Category Archives: Virtual Reality Software

Virtual Reality World Tech Magazine: Informed Immersion

Immersive technology is making significant strides in training medical professionals and as a treatment in health and wellness.

There are many ways that virtual reality (VR) can be applied in healthcare – from training medical professionals to aiding surgeons through visualisation or even robotics. But where is immersive tech really excelling right now, and what is it achieving for patients and medical professionals alike?

In the article below, Dr Jack Pottle, Chief Medical Officer at Oxford Medical Simulation, speaks to VR World Tech – discussing the views and often misconceptions that institutions have about immersive tech…

Read the full interview here

What is VR simulation good for in 2020?

Reading Time: 4 – 6 minutes

 

Every year, January brings the largest event in the global simulation calendar: IMSH. This year, we were excited by the ongoing and mounting interest in virtual reality simulation and improved learner outcomes.

 

Shifting perspectives 

At IMSH this year we noticed a marked shift in the awareness and understanding of VR simulation in the wider simulation community. 

Back in 2019, people were asking, “What do you mean exactly when you say ‘VR?’”. This year we were instead asked “VR has been around for a few years… what’s it good for?” and “Is it practical enough to be used meaningfully for sim?”. 

These are excellent questions. 

Here, we look at some of the ways that VR sim can be used to; create efficiencies, optimize data and encourage flexible learning – including some of the crucial concepts to consider when looking to implement a VR platform in your simulation facility.

Doing More with Less

Physical (mannikin-based) simulation involves significant overhead costs. Research has shown that faculty/admin hours, equipment, maintenance, space, and consumables contribute to an average cost of $390 to deliver just one traditional simulation session(13).

In contrast, immersive VR is instantly scalable, allowing institutions to deliver more simulation experiences to their learners at a greatly reduced cost. Because VR simulation is repeatable and can be used without faculty supervision – meaning engaging clinical experiences can be provided using fewer valuable resources.

One recent study showed “no significant differences in quantitative measures of learning or performance” in VR vs. physical sim, but demonstrated that VR sim was more affordable(4). Institutions have capitalized on using VR to deliver sim that is 5 – 50x cheaper than physical sim.

The ultimate goal of using VR for sim is to increase access to this incredibly powerful teaching method and make simulation part of everyday life (not just when learners are in the sim center).

Consideration #1

When seeking to implement VR sim, make sure you consider whether or not you are looking for a faculty-independent platform that will free up the time needed to run simulation sessions, as not all solutions offer this.

Supporting Data-Driven Simulation

Collecting information about a learner’s performance and behavior during physical sim can be time-consuming and often requires subjective input. Using standardized simulations in immersive VR allows educators to deliver more simulation experiences whilst leveraging the data-tracking and analytic power of a technology-based system. 

This push towards data-driven learning experiences makes 2020  one of the most exciting times to be working in simulation and is empowering institutions to further the use of sim in ways previously considered impossible.

The most immediate – and important – use of this data is to support the performance improvement of learners. However, these analytics can further be used to research clinical behavior, supplement assessment techniques, and aid in recruitment processes.

Sim educators have historically struggled to show the economic impact of their efforts. Now, for the first time in history, having simple access to the type of data VR-based systems offer allows instructors to justify sim implementation to key stakeholders who are increasingly asking simulationists to “measure the effectiveness of what we do, how we do it, and why we do it.(5)

Consideration #2 

Platforms that offer standardized and peer-reviewed VR scenarios allow for detailed, personalized, and thorough analytics. Creating custom content in VR is undoubtedly appealing and may be useful in certain cases, however it removes the possibility of having rich, scalable feedback across cohorts. Implementing a broad range of standardized scenarios may provide you with the same variations as building your own, without compromising the levels of feedback you can give to learners.

Meeting Demands of Flexible Learning

Studies are increasingly finding that immersing a learner into a virtual world via a Head-Mounted-Display (HMD) has a greater impact on educational outcomes than screen-based learning(6). However, as simulation becomes a part of everyday life and distance-learning options are increasingly in favor, institutions need a way to deliver these simulations when VR hardware is not available.

Meeting the evolving educational needs of hospitals and universities means using a virtual reality platform that can support immersive VR sim in addition to an identical screen-based experience. 

