Jan 12 2023

Virtual Reality Helps Healthcare Students Experience Clinical Scenarios

Immersive technology is transforming nursing and medical education.

Augusta University's College of Nursing realized it needed to better train students on how to support family members when patients are near the end of life after recent graduates told faculty how emotionally unprepared they were the first time they faced the situation.

In response, the Georgia university has built virtual reality simulations that enable nursing students to role-play various situations so they can learn empathy and provide the support their future patients and patients’ families will need, says Lynsey Steinberg, a board-certified medical illustrator with Augusta University’s Center for Instructional Innovation.

“We can’t bring students to actual hospice care settings where patients are dying. It’s not appropriate. But by putting a scene in front of students in virtual reality, they can experience this real-world scenario,” she says.

Universities and colleges are increasingly using VR, augmented reality and other immersive technologies as part of their curriculum, and medical and nursing schools are among the early adopters.

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With VR headsets, computers and software, students can dissect virtual cadavers; train for surgery, intubation and other procedures; and practice medical situations, from examining and diagnosing patients to handling hospice care.

“There’s tremendous value in being able to replicate real-life scenarios and try things again and again,” says Bob O’Donnell, founder and chief analyst at TECHnalysis Research. “Doing virtual surgeries — and in the case of virtual cadavers, letting people peel away the layers and explore the body — helps people figure out how everything works.”

According to the National Library of Medicine, educators can use different forms of VR in a medical school environment, including 360-degree video and interactive VR. The technology also offers cost savings compared with physical simulations, with the main upfront costs being the hardware and software.

The technology requires less space than physical simulations and can free up faculty time because, in some cases, instructors do not need to be present, the National Library of Medicine notes.

Augusta University Nursing Students Practice End-of-Life Situations

At Augusta University, two nursing professors collaborated with the university’s Center for Instructional Innovation to create six immersive, end-of-life VR scenes that students can view on an Oculus VR headset.

The scenes, each lasting one to three minutes, include telling family members that their loved one is near death and explaining why the patient looks and sounds the way they do. In another scene, an anguished family member asks if she can bring her 4-year-old child into the room to say goodbye.

To build the VR scenes, they first wrote scripts, then filmed the scenes using a 360-degree video camera and microphones, using students and staff as actors inside a patient room at the university’s healthcare simulation center.

During production, they painted visual effects on the patient’s skin and added vocal audio effects to replicate what patients look and sound like at the end of life, Steinberg says.

The College of Nursing tested the VR scenes this summer with eight students pursuing their master’s degrees. It was so successful that the college is incorporating it as part of its palliative care nursing course content this fall. About 135 nursing students pursuing bachelor’s degrees will go through the VR simulations.

“They’re shocked at how realistic it is. They say, ‘It’s like I’m right there,’” Steinberg says.

Elena Prendergast
Giving bad news is difficult. It doesn’t matter how much training you have. The difference is, we can help students be more prepared and more comfortable to have those conversations.”

Elena Prendergast Assistant Professor, Augusta University College of Nursing

The College of Nursing’s VR setup features 10 computers and four Oculus VR headsets. Students use the computers to go through a training module to learn how to speak with empathy and practice phrases they can say to the patient’s family members, Steinberg says. Then they take turns putting on the headsets to go through the VR scenarios, which last about 15 minutes.

The VR simulations provide a safe environment to practice communicating with patients’ families, says Elena Prendergast, an assistant professor at the College of Nursing. Faculty watch how students handle the situations, then talk them through the experience.

“Giving bad news is difficult. It doesn’t matter how much training you have,” Prendergast says. “The difference is, we can help students be more prepared and more comfortable to have those conversations.”

VR Enables Remote Learning at Purdue University Global

When the pandemic struck, Purdue University Global’s online nursing program needed an alternative to an onsite skills lab.

Partnering with a third-party educational VR vendor, the university developed immersive simulations using 3D animation in VR to help students learn six essential skills, says Abbey Elliott, assistant dean of immersive learning and innovation for Purdue University Global’s school of nursing. Those skills include chest tube insertion and endotracheal intubation.

The university launched the VR experience during the fall 2020 semester. Students purchased Oculus VR headsets, downloaded the app, and in guided mode, the VR application taught them step by step how to perform the procedures, Elliott says.

In expert mode, they performed the procedures without any hand-holding. Then, in exam mode, they had to do each procedure correctly before starting their clinical practice experiences.

DISCOVER: Dr. José M. Barral explains the benefits of using virtual tools for anatomy education.

The VR technology drew rave reviews from students. “We saw such a great increase in student confidence,” Elliott says. “The student response was overwhelmingly positive because it gave them flexibility.”

The VR app also provided analytics. If students struggle with a procedure, faculty members are notified on a web-based dashboard. “Faculty can talk to students about how they can do better, and if needed, they can share their screen to show them something,” she says.

Today, students pursuing an associate degree can learn nearly 70 skills, including hand hygiene and inserting an IV. They can also run AI-powered VR simulations in which they give patient exams and assess patients’ health. The program also created a community assessment in VR, where students can interview avatars in a neighborhood and learn what healthcare services they need.

“Students are much better at skills because they’ve practiced 1,000 times at home,” Elliott says.

Virtual Reality Brings Cadavers to the Medical Students

New York University's Grossman School of Medicine uses VR and AR to give students new ways to visualize and learn about the human body.

While the medical school still has human cadavers for students to inspect, they no longer dissect cadavers as part of the curriculum; they use VR and AR instead, says Greg Dorsainville, manager of immersive computing at the medical school’s Institute for Innovations in Medical Education.

“In the past, students were in the anatomy lab at all hours of the night examining real cadavers,” he says. “Now, if they are learning about the physiology of the heart, for example, they still go to the lab and see examples of the heart. But we want them to have anytime, anywhere access. So, now they can go home and see digitized versions of the heart, animations and other resources.”

Source: Translational Research in Anatomy, “Assessment of the Utility of Mixed Reality in Medical Education,” September 2022

Dorsainville has taken photos of real-life cadavers and, using photogrammetry software, stitched the photos together so students can see the human body in 3D through VR.

Students can also view 3D models of the brain and other body parts as if they are standing inside them. That allows them to better visualize the body, Dorsainville says.

“VR makes a big difference for the anatomy because it provides you the spatial relationships,” Dorsainville says. Some VR applications work directly on VR headsets. Other VR apps that are graphics-intensive require both a VR headset and a computer with a dedicated GPU chip, he says.

The medical school has 20 VR headsets on campus, including the Lenovo Varjo, Oculus Quest 2 and HTC Vive. But it also makes sure students can go home and access the VR experiences and 3D models on other devices, such as computers, tablets and smartphones.

“We’ve got to meet our learners where they are,” Dorsainville says.

UP NEXT: Explore advancements in patient care using virtual reality and extended reality.

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