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Goldust M, Grant-Kels JM. Regulatory Considerations for Safe and Ethical Use of Augmented Reality and Virtual Reality in Dermatology. Clin Dermatol 2024:S0738-081X(24)00196-2. [PMID: 39341513 DOI: 10.1016/j.clindermatol.2024.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Dermatology is beginning to investigate the uses of virtual reality (VR) and augmented reality (AR) to enhance residency education and to provide patients with comprehensive and interactive experiences. Although the applications of VR and AR to improve patient clinical care are exciting, these technologic advances may have implications about regulatory considerations, patient safety, informed consent, and privacy. We review how using artificial intelligence, VR, and AR can enhance patient care and deliberate the complex issues surrounding these potential innovations.
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Affiliation(s)
- Mohamad Goldust
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
| | - Jane M Grant-Kels
- Dermatology Department, University of Connecticut School of Medicine, Farmington, CT, USA; Dermatology Department, University of Florida, College of Medicine, Gainesville, FL, USA.
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Salimi S, Asgari Z, Mohammadnejad A, Teimazi A, Bakhtiari M. Efficacy of virtual reality and augmented reality in anatomy education: A systematic review and meta-analysis. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 39300601 DOI: 10.1002/ase.2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 09/22/2024]
Abstract
Anatomy is the cornerstone of medical education. Virtual reality (VR) and augmented reality (AR) technologies are becoming increasingly popular in the development of anatomy education. Various studies have evaluated VR and AR in anatomy education. This meta-analysis aims to evaluate the effectiveness of VR and AR in anatomical education. The protocol was registered in Prospero. Scopus, PubMed, Web of Science, and Cochrane Library databases were searched. From the 4487 articles gathered, 24 randomized controlled trials were finally selected according to inclusion criteria. According to the results of the meta-analysis, VR had a moderate and significant effect on the improvement of knowledge scores in comparison with other methods (standardized mean difference = 0.58; 95% CI = 0.22, 0.95; p < 0.01). Due to the high degree of heterogeneity (I2 = 87.44%), subgroup analyses and meta-regression were performed on eight variables. In enhancing the "attitude," VR was found to be more "useful" than other methods (p = 0.01); however, no significant difference was found for "enjoyable" and "easy to use" statements. Compared with other methods, the effect of AR on knowledge scores was non-significant (SMD = -0.02; 95% CI = -0.39, 0.34; p = 0.90); also, in subgroup analyses and meta-regression, the results were non-significant. The results indicate that, unlike AR, VR could be used as an effective tool for teaching anatomy in medical education. Given the observed heterogeneity across the included studies, further research is warranted to identify those variables that may impact the efficacy of VR and AR in anatomy education.
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Affiliation(s)
- Sajjad Salimi
- Student Research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Asgari
- Student Research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amirreza Mohammadnejad
- Student Research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ashkan Teimazi
- Student Research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Bakhtiari
- Department of Anatomical Sciences, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Einloft J, Meyer HL, Bedenbender S, Morgenschweis ML, Ganser A, Russ P, Hirsch MC, Grgic I. Immersive medical training: a comprehensive longitudinal study of extended reality in emergency scenarios for large student groups. BMC MEDICAL EDUCATION 2024; 24:978. [PMID: 39252064 PMCID: PMC11385130 DOI: 10.1186/s12909-024-05957-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 08/26/2024] [Indexed: 09/11/2024]
Abstract
Young healthcare professionals and medical graduates often fall short in the practical experience necessary for handling medical emergencies. This can not only lead to strained feelings of inadequacy and insecurity among future physicians and less experienced healthcare providers in general, but also to detrimental outcomes for patients as emergency medicine demands rapid decision-making with low tolerance for errors. New didactic modalities and approaches may be needed to effectively address this shortcoming. Immersive technologies are powerful novel educational tools with untapped potential in medical training, and may be particularly suitable for simulation trainings in the high-stakes field of emergency medicine.Herein, we systematically explored the educational potential of extended reality (XR) technology, particularly virtual reality (VR), in the management of patients presenting as medical emergencies, combining the use of the STEP-VR application with an untethered hardware setup.Importantly, we aimed at studying multiple, large cohorts of senior medical students involving a total of 529 participants and collecting data over a period of two years. We assessed students' acceptance of the training through a modified questionnaire measuring device handling, content complexity, degree of immersion, learning success, and seminar design.Our results show high, sustained acceptance and ease of use across different student cohorts and subgroups, with most students finding XR/VR engaging and beneficial for acquiring emergency medicine skills. Importantly, the prevalence of simulation sickness was minimal. Moreover, no major effect of the head-mounted displays (HMDs) price range was noted with regard to the learning experience. The results underscore the potential of XR/VR capabilities in effectively enhancing medical education, particularly in areas of high-stakes clinical scenarios and emergency care, by providing realistic and reproducible immersive training environments.In summary, our findings suggest that XR/VR-based training approaches could significantly contribute to preparing future physicians for the complexities of emergency medical care, encouraging the integration of such technologies into medical curricula. However, careful consideration must be given to its suitability for all students and the practical challenges of its implementation, highlighting the need for further research to harness its full potential for medical education.
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Affiliation(s)
- Jonas Einloft
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Hendrik L Meyer
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Simon Bedenbender
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Muriel L Morgenschweis
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Andre Ganser
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Philipp Russ
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Martin C Hirsch
- Institute for Artificial Intelligence in Medicine, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Ivica Grgic
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany.
- Institute for Artificial Intelligence in Medicine, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany.
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Díaz Molina RJ, Comesaña Castellar C, Crespí Rigo J, Radu Tomsa C, Quesada Bauzá P, Porcel Corra I, Sendra Rumbeu P, Royo Escosa V, Herrera González MD, Puchol Segarra E, Ginard Vicens D. Descriptive observational study on the use of virtual reality in patients with inflammatory bowel disease undergoing biological treatment. GASTROENTEROLOGIA Y HEPATOLOGIA 2024:502236. [PMID: 39173828 DOI: 10.1016/j.gastrohep.2024.502236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 08/11/2024] [Accepted: 08/15/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Virtual reality (VR) is a neurosensory experience in which simulated spaces a person has the sensation of being able to function within them. Some patients with inflammatory bowel disease (IBD) receive intravenous biological treatments in an Adult Day Hospital (ADH) regime. VR has been used in some fields of medicine, demonstrating its usefulness in reducing negative symptoms. However, we do not have any literature showing the applicability in real clinical practice of VR in IBD. METHODS Descriptive observational pilot study based on an initial cohort of 87 patients that were obtained from the ADH of the IBD Unit. Satisfaction and acceptance of VR through the use of 3D glasses and the reduction of negative symptoms during intravenous biological treatment in patients with IBD in ADH have been assessed. RESULTS 43 patients (52.4%) used VR and completed the study. In the comparative analysis of the results of the questionnaires before and after the use of VR, a statistically significant improvement was observed in the patients' view on the ability of VR to achieve a reduction in stress (65% patients improve; p: 0.0021) and pain (VAS, 54% p. improve; p<0.05) during treatment. Likewise, with the applicability of VR in other areas of medicine (53%; p: 0.05) and with the possibility of improving well-being during the stay in the ADH (56%; p: 0.0014). No side effects were reported with the use of the 3D glasses. CONCLUSIONS VR is a useful complementary tool to improve the stay of patients with IBD on ADH during intravenous treatment.
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Affiliation(s)
- Raúl José Díaz Molina
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain.
