Immersive and interactive virtual reality to improve learning and retention of neuroanatomy in medical students: a randomized controlled study

Virtual Reality in Neurosurgery: "Can You See It?"-A Review of the Current Applications and Future Potential

Virtual reality (VR) technology had its early development in the 1960s in the U.S. Air Force and has since evolved into a budding area of scientific research with many practical medical purposes. From medical education to resident training to the operating room, VR has provided tangible benefits to learners and trainees and has also improved surgery through enhanced preoperative planning and efficiency in the operating room. Neurosurgery is a particularly complex field of medicine, in which VR has blossomed into a tool with great usefulness and promise. In spinal surgery, VR simulation has allowed for the practice of innovative minimally invasive procedures. In cranial surgery, VR has excelled in helping neurosurgeons design unique patient-specific approaches to particularly challenging tumor excisions. In neurovascular surgery, VR has helped trainees practice and perfect procedures requiring high levels of dexterity to minimize intraoperative complications and patient radiation exposure. In peripheral nerve surgery, VR has allowed surgeons to gain increased practice and comfort with complex microsurgeries such as nerve decompression. Overall, VR continues to increase its potential in neurosurgery and is poised to benefit patients in a multitude of ways. Although cost-prohibiting, legal, and ethical challenges surrounding this technology must be considered, future research and more direct quantitative outcome comparisons between standard and VR-supplemented procedures would help provide more direction regarding the feasibility of widespread adoption of VR technology in neurosurgery.

The Use of Virtual Reality in Podiatric Medical Education

Virtual reality in medical education is a recent development that significantly improves surgical skills, which translates to improved outcomes in the operating room (OR). The development of the Western University of Health Sciences virtual OR provides podiatric medical students basic OR knowledge and skills through performing basic surgical procedures. This new method of presenting content in podiatric medical education enhances the learning experience in a less stressful environment. The virtual reality experience allows students to gain experience without undue risk to the patient. Thus students can improve competency while focusing on the experience instead of the potentially overwhelming OR setting.

An Exploration of Virtual Reality Use and Application Among Older Adult Populations

Despite increased research on virtual reality (VR) platforms in recent years, there are very few studies that specifically examine its application within a gerontological context. This study examines the usability, preferences, and application considerations of a mobile VR platform by individually interviewing community-dwelling older adults both before and after trying the Samsung Gear VR. Participants were asked to self-select and view short VR videos (30 s-3 min) that were filmed within the local community (e.g., walking path and art museum). Semi-structured interview questions explored participant perceptions of using the device and was followed with two focus group sessions. Thematic analysis was employed when reviewing observational notes and transcribed audio recordings. Ten adults (aged 63-89) participated and themes identified include (a) usability, (b) video subject matter preferences, and (c) application. These themes highlighted both the challenges and opportunities of VR use among a wide range of older populations and provided greater insight with its exploration and application in future studies. This included potential use among those older adults who have notable functional limitations, such as those who are immobile, or reside within a care facility.

Using Virtual Reality to Improve Antiretroviral Therapy Adherence in the Treatment of HIV: Open-Label Repeated Measure Study

Background

Nonadherence to HIV medications is a serious unsolved problem and is a major cause of morbidity and mortality in the HIV-positive population. Although treatment efficacy is high if compliance is greater than 90%, about 40% of people with HIV do not meet this threshold.

Objective

This study aimed to test a novel approach to improve medication adherence by using a low-cost virtual reality (VR) experience to educate people with HIV about their illness. We hypothesized that people with HIV would be more likely to be compliant with the treatment following the 7-minute experience and, therefore, should have decreasing viral load (VL), increasing cluster of differentiation 4⁺ (CD4⁺) cell counts, and improved self-reported adherence.

Methods

We showed the VR experience to 107 participants with HIV at a county hospital in Los Angeles, California. Participants were asked to self-report how often they take their medications on a Likert-scale. The self-reported question (SRQ) was given before and at least 2 weeks after the VR experience. We also compared VL and CD4⁺ cell counts before and on average 101 days after the experience. VL and CD4⁺ were obtained per the clinic’s standard care protocol. Two-tailed paired t tests were performed on the initial and follow-up SRQ scores, VL, and CD4⁺. We restricted the CD4⁺ analysis to participants who had a pre-CD4⁺ below normal (defined as 500 cells/mm³). To reduce the possibility that VL were trending down and CD4⁺ were trending up regardless of the VR experience, 2 serial VL and CD4⁺ obtained before the experience were also compared and analyzed. Immediately following the VR experience, participants were given a 4-question Likert-type postexperience questionnaire (PEQ) that assessed their opinions about the experience.

Results

SRQ scores improved from pre to post experience with high significance (P<.001). VL decreased from pre to post experience by 0.38 log₁₀ copies/mL (95% CI 0.06-0.70; P=.02). In contrast, the 2 serial VL obtained before the experience showed no statistically significant changes. There was also a statistically significant increase in CD4⁺ (95% CI –3.4 to –54.3 cells/mm³; P=.03). Analysis of the PEQ revealed that VR was comfortable for almost all of the participants and that most participants believed the experience to be educational and that it would improve their medication adherence.

Conclusions

The findings suggest that the low-cost VR experience caused an increased rate of antiretroviral therapy adherence that resulted in a decrease of VL and an increase of CD4⁺. Further studies are required to explore the duration of this effect and whether these results are generalizable to other treatment settings and populations.

Virtual reality videos used in undergraduate palliative and oncology medical teaching: results of a pilot study

BACKGROUND

Virtual reality (VR) immersive environments have been shown to be effective in medical teaching. Our university hospital received funding from our deanery, Health Education in Wales, to film teaching videos with a 360-degree camera.

AIMS

To evaluate whether VR is an effective and acceptable teaching environment. VR headsets were set up for medical students who rotated through Velindre Cancer Hospital's Palliative Care department.

METHODS

Students were asked to put on a VR headset and experience a pre-recorded 27 min presentation on nausea and vomiting in palliative care settings. They subsequently viewed a radiotherapy treatment experience from a patient's point of view.

RESULTS

Of the 72 medical students who participated, 70 found the experience comfortable, with two students stating they felt the experience uncomfortable (1=headset too tight; 1=blurry visuals). Numerical scoring on ability to concentrate in VR from 0 to 10 (0=worst, 10=best) scored an average of 8.44 (range, 7-10). Asked whether this format suited their learning style, average score was 8.31 (range 6-10). 97.2 % (n=70) students stated that they would recommend this form of learning to a colleague, with one student saying he/she would not recommend and another stating he/she was unsure. Students left anonymous free-text feedback comments which helped frame future needs in this emerging area.

DISCUSSION

This study suggests that there is room for exploring new ways of delivering teaching and expanding it more widely in palliative care and oncology, but also provides feedback on areas that need further careful attention. Comments from students included: "Might have been the novelty factor but I learnt more from this 20 min VR thing than I have from many lectures".

SUMMARY

The project has proved sufficiently popular in medical student feedback, that the VR experience is now available on YouTube and has been permanently introduced into routine teaching. Further 360-degree teaching environments have been filmed. Of note is that our 360-degree videos have been viewed in Africa, so this format of teaching could prove valuable due to its global reach.