Identifying Workflow Bottlenecks in Virtual Reality Personal Protective Equipment Simulation

Existing personal protective equipment (PPE) research in virtual reality (VR) has primarily examined overall training effectiveness. To inform design optimization, this study identified segment-level interaction hotspots in a CDC-informed head-mounted display VR PPE scenario. Thirty-nine participants completed a six-segment donning and doffing workflow using handheld controllers. Segment completion time and video-coded additional user action (AUA) counts were analyzed using repeated-measures statistics and participant-clustered generalized estimating equations, with negative binomial and mixed-effects sensitivity analyses. Platform or system anomalies were coded and reported separately from AUA counts. Both measures differed significantly across segments. Gloves-and-goggles doffing was the primary combined hotspot, showing the largest time ratio and AUA incidence rate ratio relative to gown donning, whereas goggles donning was the principal donning-specific hotspot. These findings indicate that interaction burden was concentrated in specific segments of the implemented workflow. Segment-aware redesign may improve usability and interaction efficiency in VR PPE systems.