Chapter 4 84 were taken back to the training location of the Stadtpolizei Zürich where the VirTra training simulator was located. The eight participants were split into pairs. The VirTra instructors took the first pair into the training simulator to complete the training. After the VirTra scenarios were completed, the participants received feedback on their performance while still in the system (∼5 min). When the first pair finished their VirTra training, the second pair started to train. In the meantime, the first pair returned their heart rate belts and filled in the visual analogue scales and the ITC-SOPI questionnaire using iPads at the VirTra training location. This sequence was completed until all eight participants had finished the VirTra training and filled in the questionnaires. (During their waiting time, participants were given the opportunity to train medical first aid skills at various pre-prepared stations). To ensure that participant groups could not observe each other perform during the training in VR and VirTra, the training areas were set up in such a way that the participant groups who waited to perform the trainings were in a preparation room that was separated from the execution areas. Statistical analysis 2 (training simulator: VR, VirTra) × 2 (pain stimulus: with, without) ANOVAs were performed with training simulator as the within-subjects factor and pain stimulus as the between-subjects factor. The 2 × 2 ANOVAs were performed on average heart rate (BPM), maximum heart rate (BPM), mental effort scores, perceived stress scores, and scores for spatial presence, engagement, ecological validity, and negative effects. p-Values of <0.05 were considered statistically significant. Partial eta squared was calculated as an estimate for effect size. A value of ηp 2 = 0.01 indicated a small effect size, a value of η p 2 = 0.06 indicated a medium effect size, and value of ηp 2 = 0.14 indicated a large effect size (Cohen, 1969). All statistical analyses were performed using IBM SPSS, version 27. RESULTS Mixed design ANOVAs were conducted to assess the impact of a pain stimulus on participants’ training responses (heart rate, mental effort, perceived stress) and sense of presence (spatial presence, engagement, ecological validity, negative effects) during the training with virtual training simulators (VR and VirTra). Descriptive statistics are presented in Table 4.1. For reasons of readability in this section, we only discuss statistically significant results and present full statistics of all measures in Table 4.2.
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