Lay Summary

Can virtual reality help us understand bias and discrimination in healthcare?

Written by: Zoe Chui, Helen Welsh, Rebecca Rhead, Lucia Valmaggia, Juliana Onwumere, Lucy Ensum, Stephani Hatch, and the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) study team

What is this study about?

Healthcare practitioners sometimes make decisions influenced by unconscious bias or assumptions about patients’ characteristics such as race, gender, or migration status. These biases can affect the care patients receive and contribute to health inequalities. Traditional research methods like surveys, written scenarios, and role-play don’t fully capture real-world interactions and are often expensive or difficult to scale.

This study explores the use of virtual reality (VR) to create realistic clinical encounters. In VR, healthcare staff can interact with patients of different backgrounds in a controlled, immersive, and interactive environment. VR allows researchers to study bias and discrimination safely while standardising patient behaviour and the clinical setting.

How did we do the study?

Researchers at King’s College London invited 35 healthcare practitioners from 14 NHS Trusts, including nurses, doctors, and allied health professionals, to take part in VR sessions. Participants used Oculus Quest headsets to conduct short, simulated consultations with three virtual patients, each designed with different social identities, including race, gender, and migration status.

Participants assessed patients, made treatment recommendations using a virtual dictaphone, and completed surveys on the realism, usability, and immersion of the VR experience. Researchers collected both numerical ratings and written feedback.

What did we find?

Realism and immersion

Most participants found the VR simulation realistic and engaging. Nearly half said it closely reflected real-world consultations, and most felt fully immersed, noticing little of their actual surroundings during the task.

Technical usability

Participants reported that the VR system was easy to use, with clear instructions and minimal technical problems. Some minor issues arose when recording treatment decisions or navigating question prompts, but these were quickly resolved.

Content and learning potential

Participants felt the consultation questions were clinically relevant and comprehensive. However, some noted that fixed response options limited natural dialogue and empathetic engagement. Suggestions for improvement included more flexible dialogue paths, extra clinical information, and patient scenarios better matched to practitioners’ expertise.

Why is this important?

This study shows that VR can provide a realistic, safe, and scalable platform for exploring bias and discrimination in healthcare. Unlike traditional methods, VR can simulate complex patient interactions while keeping social and technical aspects consistent. VR also allows participants to interact with patients who have multiple intersecting identities, helping practitioners understand how bias can influence clinical decisions and supporting fairer care.

What can I do with this?

I am a policy maker: Use these findings to support VR-based training programs that help healthcare staff recognise and reduce bias, promoting equitable care.

I am NHS staff: VR simulations can help you reflect on your own decision-making and develop skills in empathy and fair treatment of patients.

I am an NHS staff manager: Introduce VR-based learning to complement traditional training, and support staff in understanding how bias can influence clinical decisions.

I am a researcher: Explore VR as a tool for studying bias across multiple social identities and develop interventions to improve equitable healthcare delivery.

I am a student: Reference this study when learning about healthcare inequalities, bias, or VR in education.

I am a member of the general public: Share this summary to raise awareness about how healthcare practitioners’ decisions can be affected by bias, and how VR can help improve fairness in patient care.

Ethics and funding: This study was approved by King’s College London Research Ethics Committee and the NHS Health Research Authority. It was funded by the Wellcome Trust and the Economic and Social Research Council, with additional support for some authors from the NIHR Biomedical Research Centre.

Acknowledgements: We thank our clinical and technical collaborators, the VR Research Lab, Empathetic Media, and the participants for making this research possible.

Read the paper: