more stable models, which allow a more informative analysis of individual items.

Virtual Simulations as Preparation for Lab Exercises: Assessing Learning of Key Laboratory Skills in Microbiology and Improvement of Essential Non-Cognitive Skills.

OBJECTIVE: To investigate if a virtual laboratory simulation (vLAB) could be used to replace a face to face tutorial (demonstration) to prepare students for a laboratory exercise in microbiology. METHODS: A total of 189 students who were participating in an undergraduate biology course were randomly selected into a vLAB or demonstration condition. In the vLAB condition students could use a vLAB at home to 'practice' streaking out bacteria on agar plates in a virtual environment. In the demonstration condition students were given a live demonstration from a lab tutor showing them how to streak out bacteria on agar plates. All students were blindly assessed on their ability to perform the streaking technique in the physical lab, and were administered a pre and post-test to determine their knowledge of microbiology, intrinsic motivation to study microbiology, and self-efficacy in the field of microbiology prior to, and after the experiment. RESULTS: The results showed that there were no significant differences between the two groups on their lab scores, and both groups had similar increases in knowledge of microbiology, intrinsic motivation to study microbiology, as well as self-efficacy in the field of microbiology. CONCLUSION: Our data show that vLABs function just as well as face to face tutorials in preparing students for a physical lab activity in microbiology. The results imply that vLABs could be used instead of face to face tutorials, and a combination of virtual and physical lab exercises could be the future of science education.