| | - Carlos Comesaña Castellar
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain
| | | | | | | | | | - Pau Sendra Rumbeu
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain
| | - Vanesa Royo Escosa
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain
| | | | - Eva Puchol Segarra
- Infirmary Adult Day Hospital for Inflammatory Bowel Disease of the Son Espases University Hospital, Spain
| | - Daniel Ginard Vicens
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain; Lipids in Human Pathology Group, Institut Universitari d'Investigació en Ciències de la Salut, Universitat de les Illes Balears, 07122 Palma, Spain; Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07010 Palma, Spain
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Alhamood M, Abbass A, Hasn R. Virtual reality: a game-changer in the diagnosis and surgical planning of astrocytoma grade III: a case report. J Med Case Rep 2024; 18:388. [PMID: 39152508 PMCID: PMC11330069 DOI: 10.1186/s13256-024-04679-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 06/30/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND In the dynamic realm of modern medicine, the advent of virtual reality technology heralds a transformative era, reshaping the contours of diagnosis and surgical planning with its immersive prowess. This study delves into the groundbreaking application of virtual reality in the intricate dance of neurosurgery, particularly spotlighting its role in the management of astrocytoma grade III-a cerebral challenge of significant complexity. CASE PRESENTATION A 30-year-old Middle Eastern man from Syria grappled with the invisible tendrils of pain, manifesting as persistent headaches and a numbing sensation that crept into his neck and extremities. For two relentless months, the morning sun brought not hope but an intensification of his agony, rendering him unable to partake in the daily dance of life. The usual sentinels of relief, analgesic drugs, stood defeated, offering no respite. The neurological examination was normal, there were no pathological findings on sensory and motor examination, and he exhibited normal reflexes and neither meningeal nor cerebellar signs. He showed a family history of breast cancer. The initial foray into the enigmatic depths of his brain via computed tomography and magnetic resonance imaging imaging unveiled a finding in the right temporal lobe, a lesion that suggested something more sinister. Previous medical interventions included analgesic medications prescribed for persistent headaches, but they offered no relief. No other therapeutic interventions were administered prior to the current diagnosis. It was here that virtual reality technology emerged not as a mere tool but as a beacon of precision, casting a three-dimensional light on the shadowy intruder. This technological marvel allowed for meticulous measurement 21.8 × 14.5 mm and localization within the temporal theater, setting the stage for what was to come. With the path laid clear, the patient embarked on a surgical odyssey, a quest to excise the unwelcome guest. The operation was a triumph, a testament to human ingenuity and the symbiotic relationship between flesh and machine. The postoperative verdict was delivered through the lens of histopathology, confirming the presence of an astrocytoma grade III, a cerebral interloper known for its rapid proliferation. The battle, however, was far from over. Complementary radiotherapy and chemotherapy were enlisted as allies in this ongoing war, their potent forces working in concert to stave off the cellular insurgence. The patient's journey through the healing arts was charted by periodic clinical and neurological examinations, with laboratory tests and the vigilant gaze of brain magnetic resonance imaging ensuring a watchful eye was kept on any potential resurgence. CONCLUSIONS In this narrative of resilience and technological prowess, we witness the harmonious fusion of human touch and digital precision, a partnership that redefines the boundaries of medicine and the art of healing, by use of virtual reality technology in the diagnosis of astrocytoma and enhancing the accuracy, effectiveness, and safety of neurosurgical procedures, which can ultimately benefit patients with brain tumors.
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Affiliation(s)
- Mohammed Alhamood
- Military Medical Services Administration, Tishreen Hospital, Damascus, Syrian Arab Republic.
| | - Amin Abbass
- Military Medical Services Administration, Tishreen Hospital, Damascus, Syrian Arab Republic
| | - Rida Hasn
- Neurosurgery Department, Military Medical Services Administration, Tishreen Military Hospital, Damascus, Syrian Arab Republic
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Khan HU, Ali Y, Khan F, Al-antari MA. A comprehensive study on unraveling the advances of immersive technologies (VR/AR/MR/XR) in the healthcare sector during the COVID-19: Challenges and solutions. Heliyon 2024; 10:e35037. [PMID: 39157361 PMCID: PMC11328097 DOI: 10.1016/j.heliyon.2024.e35037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 07/16/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024] Open
Abstract
The current COVID-19 pandemic has affected almost every aspect of life but its impact on the healthcare landscape is conspicuously adverse. However, digital technologies played a significant contribution in coping with the challenges spawned by this pandemic. In this list of applied digital technologies, the role of immersive technologies in battling COVID-19 is notice-worthy. Immersive technologies consisting of virtual reality (VR), augmented reality (AR), mixed reality (MR), extended reality (XR), metaverse, gamification, etc. have shown enormous market growth within the healthcare system, particularly with the emergence of pandemics. These technologies supplemented interactivity, immersive experience, 3D modeling, touching sensory elements, simulation, and feedback mechanisms to tackle the COVID-19 disease in healthcare systems. Keeping in view the applicability and significance of immersive technological advancement, the major aim of this study is to identify and highlight the role of immersive technologies concerning handling COVID-19 in the healthcare setup. The contribution of immersive technologies in the healthcare domain for the different purposes such as medical education, medical training, proctoring, online surgeries, stress management, social distancing, physical fitness, drug manufacturing and designing, and cognitive rehabilitation is highlighted. A comprehensive and in-depth analysis of the collected studies has been performed to understand the current research work and future research directions. A state-of-the-artwork is presented to identify and discuss the various issues involving the adoption of immersive technologies in the healthcare area. Furthermore, the solutions to these emerging challenges and issues have been provided based on an extensive literature study. The results of this study show that immersive technologies have the considerable potential to provide massive support to stakeholders in the healthcare system during current COVID-19 situation and future pandemics.
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Affiliation(s)
- Habib Ullah Khan
- Department of Accounting and Information Systems, College of Business and Economics, Qatar University, Doha Qatar
| | - Yasir Ali
- Shahzeb Shaheed Govt Degree College Razzar, Swabi, Higher Education Department, KP, Pakistan
| | - Faheem Khan
- Department of Computer Engineering, Gachon University, Seongnam-si, Republic of Korea
| | - Mugahed A. Al-antari
- Department of Artificial Intelligence and Data Science, College of AI Convergence, Daeyang AI Center, Sejong University, Seoul, 05006, Republic of Korea
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Ajeet Gokani H, Sommerlad A, Jawharieh H, Ang CS, Huntley J. Carers and professionals' views on using virtual reality in dementia care: A qualitative study. DEMENTIA 2024:14713012241272786. [PMID: 39121239 DOI: 10.1177/14713012241272786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
BACKGROUND AND OBJECTIVES Virtual reality (VR) interventions provide immersive, interactive computer-simulated virtual environments. There is interest in their use for people with dementia as they may provide stimulating experiences and improve dementia symptoms and quality of life. However, as more insight is needed about carers' and clinical professionals' perspectives to understand how VR may be implemented successfully, we elicited their views on the benefits of, and challenges to, using VR in dementia care. METHODS We conducted five qualitative focus groups involving 25 healthcare professionals and informal carers with experience of dementia care. Participants received a demonstration of a VR headset and content and were then questioned following a topic guide asking for views on benefits of, and challenges to, using VR for dementia care. FINDINGS The main findings addressed the benefits of, and concerns about, the impact and implications of VR on wellbeing, ethics, implementation, caregivers and services. Overall, participants had a positive attitude toward VR and made several suggestions for its future use to enable enjoyable and immersive experiences. Examples included suggestions to personalise VR content to accommodate heterogenous profiles and stages of dementia, co-developing protocols to address health risks and side effects and further investigating shared experiences of VR with caregivers. CONCLUSION Healthcare professionals and informal carers thought that VR had potential to enhance a holistic and personalised approach to dementia care. They suggested changes which could guide future implementation of VR interventions for dementia patients and their caregivers.
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Affiliation(s)
| | - Andrew Sommerlad
- Division of Psychiatry, UCL, UK; Camden and Islington NHS Foundation Trust, UK
| | | | | | - Jonathan Huntley
- Division of Psychiatry, UCL, UK; Camden and Islington NHS Foundation Trust, UK and Faculty of Health and Life Sciences, University of Exeter, UK
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Mistry D, Geevarughese S, Brock CA, Nelson J, Drew D, Goddard CM, West RT, Kleiman K, Lindsey T. Utilizing a Virtual Reality Matrix in Medical Education. Cureus 2024; 16:e66446. [PMID: 39132090 PMCID: PMC11311931 DOI: 10.7759/cureus.66446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 08/08/2024] [Indexed: 08/13/2024] Open
Abstract
Virtual reality (VR) is an emerging technology that has demonstrated incredible value within medical education. However, medical institutions adopting VR as a learning tool need to ensure that the immersive technology product they pick possesses standard usability criteria. The current literature is limited in defining what specific criteria institutions should look for, or how to select between various VR products. Since there have been little to no algorithms available to the medical education community to aid in this process, a reproducible matrix has been developed to evaluate multiple VR platforms at once which can help identify the best option for medical education programs. The matrix is a 10-point scoring system that includes what the research team considered to be the 10 most important factors when selecting a VR product for medical education. The scores of any two or more VR products can be quantitatively compared. Therefore, the matrix is to be used as a methodological framework to help objectively select the highest-rated immersive technology platform. The research team involved in the development of the matrix consisted of an associate dean for simulation and technology, a director of simulation and technology, and eight medical students.
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Affiliation(s)
- Dipal Mistry
- Clinical, Biomedical, and Educational Research, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Sarah Geevarughese
- Clinical, Biomedical, and Educational Research, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Callaham A Brock
- College of Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Jacob Nelson
- College of Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Danielle Drew
- Clinical, Biomedical, and Educational Research, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Chris M Goddard
- Surgery, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Ryan T West
- Family Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Kyle Kleiman
- College of Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Tom Lindsey
- Surgery, Edward Via College of Osteopathic Medicine, Spartanburg, USA
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Ai X, Santamaria V, Agrawal SK. Characterizing the Effects of Adding Virtual and Augmented Reality in Robot-Assisted Training. IEEE Trans Neural Syst Rehabil Eng 2024; 32:2709-2718. [PMID: 39042524 PMCID: PMC11324333 DOI: 10.1109/tnsre.2024.3432661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Extended reality (XR) technology combines physical reality with computer synthetic virtuality to deliver immersive experience to users. Virtual reality (VR) and augmented reality (AR) are two subdomains within XR with different immersion levels. Both of these have the potential to be combined with robot-assisted training protocols to maximize postural control improvement. In this study, we conducted a randomized control experiment with sixty-three healthy subjects to compare the effectiveness of robot-assisted posture training combined with VR or AR against robotic training alone. A robotic Trunk Support Trainer (TruST) was employed to deliver assistive force at the trunk as subjects moved beyond the stability limits during training. Our results showed that both VR and AR significantly enhanced the training outcomes of the TruST intervention. However, the VR group experienced higher simulator sickness compared to the AR group, suggesting that AR is better suited for sitting posture training in conjunction with TruST intervention. Our findings highlight the added value of XR to robot-assisted training and provide novel insights into the differences between AR and VR when integrated into a robotic training protocol. In addition, we developed a custom XR application that suited well for TruST intervention requirements. Our approach can be extended to other studies to develop novel XR-enhanced robotic training platforms.