Consideration #3 

As you consider approaching a hybrid VR-immersion/screen-based implementation, evaluate whether or not your learners will also need to use VR for group-based simulations, individual learning sessions, and multiplayer for interprofessional simulation experiences. 

We’re excited to see how our partners – and the wider sim community – will continue to advance the use of virtual reality in simulation in 2020. For more information about how VR simulation can work for you, contact us here.

References

  1. McIntosh (2006). Simulation: What does it really cost? https://journals.lww.com/simulationinhealthcare/Fulltext/2006/00120/Simulation__What_does_it_really_cost_.41.aspx
  2. Iglesias-Vázquez (2007). Cost-efficiency assessment of Advanced Life Support (ALS) courses based on the comparison of advanced simulators with conventional manikins. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174929/
  3. Pottle (2019). Virtual Reality Medical Simulation: Economic Evaluation and Return on Investment. Available on request.
  4. Haerling (2018). Cost-Utility Analysis of Virtual and Mannequin-Based Simulation. https://www.ncbi.nlm.nih.gov/pubmed/29373382
  5. Waxman (2019). SSH March Presidential Message. https://www.ssih.org/About-SSH/News/articleType/ArticleView/articleId/2153/March-Presidential-Message
  6. Krokos, Plaisant, and Varshney (2019). Virtual memory palaces: immersion aids recall. https://link.springer.com/article/10.1007/s10055-018-0346-3

Contact us for further information on anything discussed in this blog.

The Importance of Simulation

Types of simulation

This week is Healthcare Simulation week and as part of the celebrations we take a look at five reasons to salute the wonderful practice of simulation…

 

 

 

1. Simulation improves patient care 

By far the most compelling benefit of simulation in healthcare is the positive impact that it can have on patients. After all, a drive to  improve patient outcomes and the quality of their care is at the basis of healthcare education systems worldwide…

Providing future healthcare workers with the resources to optimize patient care – be that through effective clinical acumen, time management, communication and everything else in between – is the bedrock of a successful healthcare system.

Essentially, simulation sets trainee doctors and nurses up to effectively make people better when they come to practice in real life. In 2012, Benjamin Zendejas (Mayo Medical School, Rochester) set out to prove how far simulation training promotes positive results for patients. The findings were powerful; simulation-based education was shown to be directly linked to patient benefits when compared to both non-simulation-based training and instances where no intervention was given at all. 

Linked to this is the propensity for simulation to reduce patient harm. No clinician wants to inadvertently complicate or worsen a patient’s condition but medical error is the third leading cause of death in hospitals worldwide. With simulation, we are able to reproduce patient care sequences with all the clinical complexities of real life scenarios allowing clinicians to cover all the bases when treating real people. 

Ultimately, simulation-based training produces more competent healthcare professionals which can only be beneficial in improving the quality and safety of patient care. 

 

2. Simulation inspires confidence

Few on-boarding periods of a new job can be as daunting as starting out as a junior doctor or nurse. Fetching coffees, navigating the intricacies of a Kafkaesque office bureaucracy, whilst remembering not to raid Belinda from Accounts’ personal HobNob stash seem like a walk in the park compared to a 12-hour shift filled with hundreds of patients with complaints ranging from the utterly absurd to the genuinely life-threatening. 

To make matters worse, strained resources, overcrowded hospitals and staff shortages mean that most junior healthcare professionals face much of this without the necessary support.   With simulation, clinicians are able to practice managing acutely unwell patients without causing real patient harm if it goes wrong. In this way, practicing emergency care during training can take the edge off the intimidating world of real life practice.

This is something we’ve been made directly aware of at Oxford Medical Simulation through the roll-out of our virtual reality simulation platform at Oxford University. There, learners told us that, “it’s really good to get the experience of being put in the driver’s seat, of making the decisions…I think it will give me more confidence to make those decisions [in real life]”.

 

What is more, simulation-based training as been shown to improve junior clincian’s confidence in pushing for improved patient outcomes within real life treatment. Healthcare training is inherently hierarchical and this can often mean that trainees are afraid to speak up when they think a senior colleague is not administering the right kind of treatment. 

