Publications

Publications

At the forefront of Extended Reality (XR), UMverse has been pioneering research that bridges the virtual with the physical, pushing the boundaries of VR, AR, and MR technologies. Our publications highlight innovative applications of XR and have garnered recognition for their contribution to both theoretical advancements and practical solutions. Through inter-disciplinary collaboration and innovative methodologies, we’ve unveiled new possibilities within XR, setting benchmarks for future research.We invite the XR community and beyond to explore our contributions.

For direct access to our research and updates on future publications, please follow @uminteractive on Instagram and UMverse on Linkedin.

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  • Beyonding: Spirituality, Ritual, and Space in the Metaverse

    Spiritual Spaces

    "Beyonding: Spirituality, Ritual, and Space in the Metaverse" is Chapter 12 (pp. 195-212) in the book "Redefining Spiritual Spaces in the Age of Technology: Innovations and Pitfalls" by Editors Stacey K. Guenther, Xiaoan Li, and Michelle A. Scheidt. Written by Kim Grinfeder, William Scott Green, and Denis H. Hector, the chapter reviews the fundatmental ways the metaverse—and its components of virtual reality and artificial intelligence—is reshaping the human experience of community, space, and spirituality. It then uses the evidence from multiple offerings of their course "Religion and Sacred Space in the Era of Artificial Intellience and Virtual Reality" to analyze how students used these technologies to devise new collective and individual spiritial experiences through the creation of rituals and shared spaces in the metaverse. The chapter concludes with suggestions for how these new technoklogies can generate and enable novel educational practices and creative forms and expressions of space, spirituality, and community. Read the Chapter | Book

     

    Grinfeder, K., Green, W.S., Hector, D.H. (2025). Beyonding: Spirituality, Ritual, and Space in the Metaverse. In: Guenther, S.K., Li, X., Scheidt, M.A. (eds) Redefining Spiritual Spaces in the Age of Technology. Management, Change, Strategy and Positive Leadership. Springer, Cham. https://doi.org/10.1007/978-3-031-93436-0_12

  • VR Interventions for Intersectional Stress Reduction Among Black Women

    The XR Access Symposium is our annual conference for leaders in industry, academia, and advocacy to come together and solve the most pressing problems in extended reality accessibility. For 2025, our focus is 3D Diversity: how can we use XR and other emerging technologies to design valuable immersive applications for increasingly diverse audiences?

    This 1.5 day conference took place June 26-27, 2025, at the Verizon Executive Education Center on Cornell Tech campus in New York City, with sessions broadcasted online. Together, we explored new ways for XR to combine with other emerging technologies like artificial intelligence and brain-computer interfaces to improve the lives of everyone, especially people with disabilities.

    Chapters

    0:00:00 Introduction | Dylan Fox and Shiri Azenkot

    0:12:50 Understanding How Blind and Low Vision Users Relate to and Use An AI-Powered Guide to Enhance VR Accessibility | Jazmin Collins

    0:37:45 Beyond Access: Meaningful Accessibility in Video Games | Brian Smith

    0:57:12 Virtual Reality Interventions for Intersectional Stress Reduction Among Black Women | Judite Blanc

    1:17:41 Designing Disability-Inclusive Avatars | Ria Gualano

    1:37:36 Cripping Up - How We Are Using VR to Challenge Ableism | Meg Fozzard & Amy Crighton

    1:55:55 Lemmings - Making Immersive Media Accessible | Justin Berry

    2:22:15 Augmented Reality Navigation System for Wheelchair Users | Anis Idrizovic, Md Mamunur Rashid, Huiran Yu

    2:39:32 Breakout Summaries

    3:01:24 Ethical Considerations in XR Research with Autistic Communities | Nigel Newbutt

    3:25:33 Day 1 Closing | Dylan Fox 

    Slides and transcript available upon request.  For more information, see https://xraccess.org/symposium

     

    Blanc, J., et al. (2025). "Virtual Reality Interventions for Intersectional Stress Reduction Among Black Women”. The Seventh Annual XR Access Symposium. June 26-27, 2025, New York City.

