Virtual reality technology is playing a growing role in training applications across the UK and Europe, with systems in place to train firefighters in fire forensics and surgical simulators to train surgeons in a more immersive and realistic way that could save lives. Reece Webb learns more.
At Oxford Medical Simulation (OMS) the company is delivering a more immersive, efficient and less expensive form of medical training for doctors and nurses using OMS’s VR software in conjunction with a VR headset.
OMS previously rolled its VR system out as a training pilot scheme and the system is now being implemented across all NHS hospitals in the East of England, as well as numerous medical and nursing institutions in the US and worldwide.
Dr Jack Pottle, medical director at OMS explains: “I realised that what we learn in medical school or nursing school is not appropriate for real life. That is the same the world over: doctors and nurses get on the wards, they make mistakes and patients die.”
Pottle has a background in educational psychology and nursing. He has been a doctor in internal medicine for seven years, working in the UK, Belize, Thailand and South Africa.
“I think a lot people just weren't using VR for the right things: you've got to focus on the problem you’re trying to solve.” - Dr Jack Pottle, medical director, Oxford Medical Simulation
Previously, medical trainees have relied on the field of simulation, using mannequins and actors to simulate real world scenarios.
Pottle notes: “Simulation works. It does change the way people learn and it is the way we should be training people, but you can't scale it and it's only in large specialist centres. Even in these specialist centres, people don't get enough simulation and that means they don't change their practice.”
Pottle was instrumental in developing a system that could replace and augment simulation training with a more immersive VR system. Pottle said “We initially developed a prototype, went through trials with University College London and then we developed our full platform.
He adds “We have our own scenarios and can collaborate with institutions to build the right content for them - scenarios where you, as a player, are thrown into a situation and you must do everything that you would do in real life. Speaking to, investigating and treating the patient while interacting with their relatives and your team. Everything that you do is logged, timestamped and linked out to best practice, so you get structured feedback on your performance and can go back in and repeat it.”
OMS targets a variety of healthcare areas, as Pottle said: “We sell to institutions, including hospitals, simulation centres, universities - anyone who is dealing with health care training.”
Using a standard Oculus Rift headset and OMS’s bespoke software, the team has developed over 60 training scenarios for medical staff to train with, tailored to individual emergencies including sepsis, heart attacks and diabetic problems.
“We can scale training and improve performance, as demonstrated in the trials that we've been through. From that, you can improve patient care and improve patient safety, which has always been the impetus behind this.”
For OMS, the focus was on creating an intuitive system that would work for trainees from all backgrounds.
“We have experimented with all different kinds of controls, including touch controllers and haptics and we've been trying out voice control. It all depends on what you are trying to do and what problem you’re trying to solve. We found that more peripherals can be a problem. For a 21-year-old gamer, they get it quickly and it’s fine, for a 50-year-old nurse just about to retire, it’s a lot harder, so we design all the way up through our whole spectrum. The simplicity of a single remote works very well.
“It depends what you're trying to teach. If you're trying to teach people surgery, then you really need to focus on the haptic side of things but we're focusing on decision making, clinical reasoning and critical thinking. It’s accessible from your most junior healthcare assistant nurses all the way up to consultants in the emergency department.”
The system has been positioned as a less expensive, more immersive alternative to traditional simulation training that can reduce staff requirements and cut costs.
Pottle explains: “It is more realistic in terms of what you can do in the interaction. Of course, with a mannequin they can't speak to you and they can't look unwell, where VR can feel more real. But more importantly when training with VR you don't need more staff, you don't need the time and you don't need the space that are required with mannequin-based training.
“We give institutions a trial period, ensure they can integrate it in their system and then think about how to implement it so that learners use it in practice, as opposed to just putting in a nice shiny benefit. It's about designing so that people use this system in practice to improve their performance.”
VR is playing an increasing role across the training sector, with Pottle believing that training centres are now beginning to take VR seriously. “I think a lot people just weren't using VR for the right things: you've got to focus on the problem you’re trying to solve.”
Emergency services and medical care are the perfect use cases and the questions that we're getting now are much more serious than they were a year ago. It's no longer about “why VR” or “what's the value of VR”, it’s very much more: “Okay, we get this, how do we implement it? How much will it cost? What does that look like in practice?”
Looking to the future, Pottle sees OMS’s platform expanding to offer deeper collaboration between users. Pottle explains: “We’re going to flesh out community-based, psychiatric, obstetrics and gynaecology content. More importantly, we’ve developed a multiplayer system that is currently in the pre-release phase. The multiplayer or ‘interprofessional’ version of our platform can allow eight players in one scenario, with the ability for a mentor to also be there watching how learners work together. Those learners can interact with the patients and each other in real time, being able to talk to each other and see body language – which really adds the element of teamwork into professional education.”
OMS also plans to continue its expansion across the health sector in the EMEA region. “We’ve completed our first contracts in Europe. Our system is in use in Denmark and the University of Tübingen in Germany with plans to deliver in Switzerland shortly. It’s not a difficult process. We just teach institutions how to use it in a training session and then they can do it for themselves, there's no extra subtlety needed.”
OMS is also expanding training to healthcare systems in addition to individual institutions – delivering training for junior doctors across 18 hospital trusts in the East of England from August 2019. This aligns with their focus on broader healthcare changes. “Where there’s the senior impetus for system-wide changes to healthcare system, hospitals or universities, we’re delighted to be involved.”
“As well as our focus on the US and UK, we will also be distributing the system across Europe and the Middle East, getting VR into locations where physical simulation with mannequins doesn't yet exist in a big way. We can then leapfrog mannequins and scale training more efficiently before hospitals have wasted all that money.”
Pottle has the final word; “With this technology, we have the ability to train healthcare professionals at scale more realistically than they do already whilst saving time, saving space and saving money. At a time when there’s so much focus on effectiveness and efficiency in healthcare, VR seems the obvious solution.”