In a study carried out by the University of Harvard and Massachusetts General Hospital, simulation was shown to increase the frequency and quality of interventions by Residents in the care suggested by their seniors. 

Simulation can therefore be seen to not only improve patient care by bolstering the doctor or nurses confidence in their individual practice, but also promoting appropriate assertion in challenging a treatment plan when they think there might be a better way. 

 

3. Simulation lets us learn from our mistakes 

In our personal and professional lives we learn best from the mistakes we make. Cultivating an attitude that embraces mistakes as an inevitable part of life that can be mined for valuable lessons is an effective way to successfully avoid making mistakes in the future. Within the context of healthcare however – where the price of our mistakes can be fatal – this kind of philosophy can be hard to accept. 

In practicing simulation a safe-space is created in which healthcare professionals can refine their clinical skills without the risk of harming real patients. When effective debrief is built into simulation, the learnings taken from this form of training  are invaluable. With learners identifying strengths and areas for improvement in a supportive atmosphere. This is a powerful combination that mitigates against these mistakes being made in real life. 

Further, the emphasis on debrief engenders good habits of self-reflection for trainees to take through their entire professional careers. When clinicians are used to assessing their own practice regularly they are personally assuring the quality of the care they provide. 

 

4. Simulation works across all healthcare disciplines 

Simulation works effectively across all healthcare domains including; medicine, nursing, paediatrics, mental health, surgery, emergency care, life-saving and more. What is more, simulation surpasses all other training mechanisms in touching the most comprehensive set of skills ranging from specific procedures to communication and teamwork. 

The controlled nature of simulation means that institutions can ensure learners are exposed to as wide a range of clinical presentations as possible to build up depth of knowledge. Stress conditions can be put in place to mirror real life scenarios and test trainees ability to cope under pressure. The debrief that follows these experiences means that learnings are not lost or left open to individual interpretation. 

Simulation is also deliverable across multiple platforms. Mannequin-based simulation has long been used to produce life-like conditions in which learners can practice patient management. Similarly, the use of standardized patients in simulation is effective in creating a true-to-life environment where learners are able to interact with a real person. Increasingly, virtual reality is being used to deliver repeatable, immersive simulation at scale. 

 

5. Simulation is widely practiced worldwide

We’ve often heard it said that – if you do not work in healthcare – simulation is probably the biggest industry that you’ve never heard of. When you stop to think about it – it makes sense. You wouldn’t expect pilots to fly planes without practicing in simulators first – so why should we expect the people taking care of our health not to do so as well? 

There are hundreds of organisations, institutions and individuals doing wonderful things in simulation across the world.  Organisations such as SSH and ASPiH organise renowned international events like the International Meeting on Simulation in Healthcare (IMSH) to encourage knowledge sharing and best practice. 

As part of Healthcare Simulation Week, Boston Children’s Hospital hosted a Facebook Live event to give the community insights into how its state-of-the-art paediatric simulation center works. Having run an immeasurably impactful simulation programme for over a decade, BCH has now taken is simulation capabilities on the road. Offering over 50 courses at nine institutions across eastern Massachusetts – its SIM Network initiative shows that simulation best practice can be distributed at scale. 

In the UK, the NHS Diabetes Programme is using simulation to directly impact the treatment of people with Type 1 diabetes. Using the OMS virtual reality simulation platform, doctors are able to practice treatment before they see real life patients. Diabetes treatment can be notoriously tricky and for many doctors the first time they have to manage diabetes-related cases is in real life. Using simulation, the NHS is able to train doctors on the specific complexities to look out for, without compromising the quality of patient care. 

The healthcare team at St Luke’s University, Pennsylvania, have customised a freight truck to serve as a mobile simulation suite. Offering training opportunities across disciplines, people that live in remote areas that once may have been unable to access a healthcare education are now able to access valuable resources to further their careers. In this way, St Luke’s mobile simulation operation is promoting diversity and social mobility in healthcare and beyond.

These are just a few examples of the ways in which simulation is being leveraged to improve healthcare training and education, and in turn, our healthcare systems and standards of patient care. 

Happy Healthcare Simulation Week! 

