Human- vs. Software-Guided VR Basic Life Support Training: Physiological Arousal, Instructional Experience, and Immediate Performance

Virtual reality (VR) enables simulation of high-pressure scenarios, yet the influence of instructor type on learners’ psychological responses and performance remains unclear. This controlled trial compared human-guided (IG; n = 33) and software-guided (MG; n = 30) VR-based Basic Life Support training. Participants completed two training sessions followed by a performance-based assessment. Electrodermal activity (EDA) indexed physiological arousal, while questionnaires assessed presence and instructional experience. Mean EDA levels did not differ between groups, but the MG group showed a steeper increase in EDA over time. The IG group achieved higher examination scores (M = 91.44 vs. 81.10, p = 0.003) and rated the instructional experience more positively (M = 6.81 vs. 6.63, p = 0.03). Presence was descriptively higher in the IG group, although not significantly (p = 0.057). Findings suggest that guidance delivery may shape immediate performance, instructional experience, and physiological arousal trajectories in immersive BLS training.