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Mergen M, Graf N, Meyerheim M. Reviewing the current state of virtual reality integration in medical education - a scoping review. BMC MEDICAL EDUCATION 2024; 24:788. [PMID: 39044186 PMCID: PMC11267750 DOI: 10.1186/s12909-024-05777-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 07/15/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND In medical education, new technologies like Virtual Reality (VR) are increasingly integrated to enhance digital learning. Originally used to train surgical procedures, now use cases also cover emergency scenarios and non-technical skills like clinical decision-making. This scoping review aims to provide an overview of VR in medical education, including requirements, advantages, disadvantages, as well as evaluation methods and respective study results to establish a foundation for future VR integration into medical curricula. METHODS This review follows the updated JBI methodology for scoping reviews and adheres to the respective PRISMA extension. We included reviews in English or German language from 2012 to March 2022 that examine the use of VR in education for medical and nursing students, registered nurses, and qualified physicians. Data extraction focused on medical specialties, subjects, curricula, technical/didactic requirements, evaluation methods and study outcomes as well as advantages and disadvantages of VR. RESULTS A total of 763 records were identified. After eligibility assessment, 69 studies were included. Nearly half of them were published between 2021 and 2022, predominantly from high-income countries. Most reviews focused on surgical training in laparoscopic and minimally invasive procedures (43.5%) and included studies with qualified physicians as participants (43.5%). Technical, didactic and organisational requirements were highlighted and evaluations covering performance time and quality, skills acquisition and validity, often showed positive outcomes. Accessibility, repeatability, cost-effectiveness, and improved skill development were reported as advantages, while financial challenges, technical limitations, lack of scientific evidence, and potential user discomfort were cited as disadvantages. DISCUSSION Despite a high potential of VR in medical education, there are mandatory requirements for its integration into medical curricula addressing challenges related to finances, technical limitations, and didactic aspects. The reported lack of standardised and validated guidelines for evaluating VR training must be overcome to enable high-quality evidence for VR usage in medical education. Interdisciplinary teams of software developers, AI experts, designers, medical didactics experts and end users are required to design useful VR courses. Technical issues and compromised realism can be mitigated by further technological advancements.
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Affiliation(s)
- Marvin Mergen
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Saarland University, Building 9, Kirrberger Strasse 100, 66421, Homburg, Germany.
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Saarland University, Building 9, Kirrberger Strasse 100, 66421, Homburg, Germany
| | - Marcel Meyerheim
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Saarland University, Building 9, Kirrberger Strasse 100, 66421, Homburg, Germany
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Maheta B, Shehabat M, Khalil R, Wen J, Karabala M, Manhas P, Niu A, Goswami C, Frezza E. The Effectiveness of Patient Education on Laparoscopic Surgery Postoperative Outcomes to Determine Whether Direct Coaching Is the Best Approach: Systematic Review of Randomized Controlled Trials. JMIR Perioper Med 2024; 7:e51573. [PMID: 38935953 PMCID: PMC11240078 DOI: 10.2196/51573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/10/2023] [Accepted: 05/06/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND As of 2022, patient adherence to postoperative guidelines can reduce the risk of complications by up to 52.4% following laparoscopic abdominal surgery. With the availability of various preoperative education interventions (POEIs), understanding which POEI results in improvement in patient outcomes across the procedures is imperative. OBJECTIVE This study aims to determine which POEI could be the most effective on patient outcomes by systematically reviewing all the POEIs reported in the literature. METHODS In total, 4753 articles investigating various POEIs (eg, videos, presentations, mobile apps, and one-on-one education or coaching) were collected from the PubMed, Embase, and Scopus databases. Inclusion criteria were adult patients undergoing abdominal laparoscopic surgery, randomized controlled trials, and studies that provided postoperative outcomes. Exclusion criteria included studies not published in English and with no outcomes reported. Title and abstract and full-text articles with POEI randomized controlled studies were screened based on the above criteria through a blinded, dual review using Covidence (Veritas Health Innovation). Study quality was assessed through the Cochrane Risk of Bias tool. The included articles were analyzed for educational content, intervention timing, intervention type, and postoperative outcomes appropriate for a particular surgery. RESULTS Only 17 studies matched our criteria, with 1831 patients undergoing laparoscopic cholecystectomy, bariatric surgery (gastric bypass and gastric sleeve), and colectomy. In total, 15 studies reported a statistically significant improvement in at least 1 patient postoperative outcome. None of these studies were found to have an overall high risk of bias according to Cochrane standards. In total, 41% (7/17) of the included studies using direct individual education improved outcomes in almost all surgery types, while educational videos had the greatest statistically significant impact for anxiety, nausea, and pain postoperatively (P<.01). Direct group education demonstrated significant improvement in weight, BMI, exercise, and depressive symptoms in 33% (2/6) of the laparoscopic gastric bypass studies. CONCLUSIONS Direct education (individual or group based) positively impacts postoperative laparoscopic surgery outcomes. TRIAL REGISTRATION PROSPERO CRD42023438698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=438698.
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Affiliation(s)
- Bhagvat Maheta
- California Northstate University College of Medicine, Elk Grove, CA, United States
| | - Mouhamad Shehabat
- California Northstate University College of Medicine, Elk Grove, CA, United States
| | - Ramy Khalil
- California Northstate University College of Medicine, Elk Grove, CA, United States
| | - Jimmy Wen
- California Northstate University College of Medicine, Elk Grove, CA, United States
| | - Muhammad Karabala
- California Northstate University College of Medicine, Elk Grove, CA, United States
| | - Priya Manhas
- California Northstate University College of Medicine, Elk Grove, CA, United States
| | - Ashley Niu
- California Northstate University College of Medicine, Elk Grove, CA, United States
| | - Caroline Goswami
- California Northstate University College of Medicine, Elk Grove, CA, United States
| | - Eldo Frezza
- California Northstate University College of Medicine, Elk Grove, CA, United States
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Siette J, Adam PJ, Harris CB. Acceptability of virtual reality to screen for dementia in older adults. BMC Geriatr 2024; 24:493. [PMID: 38840041 PMCID: PMC11151481 DOI: 10.1186/s12877-024-05115-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Early detection of dementia and cognitive decline is crucial for effective interventions and overall wellbeing. Although virtual reality (VR) tools offer potential advantages to traditional dementia screening tools, there is a lack of knowledge regarding older adults' acceptance of VR tools, as well as the predictors and features influencing their adoption. This study aims to (i) explore older adults' perceptions of the acceptability and usefulness of VR diagnostic tools for dementia, and (ii) identify demographic predictors of adoption and features of VR applications that contribute to future adoption among older adults. METHODS A cross-sectional study was conducted involving community-dwelling older adults who completed online questionnaires covering demographics, medical history, technology acceptance, previous usage, and perceived usefulness and barriers to VR adoption. Multiple linear regression was employed to assess relationships between sociodemographic factors, prior technology use, perceived ease, usefulness, and intention to adopt VR-based diagnostic tools. RESULTS Older adults (N = 77, Mage = 73.74, SD = 6.4) were predominantly female and born in English-speaking countries. Perceived usefulness of VR applications and educational attainment emerged as significant predictors of the likelihood to use VR applications for dementia screening. Generally, older adults showed acceptance of VR applications for healthcare and dementia screening. Fully immersive applications were preferred, and older adults were mostly willing to share electronic information from screening with their healthcare providers. CONCLUSIONS The field of research on VR applications in healthcare is expanding. Understanding the demographic characteristics of populations that stand to benefit from healthcare innovations is critical for promoting adoption of digital health technologies and mitigating its barriers to access.