 

Oculus Rift S Updates: what do they mean for Virtual Reality simulation? 

Healthcare professional trying out virtual reality medical simulation on the Rift S

For the past few weeks we’ve been avidly testing out the latest Oculus Rift S kit. The new hardware’s inside-out tracking shows the progression of VR technology and can only mean better, more exciting things for the world of healthcare simulation. 

So, what’s changed? 

The most significant difference between the new Rift S model and its predecessor, the Rift, is that it using inside-out tracking. This means that the sensors now sit inside the headset rather than using a separate desk-mounted sensor as with the original Rift. It has simpler halo-style headband making it easier to put on and the original over ear headphones have been replaced with directional speakers embedded into the headband. 

The screen resolution on the Rift S is slightly higher than previous models and they way the user sets up their guardian fields (ie the area in which you can “play” in VR) has changed. Now operated from entirely within VR, you draw a line to mark out your play area to map it out more precisely. New outward facing cameras on the Rift S headset mean you switch to seeing your real-world surroundings if you move outside of the physical space you’re meant to be in. It’s a clever feature that means you no longer have to worry about bumping into anything or anyone whilst your immersed in the virtual space. 

What do these changes mean for virtual reality simulation? 

In terms of how learners use the OMS simulation platform, the move to the Rift S won’t require you to change anything at all. Whether you’re using a Rift S or and original Rift model, you can still train healthcare professionals using fully immersive VR medical and nursing scenarios as before, and there are some added benefits. 

Firstly, freeing the headset from the external sensors means that the setup is even easier and quicker and the Rift S is smaller, making it even easier to store and transport. Particularly if you are looking for simulation suite that can be used across multiple sites then the Rift S is perfect.

The new guardian set up allows users to take full advantage of the six degrees of freedom (how your movement in the real world matches your movement in the virtual world) in a much simpler format. The guardian system allows you to more easily avoid any fixtures and fittings that might otherwise get in the way and interrupt your immersive experience. Because users can now view their surroundings without coming out of VR – health and safety is assured and the capacity for independent learning of VR simulation is further enhanced. 

In conclusion, in terms of learning outcomes and visual experience, the Rift S offers much the same experience as the original Rift – ie excellent. The improvements made on the Rift S tend to make the practical experience of setting up and implementing simulation simpler with fewer pieces of hardware and the smaller, more transportable kit. All of this means the Rift S continues to allow VR to provide simulation at scale, to deliver all the benefits of OMS VR simulation. 

If you want to try out the OMS VR medical or nursing simulation platform on the Rift S get in touch with one of our Educational Specialists today.

The Joy of VR: what we learned when the leading virtual reality healthcare minds gathered in Los Angeles

We attended the Virtual Medicine conference at Cedars Sinai Medical Centre in Los Angeles where we joined leaders in the virtual reality healthcare space to discuss the latest developments – and applications – of VR in patient care and medical education.

Oxford Medical Simulation (OMS) was proud to join other leading thinkers excited about the potential of virtual reality in healthcare. The Virtual Medicine conference (vMed) brought together not only healthcare professionals, but also researchers, technical developers, business leaders and patients. This made showcasing our virtual reality scenarios for healthcare training during the event all the more special.

As always, we loved getting VR newbies into the system to demo how intuitive VR can be, and it was even more encouraging to get the endorsement of VR experts who live and breath virtual reality in healthcare.

We were excited that when healthcare professionals entered our scenarios for a quick taste they quickly became so immersed that they were determined to save the patient, or delve into the details to find out more. Surprised at the level of realism in one of our virtual patient’s histories, one user at vMed19 announced; “Whoa! I’m going to ask about his social history! I want to know what kind of recreational drugs he uses.” Only in Los Angeles!

Besides the kind words about our own platform, we received a fascinating update into the other ways in which VR is impacting healthcare for the better. From helping to manage pain associated with Crohn’s Disease, to facilitating reminiscence therapy in people with dementia, the applications of therapeutic VR just keep growing. Dr David Rhew (Chief Medical Officer at Samsung Electronics America) gave a compelling talk on the effects of VR on people with dementia, loneliness and concussion amongst a host of other applications. In the case of concussions, VR is now proving to be as effective as sleep, exercise and education. Former Cedars Sinai patient Harmon Clarke recalled how meditating and travelling in VR during his hospital stay, instead of relying solely on pain medication, accelerated his recovery from Crohn’s disease.

