Essential Insights contributor, healthcare writer
Innovation Solutions Manager, Fuse by Cardinal Health
Doug Knutson, MD
System Vice President of Academic Affairs and Chief Academic Officer, OhioHealth
Emergency rooms are stressful and chaotic environments with a low tolerance for error, and acclimating newcomers to them has been a long-standing challenge. But a collaborative effort from Ohio University, Northern Arizona University and OhioHealth may have the answer: a virtual emergency room.
The team, including designers from the Immersive Media Initiative (IMI) at Ohio University's Scripps College of Communication, created a 360-degree, fully immersive trauma room experience, complete with the machines, personnel, and patients you'd expect to see in a typical emergency room. Users can choose various perspectives from which to approach the scene, including as a head nurse or head surgeon. The result is a complete picture of the realities of an ER, and one that can be utilized repeatedly to prepare students for the real thing in the future.
While augmented reality (AR) and virtual reality (VR) technologies are already being widely used in novel ways to revolutionize the patient experience, industry expert Kristina Redgrave of Fuse by Cardinal Health, the company's innovation center, predicts AR and VR will also become a standard part of medical training as costs decrease.
Below are three ways AR and VR are changing medical education.
Technologies like IMI's virtual emergency room allow medical students to practice in real-world situations, without the added stress of real lives at stake.
"For many medical students, the environment within a trauma bay can be in itself traumatizing. It looks chaotic, but in actuality is well-choreographed. Using VR helps us prepare students for the stress, acuity and pace that they’ll encounter, allowing them to focus on their learning rather the flurry of activity," said Doug Knutson, MD, system vice president of Academic Affairs and chief academic officer at OhioHealth.
Medical education has always necessitated a hands-on approach. Practice is imperative for both confidence and competence, but students are often not given many opportunities for risk-free rehearsals before being placed in stressful situations. Similar to flight simulators, which allow future and current pilots to train for real-world crises in protected environments, AR/VR applications are allowing medical students to practice their skill and ability to perform under pressure.
According to Redgrave, AR/VR can also help physicians prepare for procedures that necessitate understanding complex anatomy that may have a lot of variation from typical structures.
One example of this emerging technology is Microsoft's AR device, HoloLens. The headset uses sensors and holographs to superimpose data on top of real-world situations.
Ohio's Case Western Reserve University is one of the first major institutions to partner with Microsoft to examine the potential of the HoloLens in medical education. The university—with additional support from the Cleveland Clinic—is currently building the Health Education Campus, a technologically advanced learning center where medical students will study complex anatomical structures without a cadaver in sight. Instead, HoloLens devices will give students complete anatomical views that can be rotated and otherwise manipulated for optimum visibility. Instructors can highlight key structures or anomalies like injuries or tumors, providing students with three-dimensional representations that can accomplish in just a few minutes what might take hours in the anatomy lab.
How Case Western University is using Microsoft HoloLens to transform anatomy class.
New technology is also allowing medical students to practice complex surgical procedures that require repetition for perfection. There's not a whole lot of concrete data around just how well AR/VR translates to actual experiences, but some studies predict a future where healthcare providers are significantly less likely to make mistakes thanks to their AR/VR training. In one double-blind study examining the effects of VR-training on medical residents with regard to gallbladder dissection, researchers found that those with VR training performed the procedure 29 percent faster, and were six times less likely to make errors than those without VR training. Non-VR-trained residents were five times more likely to injure the gallbladder or other nontarget tissue.
The practical implications of AR/VR for medical teaching and training also allow students to experience situations from the patient's viewpoint.
Bedside manner and empathy can be hard to teach. Putting yourself into another person's shoes is a skill easier said than done, but with AR/VR technologies, students are able to immerse themselves in the patient experience, learning best practices for treatment and communication.
At Chicago's Embodied Labs, researchers are using VR to address the problematic lack of interest in geriatric medicine. With the U.S. Census Bureau predicting that 20 percent of the population will be 65 and older in 2030, a deficit of geriatricians could have severe consequences on our health system. Embodied Labs' "We Are Alfred" simulation allows students to experience what life is like for a 74-year-old, complete with macular degeneration and hearing loss. In an initial study of the device, students exhibited clear increases in their empathy levels toward aging adults, evidenced by self-reporting and reduced use of stereotypical negative terms to refer to older patients. The study also showed that 9.5 percent of the students reported an increased interest in practicing geriatric medicine.
AR and VR are enabling a future where today's students are better prepared to become more highly trained, skilled, and empathetic healthcare providers.
How the immersive experience of "We are Alfred" teaches medical students about the aging process.