Virtual Reality and Lived-Experience Speakers in Homelessness Education: A Mixed-Methods Study of Medical Sciences Students' Empathy and Attitudes Toward People Experiencing Homelessness

The Potential of Virtual Reality in Fostering Empathy Towards People Experiencing Homelessness

The goal of this study is to learn whether a virtual reality experience about homelessness, used together with talks from people with lived experience of homelessness, can improve empathy and attitudes toward people experiencing homelessness in undergraduate medical sciences students. The main questions it aims to answer are:

• Do students who complete a virtual reality experience before hearing from lived-experience speakers show greater improvement in attitudes toward people experiencing homelessness than students who hear from the speakers without prior virtual reality exposure?
• Do students who complete a virtual reality experience before hearing from lived-experience speakers report greater engagement with the speaker talks than students who hear from the speakers without prior virtual reality exposure?
• How do students describe the distinct value of virtual reality and lived-experience speakers in supporting empathy development and understanding of homelessness?
• How does the order of virtual reality and lived-experience speaker activities influence student learning?

The study hypothesis was that students who completed the virtual reality experience before hearing from the lived-experience speakers would show greater improvement in attitudes toward people experiencing homelessness, as measured by the Attitudes Toward Homelessness Inventory and the Health Professionals' Attitudes Toward the Homeless Inventory, than students who heard from the speakers without prior virtual reality exposure. The study also hypothesized that students who completed the virtual reality experience first would report greater engagement with the lived-experience speaker talks.

Researchers compared two groups of undergraduate medical sciences students. One group completed the virtual reality experience before hearing from guest speakers with lived experience of homelessness. The other group heard from the guest speakers first and completed the virtual reality experience after the post-intervention survey. Researchers compared the groups to see whether completing virtual reality before the speaker session led to greater changes in students' empathy, perspective-taking, and attitudes toward people experiencing homelessness. Participants completed online surveys before and after the educational sessions.

Students were invited to take part in focus group discussions about the virtual reality experience, guest speakers, empathy, and learning

Study Overview

• Status: Completed
• Conditions: Education; Education, Medical, Undergraduate; Empathy Towards People Experiencing Homelessness
• Intervention / Treatment: Behavioral: We Live Here virtual reality homelessness perspective-taking simulation; Behavioral: Lived-experience speaker session on homelessness

Detailed Description

This mixed-methods educational intervention study examined whether a perspective-taking virtual reality simulation could complement lived-experience teaching about homelessness in an undergraduate medical sciences course. The study was conducted at Western University in London, Ontario, Canada, with students enrolled in two sections of a community-engaged learning course. The course was selected because many students in the program intend to pursue careers in healthcare or related health professions.

Participants were recruited from two course sections. Students self-enrolled into course sections, and one section was randomly assigned to complete the virtual reality intervention before a lived-experience speaker session. The other section heard from the lived-experience speakers without prior virtual reality exposure. The virtual reality intervention was We Live Here, an immersive simulation in which users take the perspective of a person experiencing homelessness. The lived-experience teaching session involved guest speakers who shared personal experiences of homelessness and responded to student questions.

All participants completed a baseline survey at the beginning of the academic term. The baseline survey included validated measures of empathic concern, perspective-taking, and attitudes toward people experiencing homelessness. Three weeks later, one group completed the virtual reality simulation. One week after that, both groups attended the lived-experience speaker session. After the speaker session, both groups completed a post-intervention survey that repeated the attitude measures and included short-answer questions about how the educational activities affected their understanding of homelessness. The comparison group completed the virtual reality simulation after the post-intervention survey so that all students had access to the same educational experience.

The quantitative component compared pre- to post-intervention changes in attitudes toward people experiencing homelessness between students who completed virtual reality before the speaker session and students who heard from the speakers without prior virtual reality exposure. The primary hypothesis was that students who completed virtual reality before hearing from lived-experience speakers would show greater improvement in attitudes toward people experiencing homelessness and would report greater engagement with the speaker session. Survey responses were analyzed using Bayesian ordinal multilevel models to account for repeated responses by participant and variation across survey items.

The qualitative component was designed to help explain and extend the survey findings. Short-answer survey responses and focus group discussions were analyzed using inductive thematic analysis. Focus groups were organized by intervention sequence to explore how students perceived the distinct contributions of virtual reality and lived-experience speakers, and whether the order of these activities influenced empathy development, perspective-taking, engagement, and understanding of homelessness.

The study was approved by the Western University Research Ethics Board. Informed consent was obtained from all participants.

• Study Type: Interventional
• Enrollment (Actual): 74
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • London, Ontario, Canada
      • University of Western Ontario

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Students must be enrolled in MedSci 4995E and be able to put on and experience the VR simulation.