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Affiliation(s)
- Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia.
| | - Patrick J Adam
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia
| | - Celia B Harris
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia
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Schaake R, Leopold I, Sandberg A, Zenk B, Shafer L, Yu D, Lu X, Theingi S, Udongwo A, Cohen GS, Maresky HS. Virtual Reality for the Management of Pain and Anxiety for IR Procedures: A Prospective, Randomized, Pilot Study on Digital Sedation. J Vasc Interv Radiol 2024; 35:825-833. [PMID: 38484911 DOI: 10.1016/j.jvir.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 02/10/2024] [Accepted: 03/02/2024] [Indexed: 04/23/2024] Open
Abstract
PURPOSE To assess the analgesic and anxiolytic effects of virtual reality (VR) augmentation in patients undergoing peripherally inserted central catheter (PICC) placement or fine-needle aspiration thyroid biopsy. MATERIALS AND METHODS This is a prospective, single-center randomized controlled trial with 107 patients enrolled. Patients were randomly assigned to receive standard of care (SOC) or SOC+VR during PICC or thyroid biopsy procedures. Pain and anxiety were individually measured using the visual analog scale (VAS) before and after the procedure. Vital signs including heart rate and systolic and diastolic blood pressure were recorded. One-way analysis of variance test and Games-Howell post hoc analysis were used to assess effect size and statistical significance between SOC and SOC+VR measures. RESULTS The PICC cohort consisted of 59 patients (33 in SOC+VR and 26 in SOC), with a median age of 53.1 years (interquartile range [IQR], 38.3-62.7 years). The thyroid biopsy cohort consisted of 48 patients (26 in SOC+VR and 22 in SOC), with a median age of 60.1 years (IQR, 49.0-67.2 years). One-way analysis of individuals undergoing thyroid biopsies with adjunctive VR revealed an effect size of -1.74 points (SE ± 0.71; P = .018) on VAS pain scale when compared with SOC. Analysis of individuals undergoing PICC placements revealed an effect size of -1.60 points (SE ± 0.81; P = .053) on VAS anxiety when compared with SOC. CONCLUSIONS VR as a nonpharmacologic adjunct reduced some procedure-related pain and anxiety without increasing the procedural duration.
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Affiliation(s)
- Ryan Schaake
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
| | - Ian Leopold
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Alexander Sandberg
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Brianna Zenk
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - London Shafer
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Daohai Yu
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Xiaoning Lu
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Shunn Theingi
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Angela Udongwo
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Gary S Cohen
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Hillel S Maresky
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
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Einloft J, Bedenbender S, Michelsen M, Meyer HL, Russ PG, Heidtmann A, Hirsch MC, Grgic I. Structured Exposure Achieves High Acceptance of Immersive Technology Among Medical Students and Educators. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024; 27:363-371. [PMID: 38513055 DOI: 10.1089/cyber.2023.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Virtual reality (VR) is a potent educational tool with untapped potential in medical training. However, its integration into medical schools faces challenges such as cybersickness and hesitancy among medical students and professionals. Notably, there has been no systematic assessment of the acceptance of medical educational VR applications by both students and educators. In our single-center study, we enrolled 133 medical students and 14 medical educators. Following a practical demonstration of the established VR anatomy application, Sharecare YOU VR, participants completed a self-reporting survey based on the Technology Acceptance Model (TAM), exploring user acceptance of information technologies and focusing on perceived usefulness (PU), perceived ease of use (PEU), and attitude toward using (ATU). We also sought insights into potential future applications of VR in medical education. Our findings indicate a high level of acceptance among medical students and educators upon structured exposure to VR with significantly positive responses for all three TAM variables (PU, PEU, and ATU). Intriguingly, hands-on experience influenced acceptance. Students envisioned VR's benefits in anatomy, surgery, emergency medicine, and communication skill training with patients. Both students and educators believed that VR could enhance traditional approaches and complement the existing curriculum, anticipating improved preparedness for medical students through VR training applications. In conclusion, our results demonstrate the receptivity of both students and educators to immersive technologies, including VR, in medical education. Importantly, the data suggest that the adoption of VR in this field would be welcomed rather than resisted, potentially enhancing students' self-efficacy and enriching the medical school curriculum.
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Affiliation(s)
- Jonas Einloft
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | - Simon Bedenbender
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | - Malte Michelsen
- Didactics of Natural Sciences, Department of Biology, Philipps-University Marburg, Marburg, Germany
| | - Hendrik L Meyer
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | - Philipp G Russ
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | - Alexander Heidtmann
- Division of Information Technology, University Hospital Giessen and Marburg, Marburg, Germany
| | - Martin C Hirsch
- Institute for Artificial Intelligence in Medicine, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | - Ivica Grgic
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
- Institute for Artificial Intelligence in Medicine, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
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15
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Grewal J, Eng JJ, Sakakibara BM, Schmidt J. The use of virtual reality for activities of daily living rehabilitation after brain injury: A scoping review. Aust Occup Ther J 2024. [PMID: 38757659 DOI: 10.1111/1440-1630.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/11/2024] [Accepted: 04/14/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Individuals with acquired brain injury (ABI) experience high rates of poor functional outcomes such as inability to complete activities of daily living (ADL). Occupational therapy needs to be customised to the individual's function, goals, and environment to facilitate improvement in ADLs after ABI. Virtual reality (VR) is a novel treatment approach that aims to improve skills within an individualised environment. This study aimed to review the current literature for the use of VR platforms that incorporate ADLs to improve functional outcomes after ABI. METHODS This review followed the six-stage framework by Arksey & O'Malley (2005). Electronic databases were searched for peer-reviewed journal articles based on inclusion and exclusion criteria. RESULTS One thousand and six hundred eighty articles were screened, including 413 full text articles and 13 articles were included for review. Among the 13 articles, six were RCTs and the rest were pre-post intervention studies. Studies largely used non-immersive VR platforms, which incorporated ADLs such as grocery shopping, aiming to improve functional outcomes. CONSUMER AND COMMUNITY CONSULTATION Consumer and community were not involved in executing this study. CONCLUSION This review suggests mixed results if VR is effective at treating upper limb, cognition, and ADL function after ABI. Using their clinical reasoning, occupational therapists can determine the suitability of VR for ADL rehabilitation for specific patient populations and settings. Plain Language Summary Individuals who sustain an acquired brain injury can have difficulty performing their daily activities such as, making a meal or getting dressed, because of limited function (e.g., physical and cognitive problems). To help improve their ability to complete daily activities, occupational therapy needs to be customised to the individual's function, goals, and environment. Virtual reality is a new rehabilitation approach that allows individuals to improve their function in an individualised environment. In this study, we reviewed the current studies that have used virtual reality platforms that incorporate daily activities to improve function after acquired brain injury. We searched databases and screened the titles and abstracts of 1,680 studies. Then, 413 full-text studies were screened, and 13 studies were included. Studies mostly used non-immersive platforms to practise daily activities such as, grocery shopping, aiming to improve function after acquired brain injury. This review suggests mixed results if virtual reality can effectively treat function after acquired brain injury.
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Affiliation(s)
- Jasleen Grewal
- Rehabilitation Sciences Graduate Program, University of British Columbia, Canada
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Canada
| | - Janice J Eng
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Canada
- Department of Physical Therapy, University of British Columbia, Canada
| | - Brodie M Sakakibara
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Canada
- Centre for Chronic Disease Prevention and Management, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Canada
| | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Canada
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Mathkor DM, Mathkor N, Bassfar Z, Bantun F, Slama P, Ahmad F, Haque S. Multirole of the internet of medical things (IoMT) in biomedical systems for managing smart healthcare systems: An overview of current and future innovative trends. J Infect Public Health 2024; 17:559-572. [PMID: 38367570 DOI: 10.1016/j.jiph.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/19/2024] Open
Abstract
Internet of Medical Things (IoMT) is an emerging subset of Internet of Things (IoT), often called as IoT in healthcare, refers to medical devices and applications with internet connectivity, is exponentially gaining researchers' attention due to its wide-ranging applicability in biomedical systems for Smart Healthcare systems. IoMT facilitates remote health biomedical system and plays a crucial role within the healthcare industry to enhance precision, reliability, consistency and productivity of electronic devices used for various healthcare purposes. It comprises a conceptualized architecture for providing information retrieval strategies to extract the data from patient records using sensors for biomedical analysis and diagnostics against manifold diseases to provide cost-effective medical solutions, quick hospital treatments, and personalized healthcare. This article provides a comprehensive overview of IoMT with special emphasis on its current and future trends used in biomedical systems, such as deep learning, machine learning, blockchains, artificial intelligence, radio frequency identification, and industry 5.0.
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Affiliation(s)
- Darin Mansor Mathkor
- Research and Scientific Studies Unit, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Noof Mathkor
- Department of Pathology, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia
| | - Zaid Bassfar
- Department of Information Technology, Faculty of Computers and Information Technology, University of Tabuk, Tabuk, Saudi Arabia
| | - Farkad Bantun
- Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Petr Slama
- Laboratory of Animal Immunology and Biotechnology, Department of Animal Morphology, Physiology and Genetics, Mendel University in Brno, 61300 Brno, Czech Republic
| | - Faraz Ahmad
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Shafiul Haque
- Research and Scientific Studies Unit, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan 45142, Saudi Arabia; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon; Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates.
