(Special Issue) Examining High School Students’ Intention to Use 3D VR Teaching Materials Against Substance Abuse Author: Ying-Chieh Chang (Department of Health Promotion and Health Education, National Taiwan Normal University), Shih-Wen Wang (Department of Health Promotion and Health Education, National Taiwan Normal University), Li-Ting Lu (Department of Nursing, University of Kang Ning)

Vol.&No.：Vol. 66, No. 4
Date：December 2021
Pages：133-165
DOI：https://doi.org/10.6209/JORIES.202112_66(4).0005

Abstract：
Introduction
　　Despite preventive and intervention efforts against substance abuse for many years, the level of abuse among high school students in Taiwan has gradually increased. One potential solution is tapping into students’ capabilities of assimilating new technologies and their acceptance of teaching materials using animation media rendered in 3D virtual reality (VR). This study examined students’ intention to use anti-substance abuse 3D VR teaching materials and the factors affecting this use. Students experienced an immersive and interactive teaching method involving plot guidance using 3D VR. By combining education and entertainment, the aim was to increase students’ learning interest, enhance their knowledge and understanding of substances, strengthen their ability to refuse illicit substances, and heighten awareness against substance abuse. Policymakers can use these findings for designing preventive and intervention strategies against substance abuse in Taiwan.
Methods
　　Students from grades 1-3 of one high school were recruited as participants. School teachers or training instructors were requested beforehand to contact and invite the students to participate. After securing the students’ agreement, they were provided with the film “3D VR Teaching Materials on Substance Abuse” for learning purposes. Subsequently, in-depth interviews with 16 individual students (eight from each gender) were conducted (and recorded with a portable recorder) using sample selection based on the principle of data saturation.
　　To ensure data reliability, qualitative research experts coded a verbatim transcript to confirm coding reliability. Data triangulation was also adopted to verify content validity, including consistency of individual participants and among all participants. The discussion contents between teachers or training instructors, and participants before the interviews were also verified. During the analysis, meaningful sentences were identified, condensed, and coded according to their commonalities, classified inductively, and finally, distilled into themes.
　　The film used was based on “Preparing a Diversified Counseling Course Plan on Substance Abuse for University Students” by Professor Kuo’s research team from the National Taiwan Normal University. The planning and design of the 3D VR teaching materials, which consisted of five units, were based on the opinions of experts and scholars of prevention against substance abuse, and the characteristic needs of students addicted to substances.
Findings
　　Five interviewees had smoked tobacco products, two had consumed alcohol, and two chewed betel nuts, but none had any experience with substance abuse. Next, following repeated perusal of the interview materials and using the framework of the decomposed theory of planned behavior, the contents were summarized as follows: attitude toward 3D VR use, perceptual behavioral control (PBC), and subjective norms.
Discussion and Recommendations
　　Several studies have highlighted that technology-assisted teaching methods can increase students’ interest in learning. Particularly, the characteristics and interactivity of VR do not restrict the educational environment to book-based presentations.
i. Impact of students’ attitude toward 3D VR on their intention to use
　　High school students revealed their perceived usefulness of 3D VR during the interviews. After watching the film, they were aware of the pitfalls and symptoms of substance abuse and were prompted to reflect upon its life warnings. They acknowledged the perceived entertainment value of 3D VR and found the lessons in the film interesting. Some mentioned that the characters who attended the house party looked frightening. Fear is directly related to behavioral changes. Therefore, behavioral change can be precipitated through fear-arousal by casting characters with more terrifying appearances for the 3D VR media. Regarding 3D VR’s compatibility, participants found it to be very similar to Wii’s gameplay; notably, the screen operations were familiar and similar. However, several participants commented on their lack of prior experience in such technologies. To ensure participants’ familiarity with the operating interface, teachers can be requested to provide detailed guidance to participants, if needed. Under the technology acceptance model, users’ willingness to use information technology is analyzed through its perceived usefulness and usability. Users will positively evaluate technology with high entertainment values, leading to its increased utilization. Therefore, the use of 3D VR teaching materials against substance abuse may be more effective than traditional teaching methods.
ii. Impact of students’ PBC on their intention to use
　　Regarding self-efficacy, participants scored their level of self-confidence after completing the game on a scale of 1 to 10. Most participants scored eight or more, indicating that they had sufficient confidence. However, if the game is too simple and not sufficiently challenging, students’ interest in learning will wane. Therefore, a slight degree of difficulty should be maintained when designing the teaching materials that should not be challenging for high school students with strong learning abilities.
　　Beneficial conditions of resources increased students’ interest in learning with improved network connectivity and equipment upgrades. The aim is to improve learning motivation through technology and the willingness to learn through novel teaching materials. These factors enhance students’ sense of superiority when they use technology and increase their joy of sharing new knowledge with their peers.
iii. Impact of students’ subjective norms on their intention to use
　　Among subjective norms, the influence of significant others affected the intention of usage of 3D VR teaching materials. Parents were the most important ones, followed by the assisting instructors. Students expressed that the instructors’ patience and detailed assistance facilitated them in learning about anti-substance abuse. Notably, some students mentioned that some friends had used illicit substances like laughing gas (nitrous oxide). Future teaching materials can include this substance, and serve as a reference for operationalizing or further refining these materials.
　　Presently, 3D VR is widely used in the health sector, but not in the education sector due to funding issues. Importantly, substance abuse has increased as new illicit substances and with the continuous innovation of available substances. Therefore, two things are urgently needed: teaching materials that students are happy to learn from and ways of enhancing their ability to think critically. In this study, students were highly accepting of and strongly identified with the new teaching model involving 3D VR animation. The entertainment value of and learning motivation from these materials can be further increased by going online or gamification of these activities. Furthermore, materials can help improve students’ skills on ways to refuse substances and prevent and treat addictions, thereby strengthening their resilience.
　　Moreover, we need to connect family, school, community, and society for the optimal implementation effects. Unfortunately, the interviews revealed that the connection between youth and the influence of the community and society is lacking. Therefore, anti-substance abuse campaigns should be further extended so that their influence in the community and society is strengthened.
　　Furthermore, teaching materials on anti-substance abuse should be extended from in-person to digital formats, thereby confirming the learning habits of today’s students. With greater funding for software development, the image quality can be further refined and made more realistic. This will not only increase students’ enjoyment during the learning process but also improve their learning effectiveness. As substance abusers are becoming younger, the campaign can be extended to students of all ages.
　　In summary, innovative 3D VR teaching materials combining science and technology affect teenagers and can be a worthy area of future research, development, and promotion.

Keywords：3D virtual reality, anti-drug abuse course, usage intention, senior high school students, decomposed theory of planned behavior

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