Background: The use of extended reality (XR) technologies in healthcare can potentially address some of the significant resource and time constraints related to delivering training for healthcare professionals. While substantial progress in realising this potential has been made across several domains including surgery, anatomy, and rehabilitation, the implementation of XR in mental health training, where nuanced humanistic interactions are central, has lagged. Objectives: Given the growing societal and healthcare service need for trained mental health and care workers, coupled with the heterogeneity of exposure during training and the shortage of placement opportunities, we explored the feasibility and utility of a novel XR tool for mental health consultation training. Specifically, we set out to evaluate a training simulation created through a collaboration between software developers, clinicians and learning technologists, in which users interact with a virtual patient, Stacey, through a virtual reality or augmented reality head-mounted display. The tool was designed to provide trainee healthcare professionals with an immersive experience of a consultation with a patient presenting with perinatal mental health symptoms. Users verbally interacted with the patient, and a human instructor selected responses from a repository of pre-recorded voice-acted clips. Methods: In a Pilot Experiment, we confirmed the face validity and usability of this platform for perinatal and primary care training with subject-matter experts. In our follow-up experiment, we delivered personalised one-hour training sessions to 123 participants, comprising Mental Health Nursing trainees, General Practitioner Doctors in Training, and students in psychology and medicine. This phase involved a comprehensive evaluation focusing on usability, validity, and both cognitive and affective learning outcomes. Results: We found significant enhancements in learning metrics across all participant groups. Notably, there was a marked increase in understanding (p<.001) and motivation (p<.001), coupled with decreased anxiety related to mental health consultations (p<.001). There were also significant improvements to considerations towards careers in perinatal mental health (p<.001). Conclusions: These findings show, for the first time, that XR can be used to provide an effective, standardised, and reproducible tool for trainees to develop their mental health consultation skills. We suggest that XR could provide a solution to overcoming the current resource challenges associated with equipping current and future healthcare professionals, which are likely to be exacerbated by workforce expansion plans.

Authors from the University of Leeds declare no conflict of interest relating to this study and undertook data collection and analysis independent to the rest of the authorship team. Authors Mark-Knowles Lee (Founder, Fracture Reality) and Celia Beecham (Product Manager, Fracture Reality) led the development of the application. They were not involved in the data collection or analysis and did not contribute to the discussion section of this manuscript. Co-authors Rebecca Burgess-Dawson and Dominic Patterson, Health Education England, now NHS England, contributed to the development of the simulation scenarios created by Fracture Reality, and in developing the research project and were not involved in the data collection, or analysis. Devon Puttick, Chris Gay, Janette Hiscoe, Sally Richardson, were involved at a project supervisory level from Health Education England, now NHS England, and were not involved in data collection or analysis.

This project was funded by Health Education England, now part of NHS England. Authors RM and FM are supported in part by the National Institute for Health and Care Research (NIHR) Leeds Biomedical Research Centre (NIHR203331). FM is further supported by the European Union Horizon Research and Innovation programme under grant agreement no. 101070155 and the UKRI through the Horizon Europe Guarantee (#10039307).

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics for the study was approved by School of Psychology Ethics Committee at the University of Leeds Reference: PSYC-615.

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All data produced will anonymised dataset available on Open Science Framework on publication.