TelepresenceA Review of Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care

Authors: Donald M. Hilty, Karan Randhawa, Marlene M. Maheu, Alastair J. S. McKean, Richard Pantera, Matthew C. Mishkind & Albert “Skip” Rizzo


This scoping review article explores the application of telepresence (TPr), virtual reality (VR), and augmented reality (AR) to clinical care. A literature search of key words was conducted from January 1990 through May 2019 of the following databases: PubMed/Medline, American Psychological Association PsycNET, Pubmed/Medline, Cochrane, Embase, PsycINFO, Web of Science, Scopus, OTSeeker, ABI/INFORM, computer-mediated communication (CMC), technology-mediated communications, Arts & Humanities Citation Index, Project Muse, ProQuest Research Library Plus, Sociological abstracts, Computers and Applied Sciences Complete and IT Source. It focused on concept areas: (1) TPr related to technologies; (2) virtual, augmented, reality, environment; (3) technology or computer-mediated communication; (4) clinical therapeutic relationship (boundaries, care, communication, connect, engagement, empathy, intimacy, trust); (5) telebehavioral health; (6) psychotherapy via technology; and (7) medicine/health care. Inclusion criteria were concept area 1 in combination with 2–7 and 2 or 3 in combination with any of 4–7. From a total of 5214 potential references, the authors found 512 eligible for full-text review and found 85 papers directly relevant to the concepts. From papers’ references and a review of books and popular literature about TPr, virtual reality (VR), and augmented reality (AR), 13 other sources of information were found. The historical evolution of TPr, VR, and AR shows that definitions, foci of studies (e.g., social neuroscience to business), and applications vary; assessments of TPr also vary widely. Studies discuss VR, AR, and TPr in medicine (e.g., rehabilitation, robotics), experimental psychology (laboratory, field, mixed), and behavioral health. Virtual environment (VE) designs aid the study of interpersonal communication and behavior, using standardized social interaction partners, virtual standardized patients, and/or virtual humans—all contingent on the participants’ experience of presence and the ability to engage. Additional research is needed to standardize experimental and clinical interventions, while maintaining ecological validity. Technology can significantly improve quality of care, access to new treatments and training, if ethical and reimbursement issues are better explored.


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