  • The Future of Ophthalmology Training is Here—and it’s Digital

    Under the heading "Device Technology" Ophthalmology Times magazine published the article The future of ophthalmology training is here—and it’s digital: Virtual reality and artficial intelligence are reshaping medical education by Shalini Shah, Benjamin Lin, Giselle Ricur, and Chris Alabiad in its July/August 2025 issue (Vol. 50, No. 4). Read the article

     

    Shah, S., Lin, B., Ricur, G., Alabiad, C. (2025, July/August) The future of ophthalmology training is here—and it’s digital: Virtual reality and artificial intelligence are reshaping medical education. Ophthalmology Times , Vol. 50, No. 4, pp.8-11. https://cdn.sanity.io/files/0vv8moc6/ophtalmology/5832fbe032d332639b96b5af984acc97f58261ac.pdf/OT0825_Digital.pdf

  • Leading the Future

    Leading the Future whitepaper

    This Whitepaper: "Leading the Future: How Universities and Colleges are Fostering Innovation-Driven Regional Economic Development Initiatives," was written by John A. Cunningham, Josh Fenn, Maria Madarieta, David Metcalf, Scott Miller, Daniel O'Brien, and Michael Rosas, with a foreword by Thomas C. Merrick:

    As industries accelerate toward digital transformation, universities are evolving from traditional centers of education into engines of innovation, collaboration, and regional economic growth. Today’s most pressing challenges, whether in manufacturing, health, climate, education, etc., require rapid prototyping, interdisciplinary thinking, and immersive problem-solving environments. The convergence of extended reality (XR), artificial intelligence (AI), and digital engineering provides unprecedented tools to meet these challenges.

    This white paper explores how shared XR and digital engineering infrastructure, supported by technology providers like Virtualware and HTC VIVE, is enabling colleges and universities to play a leading role in workforce development, product innovation, and public-private collaboration. By transforming existing physical spaces into connected immersive labs, institutions are not only preparing the workforce for tomorrow, but they are also helping solve real-world problems today.

    At the University of Miami, we’ve seen firsthand how immersive technologies can support student learning, faculty research, and strategic industry partnerships. Through my work as Associate Director of VR/AR Initiatives and Chair of the North America Colleges and Universities Committee for the VR/AR Association, I have the privilege of engaging with dozens of universities working to break traditional boundaries and build collaborative ecosystems. Together, we are laying the groundwork for a new educational and economic paradigm, one where immersive tools help visualize the invisible, prototype the complex, and unite diverse minds across distance and discipline.

    Read more

  • Feasibility and Acceptability of Virtual Escape Room Simulations

    "Feasibility and Acceptability of Virtual Escape Room Simulations for Novice Anesthesia Learners in Augmented vs Virtual Reality" by Greta M. Vladinov and Cynthia Foronda was published by Elsevier/Science Direct in the Clinical Simulation in Nursing Journal, Volume 92, July 2024 (version of record May 24, 2024).

    Background
    The operating room (OR) is an intimidating environment for novice anesthesia learners. This study aimed to evaluate the feasibility and acceptability of introduction to commonly-used anesthesia equipment in virtual escape room simulations through augmented reality (AR) in comparison to virtual reality (VR).
    Sample
    Eighty-seven first-year graduate student registered nurse anesthetists completed a virtual simulated escape room experience.
    Methods
    A descriptive study was conducted over three years with data from three cohorts.
    Results
    In the AR cohort, 98% of learners found the AR user-friendly while 84% of learners found the application effective to become familiar with anesthesia equipment. With the VR cohort, 95% of learners found the VR user-friendly while 98% of learners indicated the application helped them understand use of the equipment.
    Conclusion
    Both AR and VR were reported as feasible … Read More
    Vladinov, G.M., & Foronda, C. (2024, July). Feasibility and Acceptability of Virtual Escape Room Simulations for Novice Anesthesia Learners in Augmented vs. Virtual Reality. Clinical Simulation in Nursing, 92, 101555. https://doi.org/10.1016/j.ecns.2024.101555.

