Currently submitted to: JMIR Human Factors
Date Submitted: Jan 28, 2026
Open Peer Review Period: Feb 24, 2026 - Apr 21, 2026
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Impact of the Virtual Character (Avatar) in a task-focused medical MR Telecollaboration: post-hoc study of four randomized cross-over trials
ABSTRACT
Background:
Enhancing telemedicine requires a clear understanding of how avatars influence medical collaboration. The ArtekMed study group developed a MR teleconsultation system that enables a remote expert (VR user) to interact in real-time with a local augmented reality (AR) user within a shared working space. The system was compared to a standard video call system in five randomized cross-over trials in a healthcare simulation center.
Objective:
This post-hoc study investigates user’s perceptions of a virtual character representing a remote expert across four real-time mixed-reality (MR) teleconsultation scenarios.
Methods:
A total of 56 medical professionals participated as AR users collaborating with a remote expert represented by a virtual character. A post-hoc qualitative analysis of structured post-session interviews was performed to explore participants’s perceptions of the avatar, focusing on perceived helpfulness, visual design and user engagement.
Results:
Overall, most participants did not perceive the avatar as helpful for task execution in procedural scenarios and frequently described it as unnecessary or even distracting. In contrast, in more complex and demanding scenarios, such as emergency craniotomy planning or intensive care treatment of patients with acute respiratory distress syndrome, some participants perceived the avatar as providing mentorship, guidance and psychological support. These findings suggests that while avatars may offer limited perceived value in task-focused medical collaboration, they may support user engagement in scenarios requiring sustained interaction and social presence.
Conclusions:
The results align with existing literature indicating that the impact of avatars is context dependent. In mixed-reality environments, where virtual character coexists with real-world reconstructions, avoiding behavioral incongruence and uncanny effects may be more critical than achieving high visual fidelity. Future research should prospectively explore how different levels of avatar abstraction and fidelity influence collaboration in MR telemedicine.
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