Using Virtual, Augmented and Mixed Realities for Medical Training
This DI Blog post is written by Research Associate Ada Mishler, who dives into the history of using virtual, augmented and mixed realities for medical training.
Medical training can be a tricky business. Trainees need a certain level of realism in training to develop medical skills, but giving beginners access to real patients poses an unacceptable level of risk to the patients. Not surprisingly, medical researchers and practitioners have repeatedly called for solutions to minimize these risks. So, how do we balance the needs of medical trainees with the needs of medical patients?
Enter medical simulations. Simulated patients of one sort or another- from oranges used to practice suturing to complex and costly medical mannequins with realistic injuries and real-time physiological reactions- have been around for decades. But extended reality (XR), consisting of virtual reality (VR) and augmented reality (AR), may be especially well-suited to provide the necessary level of training realism at a manageable cost. VR has the advantage of being reusable, reconfigurable, easier to administer to large numbers of students, and incurring a much lower initial expense compared to realistic hardware-based medical mannequins.
Some of the AR and VR applications in medical training include:
Low-Stakes Surgical Training
Surgical training can include low-fidelity simulations such as fresh oranges or patches of faux skin to learn incision and suturing skills, but these methods are limited in their ability to teach the complex, multi-part tasks necessary to complete a surgical procedure without harming a patient. Given the delicate nature of surgery, it is not surprising that some of the earliest VR applications in medical training were in the surgical domain. Dr. Scott Delp and his colleagues developed a desktop VR simulator of the lower limbs for the training of orthopedic surgical procedures, allowing trainees to manipulate and rotate models of the lower limbs and joints and determine how various surgical procedures would affect the limbs. Since then, VR training for orthopedic surgery has become much more realistic through the use of VR and AR headsets that recognize realistic gestures (like the virtual operating room created by Osso VR). Other companies, like Medical Realities, have further extended VR training to a broad range of surgical categories from neurosurgery to orthopedic surgery. AR and VR surgical training provide an opportunity to repeatedly practice finicky or high-risk surgeries without any risk to human patients.
Clinical Skills Training
Another early application of VR and AR has been the use of virtual patients, who are capable of answering a trainee’s questions about their symptoms. Virtual patients served as a replacement for standardized patients, live actors who serve as patients in a clinical scenario. Virtual patients have the advantage of being relatively cost-effective and more widely accessible, while providing more opportunities for repeated practice. Virtual patients began as simple and low-fidelity desktop applications, but have since been implemented in AR, with more life-like virtual patients being placed inside a real clinical space and responding to the trainee’s voice-based queries. Virtual patients provide the opportunity to practice interactive skills such as taking a patient’s history, diagnosing medical disorders and prescribing medications while receiving quantitative and qualitative feedback.
The Future: Mental Healthcare, Combat Care, and CPR
Research and development efforts continue to expand the world of XR medical training by enhancing the readiness of medical trainees to interact successfully with real patients, increasing the availability of training resources for larger numbers of trainees, and increasing patient safety. Researchers like Dr. Albert Rizzo at the University of Southern California are working to extend virtual patients into the psychological domain, supplying an opportunity to practice diagnosis and treatment of psychological disorders such as PTSD. Miami Children’s Hospital and Next Galaxy Corp. have teamed up to create a more effective CPR training program for hospital employees using mobile and heads-up virtual reality. Meanwhile, here at DI we are partnering with the Army to replace prohibitively expensive medical mannequins with relatively inexpensive VR training for pre-hospital treatment of battlefield wounds.
Still other applications have been developed in the past few years or are being developed now, including AR birth delivery simulators, AR dental care, and VR emergency trauma care. XR has an increasing presence in medical training, and has enormous potential to improve the quality and safety of patient care.
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