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Article History

Received: 17 December 2025

Accepted: 27 February 2026

First Online: 12 March 2026

Declarations

:

: The original ethics application for the VISTA study (proposal 20240422-01) was expanded into a full proposal for the multicenter roll-out (proposal 2024-226-1-dvh), which received a positive vote from the institutional review board (Ethikkommission der Julius-Maximilians-Universität Würzburg). The validation presented in this manuscript was conducted using video recordings obtained within the approved VISTA study framework. As detailed in the associated research protocol [ ], all participating students were fully informed about the study, participation was voluntary, and written informed consent was obtained. Questionnaire data and video rating results were merged using self-selected pseudonyms, which were subsequently removed so that the data were stored in anonymized form. Data processing followed local data protection regulations. Participation or non-participation had no academic consequences.

: Not applicable.

: T.M. was involved in the software development of the STEP-VR software. Moreover, T.M. reports a familial relationship to the managing director of OrangeWhip Interactive, which acquired the STEP-VR training software after the completion of data collection for this study (October 2025). OrangeWhip Interactive had no role in the study design, data acquisition, data analysis, interpretation, or the decision to publish these results. All other authors declare no competing interests.