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Bcharah G, Gupta N, Panico N, Winspear S, Bagley A, Turnow M, D'Amico R, Ukachukwu AEK. Innovations in Spine Surgery: A Narrative Review of Current Integrative Technologies. World Neurosurg 2024; 184:127-136. [PMID: 38159609 DOI: 10.1016/j.wneu.2023.12.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
Neurosurgical technologies have become increasingly more adaptive, featuring real-time and patient-specific guidance in preoperative, intraoperative, and postoperative settings. This review offers insight into how these integrative innovations compare with conventional approaches in spine surgery, focusing on machine learning (ML), artificial intelligence, augmented reality and virtual reality, and spinal navigation systems. Data on technology applications, diagnostic and procedural accuracy, intraoperative times, radiation exposures, postoperative outcomes, and costs were extracted and compared with conventional methods to assess their advantages and limitations. Preoperatively, augmented reality and virtual reality have applications in surgical training and planning that are more immersive, case specific, and risk-free and have been shown to enhance accuracy and reduce complications. ML algorithms have demonstrated high accuracy in predicting surgical candidacy (up to 92.1%) and tailoring personalized treatments based on patient-specific variables. Intraoperatively, advantages include more accurate pedicle screw insertion (96%-99% with ML), enhanced visualization, reduced radiation exposure (49 μSv with O-arm navigation vs. 556 μSv with fluoroscopy), increased efficiency, and potential for fewer intraoperative complications compared with conventional approaches. Postoperatively, certain ML and artificial intelligence models have outperformed conventional methods in predicting all postoperative complications of >6000 patients as well as predicting variables contributing to in-hospital and 90-day mortality. However, applying these technologies comes with limitations, such as longer operative times (up to 35.6% longer) with navigation, dependency on datasets, costs, accessibility, steep learning curve, and inherent software malfunctions. As these technologies advance, continuing to assess their efficacy and limitations will be crucial to their successful integration within spine surgery.
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Affiliation(s)
- George Bcharah
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | - Nithin Gupta
- Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
| | - Nicholas Panico
- Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, USA
| | - Spencer Winspear
- Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
| | - Austin Bagley
- Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
| | - Morgan Turnow
- Kentucky College of Osteopathic Medicine, Pikeville, Kentucky, USA
| | - Randy D'Amico
- Department of Neurosurgery, Lenox Hill Hospital, New York, New York, USA
| | - Alvan-Emeka K Ukachukwu
- Department of Neurosurgery, Duke University, Durham, North Carolina, USA; Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA.
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18
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Tandon I, Maldonado V, Wilkerson M, Walls A, Rao RR, Elsaadany M. Immersive virtual reality-based learning as a supplement for biomedical engineering labs: challenges faced and lessons learned. FRONTIERS IN MEDICAL TECHNOLOGY 2024; 6:1301004. [PMID: 38566843 PMCID: PMC10985327 DOI: 10.3389/fmedt.2024.1301004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Immersive virtual reality (VR) based laboratory demonstrations have been gaining traction in STEM education as they can provide virtual hands-on experience. VR can also facilitate experiential and visual learning and enhanced retention. However, several optimizations of the implementation, in-depth analyses of advantages and trade-offs of the technology, and assessment of receptivity of modern techniques in STEM education are required to ensure better utilization of VR-based labs. Methods In this study, we developed VR-based demonstrations for a biomolecular engineering laboratory and assessed their effectiveness using surveys containing free responses and 5-point Likert scale-based questions. Insta360 Pro2 camera and Meta Quest 2 headsets were used in combination with an in-person lab. A cohort of 53 students watched the experimental demonstration on VR headsets in the lab after a brief lab overview in person and then performed the experiments in the lab. Results Only 28.29% of students reported experiencing some form of discomfort after using the advanced VR equipment as opposed to 63.63% of students from the previous cohort. About 40% of the students reported that VR eliminated or reduced auditory and visual distractions from the environment, the length of the videos was appropriate, and they received enough information to understand the tasks. Discussion The traditional lab method was found to be more suitable for explaining background information and lab concepts while the VR was found to be suitable for demonstrating lab procedures and tasks. Analyzing open-ended questions revealed several factors and recommendations to overcome the potential challenges and pitfalls of integrating VR with traditional modes of learning. This study provides key insights to help optimize the implementation of immersive VR to effectively supplement in-person learning experiences.
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Affiliation(s)
| | | | | | | | | | - Mostafa Elsaadany
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, United States
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19
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Katz D, Hyers B, Patten E, Sarte D, Loo M, Burnett GW. Relationship between demographic and social variables and performance in virtual reality among healthcare personnel: an observational study. BMC MEDICAL EDUCATION 2024; 24:227. [PMID: 38439056 PMCID: PMC10981290 DOI: 10.1186/s12909-024-05180-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 02/14/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Virtual reality is emerging as an important component of medical education. Although the benefits of virtual reality are apparent, the optimal strategy to orient to or differentiate learners in the virtual space have not been delineated. The purpose of this study was to investigate the relationships between demographic variables, social variables, and self-perceived comfort with technology to performance on a standardized non-medical virtual reality experience. METHODS This observational study was performed at the International Meeting on Simulation in Healthcare in 2022. This conference includes medical and non-medical attendees. Participants provided demographic information and participated in a scored non-medical VR experience due to the heterogeneity of the sample. Participants then completed a System Usability Index and NASA Task Load Index form. Participants were dividedintolow scoring, medium scoring, and high scoring groups according to their final game score for further analysis. RESULTS 95 participants were included in final analysis. 55 (57.9%) of participants had prior virtual reality experience. Higher scores were associated with younger age (11.09, p < 0.001), identifying as male (11.09, p < 0.001), and a higher frequency of playing video games in the past (18.96, p < 0.001). The high score group was more likely to report comfort with virtual reality (6.29, p = 0.003) as well as comfort with new technology (4.61, p = 0.012). NASA Task Load Index scores trended down and System Usability Index scores trended up with increasing score. Being a nurse was a positive predictor of a higher score when compared to physicians in the multivariate analysis. CONCLUSION Performance during an immersive virtual reality experience was most closely related to age, gender, and frequency of playing video games. Self-perceived comfort with virtual reality was more predictive of score than prior virtual reality experience.
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Affiliation(s)
- Daniel Katz
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, 10029, New York, NY, USA
| | - Benjamin Hyers
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, 10029, New York, NY, USA
| | - Eric Patten
- Department of Academic Learning Environment, Ross University School of Medicine, 1600 SW 80th Terrace, Suite106A, 33324, Plantation, FL, USA
| | - Darren Sarte
- Department of Academic Learning Environment, Ross University School of Medicine, 1600 SW 80th Terrace, Suite106A, 33324, Plantation, FL, USA
| | - Mariano Loo
- Department of Academic Learning Environment, Ross University School of Medicine, 1600 SW 80th Terrace, Suite106A, 33324, Plantation, FL, USA
| | - Garrett W Burnett
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, 10029, New York, NY, USA.
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20
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Naqvi WM, Naqvi I, Mishra GV, Vardhan V. The Dual Importance of Virtual Reality Usability in Rehabilitation: A Focus on Therapists and Patients. Cureus 2024; 16:e56724. [PMID: 38646260 PMCID: PMC11032731 DOI: 10.7759/cureus.56724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Virtual reality (VR) has advanced in medical education and rehabilitation from basic graphical applications due to its ability to generate a virtual three-dimensional (3D) environment. This environment is mostly used to practice professional skills, plan surgery procedures, simulate surgeries, display 3D anatomy, and rehabilitate various disorders. VR has transformed the field of rehabilitation therapy by providing immersive and engaging experiences that go beyond traditional bounds, significantly improving patient care and therapeutic results. Considering the direct impact of VR on the efficacy of the treatment for both therapists and patients, its dual significance for usability and user experience cannot be overstated. The purpose of this article is to determine the synergistic association between VR accessibility and the rehabilitation process, highlighting the significance of VR technology in designing the future of rehabilitation therapy and demonstrating how advancing VR technology can improve therapeutic outcomes despite overcoming obstacles encountered during VR usage. In conclusion, VR offers a personalized, efficient, interesting, and engaging rehabilitative environment for patients, while also assisting therapists in cultivating empathy and efficiency and encouraging innovative approaches in treatment procedures.