Exclusion Criteria:

• Students with visual/audio impairments may not be able to participate in the VR experience.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: VR Before Lived-Experience Speakers; Participants in this arm completed the We Live Here virtual reality simulation before attending the lived-experience speaker session. The simulation placed students in the perspective of a person experiencing homelessness and was intended to provide an immersive introduction to the topic. One week later, participants heard from guest speakers with lived experience of homelessness. Participants completed baseline and post-intervention surveys assessing empathy, perspective-taking, and attitudes toward people experiencing homelessness, and were invited to participate in focus group discussions.	Behavioral: We Live Here virtual reality homelessness perspective-taking simulation; Participants completed We Live Here, an immersive virtual reality simulation designed to support perspective-taking about homelessness. The simulation was created in collaboration with a person with lived experience of homelessness and places the user in the perspective of "Rocky," a woman experiencing homelessness. The experience begins with a voiceover describing how Rocky came to experience homelessness after job loss. Participants are then placed inside her tent during a police operation at an encampment and are asked to interact with personal items, such as photographs, a radio, and a music box, that provide information about Rocky's life, relationships, memories, and sense of home. The simulation is intended to help students visualize and emotionally engage with the circumstances, losses, and human experiences associated with homelessness before or after hearing from lived-experience speakers.; Behavioral: Lived-experience speaker session on homelessness; Participants attended a classroom-based session with guest speakers who had lived experience of homelessness. The speakers shared personal narratives about how they came to experience homelessness, the challenges and barriers they faced, how they were treated while experiencing homelessness, and their experiences with housing, education, stigma, and support systems. Students had the opportunity to listen to the speakers' stories and ask questions. The session was intended to deepen students' understanding of homelessness, challenge misconceptions, and support empathy toward people experiencing homelessness.
Active Comparator: Speaker Session With Delayed VR Exposure; Participants in this arm attended the lived-experience speaker session without prior exposure to the We Live Here virtual reality simulation. The speaker session included guest speakers who shared personal experiences of homelessness and responded to student questions. Participants completed baseline and post-intervention surveys assessing empathy, perspective-taking, and attitudes toward people experiencing homelessness. After the post-intervention survey, participants completed the We Live Here virtual reality simulation as delayed exposure, so that all students had access to the same educational activity. Participants were also invited to participate in focus group discussions.	Behavioral: We Live Here virtual reality homelessness perspective-taking simulation; Participants completed We Live Here, an immersive virtual reality simulation designed to support perspective-taking about homelessness. The simulation was created in collaboration with a person with lived experience of homelessness and places the user in the perspective of "Rocky," a woman experiencing homelessness. The experience begins with a voiceover describing how Rocky came to experience homelessness after job loss. Participants are then placed inside her tent during a police operation at an encampment and are asked to interact with personal items, such as photographs, a radio, and a music box, that provide information about Rocky's life, relationships, memories, and sense of home. The simulation is intended to help students visualize and emotionally engage with the circumstances, losses, and human experiences associated with homelessness before or after hearing from lived-experience speakers.; Behavioral: Lived-experience speaker session on homelessness; Participants attended a classroom-based session with guest speakers who had lived experience of homelessness. The speakers shared personal narratives about how they came to experience homelessness, the challenges and barriers they faced, how they were treated while experiencing homelessness, and their experiences with housing, education, stigma, and support systems. Students had the opportunity to listen to the speakers' stories and ask questions. The session was intended to deepen students' understanding of homelessness, challenge misconceptions, and support empathy toward people experiencing homelessness.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in attitudes toward people experiencing homelessness	Change from baseline to post-intervention in attitudes toward people experiencing homelessness, measured using selected items from the Attitudes Toward Homelessness Inventory and the Health Professionals' Attitudes Toward the Homeless Inventory. Responses were collected on ordered Likert scales, with negatively worded items reverse-coded so that higher scores reflected more positive attitudes toward people experiencing homelessness.	Baseline and 4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Empathic concern	Empathic concern was measured at baseline using the Empathic Concern subscale of the Interpersonal Reactivity Index. Scores were used to characterize participants and examine whether empathic concern was associated with attitudes toward people experiencing homelessness.	Baseline
Perspective-taking	Perspective-taking was measured at baseline using the Perspective-Taking subscale of the Interpersonal Reactivity Index. Scores were used to characterize participants and examine whether perspective-taking was associated with attitudes toward people experiencing homelessness.	Baseline
Student-reported impact of VR on understanding speaker talks	Students in the VR-before-speaker group answered an open-ended post-intervention survey question asking whether the VR experience affected their understanding of the guest speaker talks. Responses were analyzed using inductive thematic analysis.	4 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Student-reported change in perspective toward homelessness	Focus group discussions explored students' perceptions of the distinct benefits of the VR simulation and lived-experience speaker session for empathy development, perspective-taking, engagement, and understanding of homelessness. Transcripts were analyzed using inductive thematic analysis.	Up to 6 weeks
Perceived effect of intervention order on learning	Focus group discussions explored whether students perceived the order of the VR simulation and lived-experience speaker session as influencing learning, engagement, empathy, and understanding of homelessness.	Up to 6 weeks

Collaborators and Investigators

• Sponsor: Western University

Study record dates

Study Major Dates

• Study Start (Actual): September 9, 2025
• Primary Completion (Actual): November 14, 2025
• Study Completion (Actual): November 14, 2025

Study Registration Dates

• First Submitted: July 20, 2026
• First Submitted That Met QC Criteria: July 24, 2026
• First Posted (Actual): July 27, 2026

Study Record Updates

• Last Update Posted (Actual): July 27, 2026
• Last Update Submitted That Met QC Criteria: July 24, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Education; Virtual reality; Empathy; Homelessness; Perspective-taking; Lived experience
• Other Study ID Numbers: 122903

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No