  • Evaluating the Effect of a VR Digital Therapeutic on Maternal Stress

    Background

    Maternal mental health is vital to overall well-being, particularly among expectant and postpartum Black and Latina women who experience higher stress levels and mental health challenges. Traditional healthcare systems often fail to meet these needs, underscoring the need for innovative and accessible interventions. NurtureVR, a digital maternal mental health and educational program, leverages virtual reality to offer mindfulness, relaxation, and guided imagery to support these women.

    Objectives

    This protocol aims to evaluate whether NurtureVR, a digital therapeutic, can reduce stress levels and mental health symptoms in pregnant and postpartum Black and Latina women, improve sleep, enhance pregnancy and childbirth experiences, and increase pregnancy and postpartum health literacy.

    Methods

    The Nurturing Moms study uses a pre- and post-intervention design with a 5-week NurtureVR program. Fifty participants, 25 expectant and 25 postpartum Black and Latina women, will be recruited through clinics, community organizations, and online platforms. The study involves three phases: baseline assessments of stress, mood, self-efficacy, demographics, and health history; daily use of NurtureVR for 15 minutes during the third trimester and six weeks postpartum; and follow-up assessments at six weeks postpartum. The program includes 49 modules on labor and delivery, stress during pregnancy, nutrition, breastfeeding, hormonal changes, 3D VR representations of fetal development, pain management simulations, and mindfulness exercises for labor. Participants will report stress, anxiety, mood, and pain levels following each VR session. Additional qualitative insights will be gathered through focus groups, and an optional survey will be administered one-year post-intervention to evaluate long-term effects.

    Conclusions

    The Nurturing Moms study seeks to create a more inclusive and equitable healthcare landscape, demonstrating that digital interventions like NurtureVR are essential for providing high-quality maternal care. By democratizing access to clinical research and healthcare, this decentralized trial promotes equity, improves the generalizability of findings, and accelerates the development of new treatments. The study’s innovative approach has the potential to improve maternal experiences of stress, sleep, and overall health outcomes for Black and Latina mothers and children, despite limitations such as sample size, language barriers, and the preliminary nature of a pilot and feasibility study. Read More

     

    Carrasco, M., Dimanche, S., Fouladian, J., Neff, M., Scaramutti, C., Moloney, M., Blanc, J., Seixas Azizi, Evaluating the effect of a virtual reality digital therapeutic on maternal stress among expectant and postpartum Black and Latina mothers: a protocol paper,  Frontiers in Psychiatry, Volume 15, 2024. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1481453. DOI=10.3389/fpsyt.2024.1481453. ISSN=1664-0640

  • Usability of a VR Application to Educate Family Caregivers of Children with Asthma

    User view of multiple choice question

    The purpose of this study was to evaluate the usability and user experience of the Asthma Academy App—an app designed to educate caregivers on how to manage a child’s asthma attack. Thirty eight doctor of nursing practice students participated in the alpha-testing.

    Team:
    Cynthia Foronda, PhD, RN, CNE, CHSE, ANEF, FAANa
    Esha Mehtab
    Marcos J. Moralesb
    Max Cacchione, MBA, PMP, SAFe, CSPOc
    Karina A. Gattamorta, PhDd
    Monica Cardenas, MD, FAAPe

     

    Foronda, C., Mehta, E., Morales, M.J., Cacchione, M., Gattamorta, K.A. & Cardenas, M. (2023, November). Usability of a Virtual Reality Application to Educate Family Caregivers of Children with Asthma. Clinical Simulation in Nursing, 84, 101465. https://doi.org/10.1016/j.ecns.2023.101465.

  • Comparison of VR to Traditional Simulation in Health Professions Education

    "Comparison of Virtual Reality to Traditional Simulation in Health Professions Education: A Systematic Review" by Cynthia Foronda, Laura Gonzalez, Merrick M. Meese, Nicholas Slamon, Mariju Baluyot, Jiye Lee, and Michelle Aebersolf was e-published in Simulation in Healthcare, the Journal for the Society for Simulation in Healthcare, in August 2023.

