Virtual reality has been present in the field of healthcare for over 20 years. It is used as a training tool both for the healthcare professionals and their patients.
What is virtual reality?
According to the Healthcare Simulation Dictionary, virtual reality (VR) is a computer-generated-three-dimensional environment projected on a display that is often mounted on a helmet. The virtual simulation, on the other hand, is two-dimensional because the virtual environment is displayed on a computer screen. Augmented reality (AR) refers to a real environment in which virtual elements are added.
Advantages and Disadvantages
Virtual reality makes it easy to repeat learning while preventing any serious consequences for the actions taken. The immersive effect of virtual reality allows for an accurate and realistic depiction of the environment, which constitutes an advantage of virtual reality over virtual simulation. The learner is more susceptible to be engaged in his learning process, to expand his thought process and to develop his clinical reasoning. Virtual reality also allows the development of psychomotor skills.
However, there is a limit to the execution of fine and precise movements. At the present time, the controllers held in the learners’ hands don’t allow them to practice very technical gestures. Thus, it is preferable to practice an arterial puncture on a mannequin. One can also note that a VR helmet is more cumbersome than AR glasses. Another inconvenience of VR: the possible discomforts (headaches and nausea) that the user can experience. Finally, its price can represent a barrier for some.
VR at the Service of the Healthcare Professional
Virtual reality is intended for both initial and continuing education of healthcare professionals.
Université de Montréal inaugurated its new school of nursing simulation centre in January 2020. The facility includes a virtual reality room that immerses the student at the core of their profession and exposes them to numerous clinical situations and various care settings. The students also have access to individual immersive VR equipment with which they can experience various scenarios. This active learning environment is also available to UQAR nursing and kinesiology students. Like other simulation modalities, VR allows the standardization of teaching by exposing a large number of students to the same large set of clinical situations without being dependent on real-life cases occurring during clinical rotations. During the pandemic, VR is a pedagogical tool of choice as compared to others considering access to simulation centers with mannequins and simulated patients are no longer available. Online platforms allow the creation of new scenarios that can then be shared with the students.
Experiment a Surgical Procedure
Due to VR, a surgeon can rehearse before performing surgery on a patient. Medical imagery from two different patient exams are combined to create a tridimensional representation of the patient anatomy. The surgeon can then use a VR helmet to visualize the anatomy with great precision and then plan the procedure. This is particularly pertinent with complex surgery but also to prevent encountering unexpected situations in the operating room. Thus, an increase in patient safety, combined with learning opportunities for the colleagues.
Empathy, a competency at the core of the therapeutic relationship, is the ability to put oneself in the other’s shoes to better understand his reality. VR literally allows experiencing the situation by seeing it through their eyes! The learner can then role-play the professional and demonstrate his empathy by sharing his understanding to the patient. Then, the learner can go back to the patient perspective to experiment the effect of his own intervention. A promising way to develop empathy! Here is an ongoing study that evaluates the use of VR in the teaching of empathy.
VR at the Service of the Patient
Thanks to VR, the patient can learn different things. Following are some examples:
Anxiety and Pain Management
Patients suffering from phobias can benefit from VR. The Virtual Reality Exposure Therapy (VRET) immerses the patient in anxiety-provoking situations (fear of heights, crowds, etc.) He can then progressively learn to overcome his fears by accomplishing increasingly difficult tasks. Following task completion, the patient receives feedback that guides his management of emotions and helps him get a hold of his perceptions of danger while increasing his self-confidence. Other VR applications teach relaxation using breathing and distraction (focusing one’s attention away from the pain) to reduce anxiety and pain.
Acquiring Health Concepts
Using VR, a patient can navigate the inside of his body and visualize the impact of health habits, for example, the negative impact of excessive salt consumption on his cardiovascular system.
Practice Motor Functions
VR can be used in rehabilitation to help the patient improve his musculoskeletal functions (limb strength and movement, balance when walking, etc.). Whether secondary to a stroke, cerebral palsy or any other conditions, VR encourages the patient to perform various tasks that stimulate his rehabilitation. There are an increasing number of research projects that study the effectiveness of VR in rehabilitation.
VR as a training tool is progressing in the healthcare domain. Current results are promising. More studies are necessary to obtain scientific evidence. There is still ambiguity in the terminology used when referring to virtual technologies. In some studies, virtual reality combines immersive VR and non-immersive VR (called virtual simulation). It would be important to standardize the terminology to ensure that the data collected is attributed to the right type of virtual technology.