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Affiliation(s)
- Waqar M Naqvi
- Interdisciplinary Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, ARE
| | - Ifat Naqvi
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vishnu Vardhan
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Shrestha AB, Taha AM, Siddiq A, Shrestha S, Thakur P, Chapagain S, Sharma S, Halder A, Rajak K, Shah V. Virtual and augmented reality in cardiovascular care in low and middle income country. Curr Probl Cardiol 2024; 49:102380. [PMID: 38191103 DOI: 10.1016/j.cpcardiol.2024.102380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
The global health sector has witnessed an escalating integration of Virtual Reality (VR) and Augmented Reality (AR) technologies, particularly in high-income countries. The application of these cutting-edge technologies is gradually extending to Low- and Middle-Income Countries (LMICs), notably in the domain of cardiovascular care. AR and VR technologies are revolutionizing cardiovascular care by offering solutions for diagnosis, medical training, and surgical planning. AR and VR provide detailed and immersive visualizations of cardiac structures, aiding in diagnosis and intervention planning. In cardiovascular care, VR reduces patient-reported pain, eases anxiety, and accelerates post-procedural recovery. AR and VR are also valuable for life support training, creating immersive and controlled learning environments. AR and VR have the potential to significantly impact healthcare in low- and middle-income countries with enhanced accessibility and affordability. This review outlines the existing spectrum of VR and AR adoption and its burgeoning utility in the cardiovascular domain within LMICs.
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Affiliation(s)
- Abhigan Babu Shrestha
- Department of Internal medicine, M Abdur Rahim Medical College, Dinajpur, Bangladesh.
| | | | | | | | - Prince Thakur
- Nepalgunj Medical College and Research Institute, Nepalgunj, Nepal
| | | | | | - Anupam Halder
- Department of Internal Medicine, UPMC Harrisburg, PA, United States
| | - Kripa Rajak
- Department of Internal Medicine, UPMC Harrisburg, PA, United States
| | - Vaibhav Shah
- Department of Internal Medicine, Icahn School of Medicine, Mount Sinai- Elmhurst Hospital Centre, New York, United States
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22
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Zaki MM, Joshi RS, Joseph JR, Saadeh YS, Kashlan ON, Godzik J, Uribe JS, Park P. Virtual Reality-Enabled Resident Education of Lateral-Access Spine Surgery. World Neurosurg 2024; 183:e401-e407. [PMID: 38143034 DOI: 10.1016/j.wneu.2023.12.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE Lateral-access spine surgery has many benefits, but adoption has been limited by a steep learning curve. Virtual reality (VR) is gaining popularity and lends itself as a useful tool in enhancing neurosurgical resident education. We thus sought to assess whether VR-based simulation could enhance the training of neurosurgery residents in lateral spine surgery. METHODS Neurosurgery residents completed a VR-based lateral spine module on lateral patient positioning and performing lateral lumbar interbody fusion using the PrecisionOS VR system on the Meta Quest 2 headset. Simulation occurred 1×/week every other week for a total of 3 simulations over 6 weeks. Pre- and postintervention surveys as well as intrasimulation performance metrics were assessed over time. RESULTS The majority of resident participants showed improvement in performance scores, including an automated PrecisionOS precision score, number of radiographs used within the simulation, and time to completion. All participants showed improvement in comfort with anatomic landmarks for lateral access surgery, confidence performing lateral surgery without direct supervision, and assessing fluoroscopy in spine surgery for hardware placement and image interpretation. Participant perception on the utility of VR as an educational tool also improved. CONCLUSIONS VR-based simulation enhanced neurosurgical residents' ability to understand lateral access surgery. Immersive surgical simulation resulted in improved resident confidence with surgical technique and workflow, perceived improvement in anatomical knowledge, and simulation performance scores. Trainee perceptions on virtual simulation and training as a curriculum supplement also improved following completion of VR training.
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Affiliation(s)
- Mark M Zaki
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Rushikesh S Joshi
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacob R Joseph
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Yamaan S Saadeh
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Osama N Kashlan
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jakub Godzik
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Juan S Uribe
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Paul Park
- Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee, USA.
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Twamley J, Hamer O, Hill J, Kenyon R, Twamley H, Casey R, Zhang J, Williams A, Clegg A. Exploring the perceptions of former ICU patients and clinical staff on barriers and facilitators to the implementation of virtual reality exposure therapy: A qualitative study. Nurs Crit Care 2024; 29:313-324. [PMID: 36458458 DOI: 10.1111/nicc.12868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/18/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Virtual reality (VR) as a digital technology has developed rapidly, becoming more realistic, portable, sensory and easier to navigate. Although studies have found VR to be effective for many clinical applications, patients and clinicians have described several barriers to the successful implementation of this technology. To remove barriers for implementation of VR in health care, a greater understanding is needed of how VR can integrate into clinical environments, particularly complex settings such as an intensive care unit. AIM This study aimed to explore the perceived barriers and facilitators for the implementation of VR exposure therapy for intensive care patients and clinical staff. STUDY DESIGN A qualitative study using an Interpretative Description approach was undertaken. Semi-structured focus groups were conducted with 13 participants: nine patients and four health care professionals. Focus groups explored barriers and facilitators of using virtual reality (VR) exposure therapy in intensive care. Thematic analysis was employed to produce codes and themes. RESULTS In total, eight themes describing the perceived barriers and facilitators to implementing VR exposure therapy were identified. Four themes related to the perceived barriers of implementing VR exposure therapy in intensive care were identified: psychological, sensory, environmental and staff competency and confidence. There were a further four themes related to the perceived facilitators to the implementation of VR exposure therapy: staff training, patient capacity, orientation to technology and support during the intervention. CONCLUSIONS This study identified novel barriers and facilitators that could be expected when implementing VR exposure therapy for patients' post-intensive care unit stay. The findings suggest that psychological barriers of fear and apprehension were expected to provoke patient avoidance of exposure therapy. Perceived barriers for staff focused on preparedness to deliver the VR exposure therapy and a lack of technological competence. Both patients and staff stated that a comprehensive induction, orientation and training could facilitate VR exposure therapy, improving engagement. RELEVANCE TO CLINICAL PRACTICE This study has identified that with appropriate staff training, resources, and integration into current patient care pathways, VR exposure therapy may be a valuable intervention to support patient recovery following critical illness. Prior to undertaking VR exposure therapy, patients often need reassurance that side-effects can be managed, and that they can easily control their virtual exposure experience.
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Affiliation(s)
- Jacqueline Twamley
- Centre for Health Research and Innovation, NIHR Lancashire Clinical Research Facility, Chorley, UK
| | - Oliver Hamer
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - James Hill
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - Roger Kenyon
- Critical care survivor, University of Central Lancashire, Preston, UK
| | - Huw Twamley
- Intensive Care Department, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, UK
| | - Rob Casey
- Digital Therapy Solutions to empower Stroke, Dementia, Parkinson's Rehabilitation, DancingMind Pte Ltd, London, England, United Kingdom
| | | | - Alexandra Williams
- Intensive Care Department, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, Lancashire, United Kingdom
| | - Andrew Clegg
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
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Gohman T, Nisar H, Gupta A, Javed MJ, Rau N. Development and usability of a virtual reality umbilical venous catheter placement simulator. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03072-8. [PMID: 38400949 DOI: 10.1007/s11548-024-03072-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/01/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE Exposure to procedures varies in the neonatal intensive care unit (NICU). A method to teach procedures should be available without patient availability, expert oversight, or simulation laboratories. To fill this need, we developed a virtual reality (VR) simulation for umbilical vein catheter (UVC) placement and sought to establish its face and content validity and usability. METHODS Engineers, software developers, graphic designers, and neonatologists developed a VR UVC placement simulator following a participatory design approach. The software was deployed on the Meta Quest 2 head-mounted display (HMD). Neonatal nurse practitioners (NNPs) from a level 4 NICU used the simulator and completed an 11-item questionnaire to establish face and content validity. Participants also completed the validated simulation task load index and system usability scale to assess the usability of the simulator. Group 1 tested the VR simulation, which was optimized based on feedback, prior to Group 2's participation. RESULTS A total of 14 NNPs with 2-37 years of experience participated in testing. Participants scored the content and face validity of the simulator highly, with most giving scores ≥ 4/5. Usability was established with relatively high average system usability scores for both groups (Group 1: 67.14 ± 7.8, Group 2: 71 ± 14.1) and low SIM-TLX scores indicating manageable load while using the simulator. CONCLUSION After optimization, Group 2 found the UVC simulator to be realistic and effective. Both groups felt the simulator was easy to use and did not cause physical or cognitive strain. All participants felt the UVC simulator provided a safe environment to make mistakes, and the majority would recommend this experience to trainees.
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Affiliation(s)
- Taylor Gohman
- Division of Neonatology, Department of Pediatrics, University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Ave., Peoria, IL, 61637, USA
| | - Harris Nisar
- Healthcare Engineering Systems Center, University of Illinois at Urbana-Champaign, 1206 W. Clark St., Urbana, IL, 61801, USA.