The Patient Panel on Day 2 was another highlight: the moving accounts of four patients who had experienced therapeutic VR really brought home the positive results that this technology can have.

Research on the efficacy and optimal methods of delivering VR therapy remains in its infancy and is a fascinating topic. The groundbreaking work done by Skip Rizzo on the applications of VR to treat PTSD and anxiety in particular and Mel Slater on VR in cognitive neuroscience and body-swapping keep us pushing the boundaries of what VR can do and how it can deeply affect individuals perceptions and abilities to learn.

Despite the excitement of the forefront on the technology, the ongoing message of matching appropriate immersive content and delivery to the individual’s needs remains central to all VR design. At OMS we couldn’t agree more. We often ask ourselves and others considering virtual reality “what are your learning objectives?” and ensure that everything we design meets a specific need.

Cedars Sinai Medical Centre proved to be a compelling setting for the event, too. Set against the backdrop of one of the largest academic health centres in the US, the discussions, revelations and real life stories felt even more relevant. It almost felt like we – as a global VR in healthcare community – were more galvanised, united and inspired by physically locating us within the system we’re seeking to change.

It was this collective feeling of inspiration and celebration that made vMed19 such an impactful conference. The world’s leading thinkers and innovators in VR medicine came together in one place to share new developments and celebrate success stories, and we left with a boosted motivation to continue our work in the space. Brennan Spiegel, Director of Health Research at Cedars Sinai and the driving force behind the vMed conference summed up this feeling best when he offered some uplifting advice in his closing remarks: “VR offers joy. Leverage that like crazy.”

Read how Oxford University uses virtual reality to power blended learning and boost medical student education.

 

Oxford University uses virtual reality to power blended learning and boost medical student education

Students at Oxford University use virtual reality simulation to augment medical student education.

Blended learning combines traditional learning techniques with interactive, digital resources to optimise student engagement. This practice can be particularly effective within the context of medical education – where students are required to absorb vast amounts of complex practical and conceptual knowledge. With this in mind, Oxford Medical Simulation’s platform has been designed to complement in-classroom teaching methods with cutting edge virtual reality simulation to take medical students’ learning to the next level.

Medical students at Oxford University have been using our simulation software at the OxSTaR centre to effectively combine learning techniques. Blending the use of our platform with conventional lectures, learners have followed in-classroom study by cementing their practical and clinical skills in VR. Users at Oxford told us that: “As a learning experience, pairing the VR with a lecture beforehand worked well – the VR was an opportunity to consolidate and put the learning into practice.”

Differentiated learning is not a radically new concept in medical training and education – students have traditionally supported their theoretical studies with physical, mannequin-based simulation. However, it’s not uncommon for medical students to get access to a physical simulation session as little as once in an academic year. What is exciting about how Oxford University is using our virtual reality simulation platform is the immediate nature of learning theory in the lecture hall and then instantly – and seamlessly – applying that learning within a simulated scenario.

The upshot of embedding virtual reality simulation into medical training is improved learner confidence and transfer of learning to practice. Because the simulation software is readily accessible, students can repeat scenarios as many times as they need to build confidence. This is crucial to priming learners to enter the hospital environment. The medical students at Oxford University recognise how VR simulation will help them prepare for real-life situations: “It’s really good to get the experience of being put in the driver’s seat, making the decisions and then following through with the management. As a medical student, there is a lot of standing around watching people do things. You tell yourself that you would make those decisions, but it’s nice to actually practice making the decisions. I think it will give me more confidence to make those decisions in real life.”

It’s encouraging to see students responding to virtual reality simulation with virtual patients in such a positive way. Providing readily available, scalable and accessible learning content that transforms learning and, ultimately, real-life practice, is built into the design of our platform. Oxford Medical Simulation will be keeping up the good work with Oxford University and leading institutions to bring this experience to learners around the world.

Here is another blog that may interest you: NHS doctors train using virtual reality to improve care for people with diabetes