The Experience Gap: Better Appraisals for Clinical XR

Formative evaluation is a vital pillar of implementation science, used to identify early barriers to adoption before deploying new health technologies. Traditionally, this process relies on gathering stakeholders’ expectations through preuse questionnaires. While this works well for standard screen-based apps, it hits a bottleneck when applied to immersive systems like Extended Reality (XR).

In a recent viewpoint article published in JMIR Formative Research, José Ferrer Costa and Manuel Armayones Ruiz examine this methodological misalignment, introducing a concept called the experience gap and offering a practical solution for technology adoption.

What Is the Experience Gap?

When evaluating traditional digital tools, clinicians draw upon a lifetime of experience with smartphones or computers. However, large segments of the healthcare workforce remain entirely XR-naive; surveys show only 5% of clinicians in public hospitals have used virtual reality in care.

Without direct exposure to head-mounted displays, stakeholders answering early surveys must rely on pure anticipation. This lack of a reference point creates an experience gap, where simple uncertainty about physical comfort, safety, or usability is frequently misclassified as a fixed structural barrier to adoption. This can cause health systems to abandon promising pilot initiatives entirely because of artifacts in how the initial survey was timed.

The Solution: Experiential Familiarization

To bridge this gap, the authors propose a low-burden preparatory modification to standard workflows: incorporating brief experiential familiarization before collecting stakeholder perceptions.

Rather than executing a resource-intensive pilot deployment, organizations can run structured encounters lasting just 10 to 20 minutes:

1. Operational Handling: 5 minutes
   Provide a baseline physical overview where participants handle the headset hardware and see the interface projected on an external screen.
2. First-Person Immersive Use: 10 minutes
   Guide the stakeholder through a short first-person virtual experience, using the exact application under consideration for routine practice.
3. Immediate Post-Exposure Appraisal: 5 minutes
   Administer standard implementation surveys to capture perceptions of safety, comfort, and relevance now that they are anchored in real experience.

The authors chose JMIR Formative Research to share these insights due to the journal's focus on the intersection of digital health and professional practice. As healthcare systems globally undergo digital transformations, this analysis provides a clear methodological guideline to ensure early-stage evaluations yield accurate, actionable data for technology integration.

Curious to see how experiential exposure is reshaping the future of healthcare technology integration? Watch the video featuring José Ferrer Costa and read the full viewpoint article to explore the experience-informed framework and the strategic roadmap for responsible XR adoption.