Stretton, TCochrane, TSevigny, CStander, JMerolli, Mark2025-02-162025-02-162025-02-14Virtual Reality, ISSN: 1434-9957 (Online), Springer Science and Business Media LLC, 29(1). doi: 10.1007/s10055-025-01115-21434-9957http://hdl.handle.net/10292/18662Critical thinking is essential in health disciplines though is reportedly underdeveloped in student health professionals. Immersive mobile extended reality (mXR) may facilitate critical thinking in health education though has not yet been fully explored. The main aim of this study was to evaluate the impact of co-designing a virtual environment on the facilitation of critical thinking in health education students. Second-year graduate-entry Doctor of Physiotherapy students (<jats:italic>n</jats:italic> = 25) co-designed health-related case scenarios over six weeks in a web-based 360-degree immersive environment. This included embedding exercise prescription videos that incorporated prompts for critical thinking of a target population. The evaluation included pre- and post-evaluation surveys, the Health Science Reasoning Test (HSRT-N) and the System Usability Scale (SUS). The results of this study demonstrated a positive effect on critical thinking skills- particularly in analysis, interpretation, inference, deduction, numeracy and overall (<jats:italic>p</jats:italic> &lt; .05). Participants reported favourable perceptions of mXR usability and the learning experience, although challenges such as cybersickness and technical complexities were noted. Peer feedback suggested that the virtual environment promoted engagement and authenticity in learning. Recommendations for future iterations include enhancing population representation, addressing challenges in system usability, and refining instructional design elements. Overall, the study demonstrates the potential of mobile immersive reality to enhance critical thinking and foster authentic learning experiences in health education. Further design principles and implications for research design are proposed in the study.Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.http://creativecommons.org/licenses/by/4.0/0801 Artificial Intelligence and Image Processing0909 Geomatic Engineering1702 Cognitive SciencesHuman Factors4607 Graphics, augmented reality and gamesJournal ArticleOpenAccess10.1007/s10055-025-01115-2