Minimal virtual reality-induced symptoms and effects in anatomy education across controller types

With the increasing adoption of virtual reality (VR) in anatomy education, understanding VR-induced symptoms and effects (VRISE) is pivotal to effective curriculum design. To compare self-reported VRISE across different VR controller types, the study included 199 responses from students aged 18-54, enrolled in visceral anatomy or neuroanatomy courses, assigned to handheld (n = 109), hand-track (n = 50), or haptic (n = 40) controller groups. Participants rated VRISE (mental stress, physical stress, and sickness) on a 5-point Likert scale, following a 5- to 10-min VR activity. Overall, VRISE scores were low (Median = 1.33, Q1-Q3 1:00-2:00), with over 85% reporting none to minimal symptoms and scores did not differ by controller type (ε²R = 0.016). Males reported significantly lower VRISE (Median = 1:00, Q1-Q3 1:00-2:00) than females (Median = 1.67, Q1-Q3 1:00-2.33) and participants identifying as "others" (Median = 2.50, Q1-Q3 1.92-3.33), indicating a gender difference in VR experience, although interpretation should be cautious due to the small "other" sample. Subgroup analyses showed no associations with age, prior VR experience, or course enrolment. However, regression modeling indicated that prior VR experience increased the odds of reporting VRISE (OR 3.09, p = 0.013), while males were less likely to report symptoms (OR 0.15, p = 0.047), suggesting user characteristics may influence VRISE risk beyond content or device factors. Neither factor was significantly associated with controller type. Overall, VR anatomy sessions were well tolerated, with minimal VRISE across handheld, hand-tracking, and haptic controllers. These findings support the safe use of diverse VR controllers in anatomy education, although targeted support may benefit some demographic groups.