- Department of Industrial and Enterprise Systems Engineering, University of Illinois at Urbana-Champaign, Street, 104 S. Matthews Ave., Urbana, IL, 61801, USA.
| | - Avinash Gupta
- Department of Industrial and Enterprise Systems Engineering, University of Illinois at Urbana-Champaign, Street, 104 S. Matthews Ave., Urbana, IL, 61801, USA
| | - M Jawad Javed
- Division of Neonatology, Department of Pediatrics, University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Ave., Peoria, IL, 61637, USA
| | - Nicole Rau
- Division of Neonatology, Department of Pediatrics, University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Ave., Peoria, IL, 61637, USA
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Teh JJ, Pascoe DJ, Hafeji S, Parchure R, Koczoski A, Rimmer MP, Khan KS, Al Wattar BH. Efficacy of virtual reality for pain relief in medical procedures: a systematic review and meta-analysis. BMC Med 2024; 22:64. [PMID: 38355563 PMCID: PMC10865524 DOI: 10.1186/s12916-024-03266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Effective pain control is crucial to optimise the success of medical procedures. Immersive virtual reality (VR) technology could offer an effective non-invasive, non-pharmacological option to distract patients and reduce their experience of pain. We aimed to evaluate the efficacy of Immersive virtual reality (VR) technology in reducing patient's pain perception during various medical procedures by conducting a systematic review and meta-analysis. METHODS We searched MEDLINE, EMBASE, CENTRAL, CINAHL, and SIGLE until December 2022 for all randomised clinical trials (RCT) evaluating any type of VR in patients undergoing any medical procedure. We conducted a random effect meta-analysis summarising standardised mean differences (SMD) with 95% confidence intervals (CI). We evaluated heterogeneity using I 2 and explored it using subgroup and meta-regression analyses. RESULTS In total, we included 92 RCTs (n = 7133 participants). There was a significant reduction in pain scores with VR across all medical procedures (n = 83, SMD - 0.78, 95% CI - 1.00 to - 0.57, I 2 = 93%, p = < 0.01). Subgroup analysis showed varied reduction in pain scores across trial designs [crossover (n = 13, SMD - 0.86, 95% CI - 1.23 to - 0.49, I 2 = 72%, p = < 0.01) vs parallel RCTs (n = 70, SMD - 0.77, 95% CI - 1.01 to - 0.52, I 2 = 90%, p = < 0.01)]; participant age groups [paediatric (n = 43, SMD - 0.91, 95% CI - 1.26 to - 0.56, I 2 = 87%, p = < 0.01) vs adults (n = 40, SMD - 0.66, 95% CI - 0.94 to - 0.39, I 2 = 89%, p = < 0.01)] or procedures [venepuncture (n = 32, SMD - 0.99, 95% CI - 1.52 to - 0.46, I 2 = 90%, p = < 0.01) vs childbirth (n = 7, SMD - 0.99, 95% CI - 1.59 to - 0.38, I 2 = 88%, p = < 0.01) vs minimally invasive medical procedures (n = 25, SMD - 0.51, 95% CI - 0.79 to - 0.23, I 2 = 85%, p = < 0.01) vs dressing changes in burn patients (n = 19, SMD - 0.8, 95% CI - 1.16 to - 0.45, I 2 = 87%, p = < 0.01)]. We explored heterogeneity using meta-regression which showed no significant impact of different covariates including crossover trials (p = 0.53), minimally invasive procedures (p = 0.37), and among paediatric participants (p = 0.27). Cumulative meta-analysis showed no change in overall effect estimates with the additional RCTs since 2018. CONCLUSIONS Immersive VR technology offers effective pain control across various medical procedures, albeit statistical heterogeneity. Further research is needed to inform the safe adoption of this technology across different medical disciplines.
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Affiliation(s)
- Jhia J Teh
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | | | - Safiya Hafeji
- Kings College Hospital, Denmark Hill, Brixton, London, UK
| | | | - Adam Koczoski
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Michael P Rimmer
- MRC Centre for Reproductive Health, Institute of Regeneration and Repair, Edinburgh BioQuarter, University of Edinburgh, Edinburgh, UK.
- . Johns Hospital, Livingston, West Lothian, Scotland, UK.
| | - Khalid S Khan
- Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Bassel H Al Wattar
- University College London, London, UK
- Beginnings Assisted Conception Unit, Epsom and St Helier University Hospitals, London, UK
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Khodabakhshian N, Gaeul Lee K, Marawi T, Sorkhou M, Vyravanathan S, Harnett N. Virtual Reality for Developing Patient-Facing Communication Skills in Medical and Graduate Education: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e53901. [PMID: 38300671 PMCID: PMC10870214 DOI: 10.2196/53901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Clinician-patient communication is an integral component in providing quality medical care. However, research on clinician-patient communication has shown overall patient discontent with provider communication skills. While virtual reality (VR) is readily used for procedural-based learning in medical education, its potential for teaching patient-facing communication skills remains unexplored. This scoping review aims to evaluate the effectiveness and feasibility of VR applications used for patient-facing communication skills development in medical education. OBJECTIVE The primary objective is to synthesize and evaluate the effectiveness of available VR tools and applications used for patient-facing communication skills development in medical education. The secondary objectives are to (1) assess the feasibility of adapting VR applications to develop patient-facing communication skills in medical education and (2) provide an overview of the challenges associated with adapting VR applications to develop patient-facing communication skills in medical education. METHODS A total of 4 electronic databases (ERIC, Embase, PubMed, and MEDLINE) were searched for primary peer-reviewed articles published through April 11, 2023. Articles evaluating the implementation of non-, semi-, and fully immersive VR training for patient- or caregiver-facing communication skills training provided to graduate, medical, or other allied health care professions students were included. Studies that assessed augmented reality, mixed reality, artificial intelligence, or VR for non-communication-based training were excluded. Study selection will include a title, abstract, and full-text screening by 4 authors. Data from eligible studies will be extracted and entered into a database and presented in tabular format. Findings will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews. RESULTS As of April 11, 2023, the search strategy has been confirmed and the search has been completed. We are currently at the title and abstract screening stage. Once complete, the articles will undergo full-text screening according to eligibility criteria as described in the methods. CONCLUSIONS The findings of this review will inform the development of a graduate-level clinical skills research course within the Institute of Medical Science graduate department at the University of Toronto. It is also expected that these findings will be of interest to other health care-specific faculties inside and beyond our institution. Further, our scoping review will summarize the limited field of literature on VR use in medical communications training and identify areas for future inquiry. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53901.
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Affiliation(s)
- Nairy Khodabakhshian
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kyla Gaeul Lee
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Sinai Health, Toronto, ON, Canada
| | - Tulip Marawi
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, Toronto, ON, Canada
| | - Maryam Sorkhou
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Nicole Harnett
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
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du Plessis J, Jordaan J. The impact of virtual reality on the psychological well-being of hospitalised patients: A critical review. Heliyon 2024; 10:e24831. [PMID: 38312552 PMCID: PMC10835256 DOI: 10.1016/j.heliyon.2024.e24831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 02/06/2024] Open
Abstract
Background and objectives Improving hospitalised patients' psychological well-being (PWB) is relevant to their recovery and overall quality of life. Virtual Reality (VR) holds the potential to emerge as a novel tool for increasing the PWB of hospitalised patients. This study critically reviewed existing research concerning the use and impact of VR on the PWB of hospitalised patients with serious illnesses. The primary aim of this study was to evaluate the efficacy and practical applicability of VR in enhancing the PWB for hospitalised patients dealing with serious illnesses. Methodology In the initial search, the authors identified 106 sources that provided valuable insights into the broader field of VR, PWB, and the influence of VR on the psychological functioning of hospitalised patients. However, only eight articles were selected for the critical review, following the SALSA method. The SALSA method comprises the following steps: (S) Search, (AL) Appraisal, (S) Synthesis and (A) Analysis. Data extracted from these eight articles were subjected to reflexive thematic analysis, through which patterns were identified to examine the use and impact of VR on the PWB of hospitalised patients with serious illnesses. The thematic analysis process involves data gathering and familiarisation, code identification, and formulating and refining various themes to produce a thematic analysis report. Results The themes that emerged from the analysis were (i) positive psychological effects (with sub-themes including the effectiveness of VR in improving psychological symptoms, its role as an equivalent or adjunctive treatment, and symptom reduction), (ii) perceptions and the adoption of novel technology, (iii) characteristics that influence the effectiveness of VR, and (iv) statistical and practical applicability and diversity of VR. Conclusion and recommendation The use of VR to increase the PWB of hospitalised patients is a relatively recent innovation. Nevertheless, the themes identified in this study indicate that the use of VR within the context of hospitalised patients can benefit their psychological functioning, ultimately contributing to an improvement in their overall PWB. Further in-depth studies are needed to provide a comprehensive conclusion on the potential benefits of VR on the PWB of hospitalised patients dealing with serious illnesses.
