Using virtual reality to investigate bias and discrimination in clinical decision making: A proof of concept study

Background Biases held by healthcare practitioners can shape clinical interactions, leading to discrimination and poor patient outcomes. Traditional methods, such as vignettes or self-report measures, often lack ecological validity. Objective We evaluated a novel VR simulation designed to explore bias and discrimination in clinical decision-making. Methods Thirty-five healthcare practitioners across 14 NHS trusts completed an in-person VR simulation and provided feedback on realism, immersion, and usability via surveys and open-ended responses. Patients in the simulation had intersecting sociodemographic characteristics (race, gender, migration status). Results Most participants rated the VR environment as at least moderately realistic (88.6%), with 42.9% rating it very or extremely realistic. Nearly half (45.7%) reported consistency with real-world experience. Open-text feedback highlighted strengths in realism, immersion, and educational potential, with suggestions to improve dialogue flexibility. Conclusions VR is a feasible, immersive, and scalable tool for investigating bias in clinical decision-making.