    Abstract

    With the increasing availability of virtual reality (VR) and its lower overall costs of use, the objective of this review was to compare VR to traditional simulation in terms of learning outcomes. Studies were included if they met the following criteria: ( a ) research study (of any design), ( b ) focused on learners in health professions, and ( c ) compared VR with traditional simulation. Studies were excluded for the following reasons: ( a ) not a research study, ( b ) focused on learners outside health professions, ( c ) used screen-based or computer-based simulation, ( d ) used a task trainer, and ( e ) did not involve a comparison of VR to traditional simulation. The searches were run on November 11 and 12, 2021, in CINAHL via EBSCO, Ovid Embase, ERIC via EBSCO, IEEE Xplore, Ovid Medline, Ovid PsycINFO, Scopus, and Web of Science Core Collection. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines guided the review. A team of researchers applied Kirkpatrick's Levels, Melnyk's Levels of Evidence, and Critical Appraisal Skills Programme guidelines to assess the level of evidence and look for bias. Fifteen studies were reviewed including 11 randomized controlled trials. The lead researcher synthesized the study results into 3 categories: (1) traditional simulation performed better, (2) VR performed better, and (3) comparable outcomes. There is insufficient evidence to endorse one form of simulation (VR or traditional) as more effective at this time. The body of evidence contained too few studies to draw meaningful conclusions to answer the guiding question. The studies covered a large range of modalities, learner groups, and healthcare topics, preventing a meta-analysis. Based on the literature and experience, we recommend that VR experiences be proctored, include debriefing, have a backup plan for cybersickness or myopia, and have time and costs documented. Use of VR is likely to expand; thus, research is needed to inform the best contexts and applications. Read More

     

    Foronda CL, Gonzalez L, Meese MM, Slamon N, Baluyot M, Lee J, Aebersold M. A Comparison of Virtual Reality to Traditional Simulation in Health Professions Education: A Systematic Review. Simul Healthc. 2024 Jan 1;19(1S):S90-S97. doi: 10.1097/SIH.0000000000000745. Epub 2023 Aug 31. PMID: 37651101. https://www.researchgate.net/publication/373553935_A_Comparison_of_Virtual_Reality_to_Traditional_Simulation_in_Health_Professions_Education_A_Systematic_Review

  • Use of Virtual Reality in Family Caregiver Education: A Literature Review

    The use of virtual reality (VR) in health professions education is on the rise. Virtual reality is “a 360-degree immersion offered through a head-mounted display that may or may not come with a haptic device.”1(p8) The results of VR technology in teaching and learning have been promising. A systematic review conducted by Kyaw and colleagues2 indicated that use of VR is more effective in improving knowledge and skills in health professionals than other types of traditional digital education such as online education.

    Besides educating health professionals, VR has also been used to improve patient outcomes.3,4 Virtual reality has been used to educate patients regarding conditions including an abdominal aortic aneurysm3 and cancer,4 and VR has been examined in the context of medical somatic treatment.5 In nursing, VR has been used as an intervention to decrease patients' pain and anxiety levels.6,7 The potential applications of VR seem limitless.

    Although evidence is growing regarding the effectiveness of VR in health professions education and patient education, there is a gap of knowledge regarding the use of VR to educate family caregivers. A family caregiver is defined as “any relative, partner, friend or neighbor who has a significant personal relationship with, and provides a broad range of assistance for, an older person or an adult with a chronic or disabling condition.”8(para6) Self-management and home-based care efforts are growing, and family caregivers hold an important role in the management of chronic diseases. Family caregivers are a relatively untapped resource in healthcare with potential to greatly and positively impact patient outcomes. As VR may be a novel and potentially effective way to empower and better educate family caregivers to care for their family members, the literature was reviewed to unveil what is known in this area. Read More

     

    Foronda, Cynthia PhD, RN, CNE, CHSE, ANEF, FAAN; Lee, Jiye MSN, CPNP-AC; Santiesteban, Zaily MSN, APRN, AGPCNP-BC. Use of Virtual Reality in Family Caregiver Education: A Literature Review. CIN: Computers, Informatics, Nursing 41(3):p 125-127, March 2023. | DOI: 10.1097/CIN.0000000000001004. https://journals.lww.com/cinjournal/fulltext/2023/03000/Use_of_Virtual_Reality_in_Family_Caregiver.1.aspx

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