Comparing 360-degree VR Video of Local vs Overseas Environment on Psychological Health

February 25, 2026 updated by: Universiti Kebangsaan Malaysia Medical Centre

The Use Of 360-Degree VR Video For The Psychological Health Of Medical Students: Comparison Of Effectiveness Between Local And Overseas Environments

Medical students frequently experience high levels of stress, anxiety, and depression due to intense academic pressures. While spending time outdoors in nature is a proven way to reduce these negative feelings, students rarely have the time to do so. This study aims to find out if using a 360-degree Virtual Reality (VR) headset to experience immersive nature environments can provide similar relaxing benefits.

The main question this study attempts to answer is whether the type of nature environment matters: Does watching a familiar, local Malaysian nature scene reduce stress more or less effectively than watching a novel, overseas nature scene?

The researchers hypothesize that a brief, 15-minute exposure to either 360-degree VR nature environment will successfully reduce short-term feelings of stress, anxiety, and depression. Furthermore, they hypothesize that there will be a measurable difference in the psychological benefits between the local and overseas environments, driven by either the comfort of familiarity (local) or the distraction of escapism (overseas).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Background and Rationale:

Accessible, non-pharmacological interventions are increasingly necessary to support the mental wellness of university cohorts facing high academic strain. While the restorative effects of natural environments on human psychology are well-documented, physical access to such spaces is often limited in urban academic settings. 360-degree Virtual Reality (VR) offers a highly immersive, scalable alternative. By simulating spatial presence, VR can trigger physiological and psychological relaxation responses similar to actual nature exposure. However, a gap remains in the literature regarding the semantic content of the VR exposure. Specifically, it is unclear whether the therapeutic efficacy of VR nature exposure is heavily influenced by environmental familiarity (which may foster psychological safety and place attachment) versus environmental novelty (which may promote greater cognitive distraction and escapism).

Study Design and Randomization:

This protocol utilizes a randomized, parallel-group behavioral trial design. To ensure group equivalence and minimize gender as a potential confounding variable in psychological stress reporting, a custom-developed Python script will be utilized to execute stratified randomization. This algorithm ensures a strict 1:1 allocation ratio into either the active local environment arm or the active overseas environment arm, while maintaining a perfectly balanced male-to-female ratio within each experimental group.

Intervention Delivery and Statistical Plan:

Participants undergo a structured behavioral intervention consisting of immersive 360-degree VR video viewing via a head-mounted display. The protocol requires two identical exposure sessions, separated by a strict two-week interval to evaluate repeated-dose efficacy and short-term trajectory. All self-reported psychological and well-being metrics are collected at baseline, immediately post-initial exposure, and immediately post-secondary exposure. Data will be evaluated utilizing a repeated-measures analysis of variance (ANOVA). This statistical approach is specifically chosen to assess two primary effects: the main effect of time (evaluating the overall impact of the VR intervention across all participants throughout the two-week study period) and the interaction effect of time and group (determining if there is a statistically significant divergence in the trajectory of symptom reduction between the local and overseas experimental arms).

Study Type

Interventional

Enrollment (Actual)

82

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Malaysia
    • Selangor
      • Cheras, Selangor, Malaysia, 56000
        • Psychiatry Department, Hospital Canselor Tuanku Muhriz UKM

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Academic Status: Actively enrolled as a fourth-year or fifth-year undergraduate medical student at Universiti Kebangsaan Malaysia (UKM).
  • Age: 18 years of age or older (necessary for providing legal informed consent).
  • Sensory Ability: Normal or corrected-to-normal vision and hearing (the participant can wear contact lenses or glasses that comfortably fit inside the VR headset).
  • Availability: Willing and able to commit to the full 2-week study timeline, including both the baseline and follow-up VR sessions.

Exclusion Criteria:

  • VR Safety (Neurological): Personal history of epilepsy, seizure disorders, or frequent migraines, as VR screens can occasionally trigger these conditions.
  • VR Safety (Vestibular): History of severe motion sickness, vertigo, or inner ear disorders.
  • Confounding Medical Factors: Currently receiving active, formal psychiatric treatment or taking prescribed psychoactive medications (such as antidepressants or anxiolytics).
  • Physical Limitations: Severe visual or auditory impairments that would prevent full immersion in the visual and auditory elements of the VR environment.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Local VR Group
Participants assigned to this group will exclusively view the local 360-degree VR environment.
Behavioral: Local Environment 360-degree VR Video
Participants undergo a 15-minute viewing of a 360-degree local environment video via a VR headset. This session is repeated once, exactly two weeks after the initial session.
Other Names:
  • Malaysian Environment
Active Comparator: Overseas VR Group
Participants assigned to this group will exclusively view the overseas 360-degree VR environment.
Behavioral: Overseas Environment 360-Degree VR Video
Participants undergo a 15-minute viewing of a 360-degree overseas environment video via a VR headset. This session is repeated once, exactly two weeks after the initial session.
Other Names:
  • Western European Environment

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Depression, Anxiety, and Stress Severity (DASS-21)
Time Frame: Baseline (T0 - immediately before the first 15-minute intervention), Day 0 (T1 - immediately after the first intervention), and Week 2 (T2 - immediately after the second intervention).
Evaluated using the Depression, Anxiety and Stress Scale-21 Items (DASS-21). This 21-item self-report questionnaire measures the core symptoms of depression, anxiety, and stress across three 7-item subscales. Items are rated on a 4-point Likert scale. Raw subscale scores are summed and multiplied by two to calculate final subscale scores. Higher scores indicate a greater severity of negative emotional symptoms.
Baseline (T0 - immediately before the first 15-minute intervention), Day 0 (T1 - immediately after the first intervention), and Week 2 (T2 - immediately after the second intervention).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Subjective Psychological Well-Being (WHO-5)
Time Frame: Baseline (T0 - immediately before the first 15-minute intervention), Day 0 (T1 - immediately after the first intervention), and Week 2 (T2 - immediately after the second intervention).
Evaluated using the WHO-5 Well-Being Index. This 5-item self-report questionnaire measures subjective psychological well-being. Items are rated on a 6-point scale from 0 ("At no time") to 5 ("All of the time"). The raw score (ranging from 0 to 25) is multiplied by 4 to convert it to a percentage scale from 0 to 100. Higher scores reflect better subjective well-being.
Baseline (T0 - immediately before the first 15-minute intervention), Day 0 (T1 - immediately after the first intervention), and Week 2 (T2 - immediately after the second intervention).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Universiti Kebangsaan Malaysia Medical Centre

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 15, 2024

Primary Completion (Actual)

July 1, 2025

Study Completion (Actual)

August 31, 2025

Study Registration Dates

First Submitted

February 25, 2026

First Submitted That Met QC Criteria

February 25, 2026

First Posted (Actual)

March 3, 2026

Study Record Updates

Last Update Posted (Actual)

March 3, 2026

Last Update Submitted That Met QC Criteria

February 25, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • JEP-2024-039

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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