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Affiliation(s)
- Jolize du Plessis
- Department of Psychology, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein, 9301, South Africa
| | - Jacques Jordaan
- Department of Psychology, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein, 9301, South Africa
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Saini RS, Bavabeedu SS, Quadri SA, Gurumurthy V, Kanji MA, Kuruniyan MS, Binduhayyim RIH, Avetisyan A, Heboyan A. Impact of 3D imaging techniques and virtual patients on the accuracy of planning and surgical placement of dental implants: A systematic review. Digit Health 2024; 10:20552076241253550. [PMID: 38726220 PMCID: PMC11080757 DOI: 10.1177/20552076241253550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
Aim The integration of advanced technologies, including three-dimensional (3D) imaging modalities and virtual simulations, has significantly influenced contemporary approaches to preoperative planning in implant dentistry. Through a meticulous analysis of relevant studies, this review synthesizes findings related to accuracy outcomes in implant placement facilitated by 3D imaging in virtual patients. Methods A comprehensive literature search was conducted across relevant databases to identify relevant studies published to date. The inclusion criteria were studies utilizing 3D imaging techniques, virtual patients, and those focusing on the accuracy of dental implant planning and surgical placement. The selected studies were critically appraised for their methodological quality. Results After a rigorous analysis, 21 relevant articles were included out of 3021 articles. This study demonstrates the versatility and applicability of these technologies in both in vitro and in vivo settings. Integrating Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), cone bean computed tomography (CBCT), and advanced 3D reconstruction methodologies showcases a trend toward enhanced precision in implant planning and placement. Notably, the evaluation parameters varied, encompassing distances, discrepancies, and deviations in the implant placement. The ongoing integration of systems such as dynamic navigation systems, augmented reality, and sophisticated software platforms shows a promising trajectory for the continued refinement of virtual reality applications in dental implantology, providing valuable insights for future research and clinical implementation. Moreover, using stereolithographic surgical guides, virtual planning with CBCT data, and 3D-printed templates consistently demonstrates enhanced precision in dental implant placement compared to traditional methods. Conclusion The synthesis of the available evidence underscores the substantial positive impact of 3D imaging techniques and virtual patients on dental implant planning and surgical placement accuracy. Utilizing these technologies contributes to a more personalized and precise approach that enhances overall treatment outcomes. Future research directions and potential refinements to the application of these technologies in clinical practice should be discussed.
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Affiliation(s)
- Ravinder S Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | - Shashit Shetty Bavabeedu
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | | | - Masroor Ahmed Kanji
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | | | | | - Anna Avetisyan
- Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Bryant L, Sedlarevic N, Stubbs P, Bailey B, Nguyen V, Bluff A, Barnett D, Estela M, Hayes C, Jacobs C, Kneebone I, Lucas C, Mehta P, Power E, Hemsley B. Collaborative co-design and evaluation of an immersive virtual reality application prototype for communication rehabilitation (DISCOVR prototype). Disabil Rehabil Assist Technol 2024; 19:90-99. [PMID: 35442823 DOI: 10.1080/17483107.2022.2063423] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Virtual reality (VR) lends itself to communication rehabilitation by creating safe, replicable, and authentic simulated environments in which users learn and practice communication skills. The aim of this research was to obtain the views of health professionals and technology specialists on the design characteristics and usability of a prototype VR application for communication rehabilitation. MATERIALS AND METHODS Nine professionals from different health and technology disciplines participated in an online focus group or individual online interview to evaluate the application and use of the VR prototype. Data sources were analysed using a content thematic analysis. RESULTS Four main themes relating to VR design and implementation in rehabilitation were identified: (i) designing rehabilitation-focused virtual worlds; (ii) understanding and using VR hardware; (iii) making room for VR in rehabilitation and training; and (iv) implementing VR will not replace the health professional's role. DISCUSSION Health professionals and technology specialists engaged in co-design while evaluating the VR prototype. They identified software features requiring careful consideration to ensure improved usability, client safety, and success in communication rehabilitation outcomes. Continuing inclusive co-design, engaging health professionals, clients with communication disability, and their families will be essential to creating useable VR applications and integrating these successfully into rehabilitation. Implications for rehabilitationHealth and technology professionals, along with clients, are integral to the co-design of new VR technology applications.Design of VR applications needs to consider the client's communication, physical, cognitive, sensory, psychosocial, and emotional needs for greater usability of these programs.Realism and authenticity of interactions, characters, and environments are considered important factors to allow users to be fully immersed in virtual simulations to enhance rehabilitation.
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Affiliation(s)
- Lucy Bryant
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Neira Sedlarevic
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Peter Stubbs
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Benjamin Bailey
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Vincent Nguyen
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Andrew Bluff
- Faculty of Transdisciplinary Innovation, University of Technology Sydney Animal Logic Academy, Sydney, Australia
| | - Diana Barnett
- Occupational Therapist Children's Hospital, Westmead, Australia
| | | | - Carolyn Hayes
- Susan Wakil School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Sydney, Sydney, Australia
| | - Chris Jacobs
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Ian Kneebone
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Cherie Lucas
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Poonam Mehta
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Emma Power
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Bronwyn Hemsley
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
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Kim HJ, Lee HK, Jang JY, Lee KN, Suh DH, Kong HJ, Lee SH, Park JY. Immersive virtual reality simulation training for cesarean section: a randomized controlled trial. Int J Surg 2024; 110:194-201. [PMID: 37939117 PMCID: PMC10793750 DOI: 10.1097/js9.0000000000000843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Caesarean section (CS) is a complex surgical procedure that involves many steps and requires careful precision. Virtual reality (VR) simulation has emerged as a promising tool for medical education and training, providing a realistic and immersive environment for learners to practice clinical skills and decision-making. This study aimed to evaluate the educational effectiveness of a VR simulation program in training the management of patients with premature rupture of membranes (PROM) and CS. MATERIALS AND METHODS A two-arm parallel randomized controlled trial was conducted with 105 eligible participants randomly assigned to the VR group ( n =53) or the control group ( n =52) in a 1:1 ratio. The VR group received VR simulation training focused on PROM management and CS practice, while the control group watched a video presentation with narrative of clinical scenario and recording of CS. Both groups completed questionnaires assessing their prior experiences with VR, experience in managing patients with PROM and performing CS, as well as their confidence levels. These questionnaires were administered before and after the intervention, along with a mini-test quiz. RESULTS Baseline characteristics and previous experiences were comparable between the two groups. After the intervention, the VR group had higher confidence scores in all four aspects, including managing patients with PROM, performing CS as an operator, and understanding the indications and complications of CS, compared to the control group. The VR group also achieved significantly higher scores on the mini-test quiz [median (interquartile range), 42 (37-48) in the VR group; 36 (32-40) in the control group, P <0.001]. CONCLUSION VR simulation program can be an effective educational tool for improving participants' knowledge and confidence in managing patients with PROM and performing CS.
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Affiliation(s)
- Hyeon Ji Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hee Kyeong Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Yeon Jang
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyong-No Lee
- Department of Obstetrics and Gynecology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyoun-Joong Kong
- Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung-Hee Lee
- Department of Medical Education, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jee Yoon Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Emami P, Boozari Pour M. Enhancing Cardiopulmonary Resuscitation Training Through Virtual Reality Technology: Assessing Efficiency and Impact. Bull Emerg Trauma 2024; 12:99-101. [PMID: 39224471 PMCID: PMC11366266 DOI: 10.30476/beat.2024.101899.1498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/15/2024] [Indexed: 09/04/2024] Open
Affiliation(s)
- Payam Emami
- Department of Emergency Medical Sciences, Faculty of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mahsa Boozari Pour
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti Univers
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Coduri M, Calandrino A, Addiego Mobilio G, Casadio M, Ricci S. RiNeo MR: A mixed reality simulator for newborn life support training. PLoS One 2023; 18:e0294914. [PMID: 38128019 PMCID: PMC10734996 DOI: 10.1371/journal.pone.0294914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Abstract
Neonatal resuscitation is an uncommon, albeit critical task that is more likely to succeed if performed properly and promptly. In this context, simulation is an appropriate way for training and assessing the abilities of all medical staff involved in delivery room care. Recent studies have shown that learning is enhanced if the simulation experience is realistic and engaging. Hence, Virtual Reality can be beneficial for newborn resuscitation training. However, the difficulty of providing realistic haptic interaction limits its use. To overcome this constraint, we have designed RiNeo MR, a simulator for newborn life support training, combining a sensorized manikin to monitor in real time resuscitation skills, with a Virtual Reality application. The system includes a Virtual Reality headset, Leap Motion to track the user's hands, sensorized bag valve mask, and manikin to monitor head and mask positioning, ventilation, and chest compression. RiNeo MR can be used in two modalities: 2D to let the trainee practice resuscitation manoeuvres on the physical manikin, while receiving real time feedback; 3D that allows the user to be immersed in a virtual environment and practice in an hospital-like setting. In the 3D mode, virtual and real manikins are overlapped and communicate in real time. Tests on 16 subjects (11 controls without medical expertise and 5 paediatric residents) demonstrated that the simulator is well tolerated in terms of discomfort. Moreover, the simulator is high rated for user experience and system usability, suggesting that RiNeo MR can be a promising tool to improve newborn life support training. RiNeo MR is a proof of concept of a mixed-reality newborn life support simulator that can be a promising tool to spread newborn resuscitation high-quality training among healthcare providers involved in perinatal medicine.
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Affiliation(s)
- Mara Coduri
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- Simulation and Advanced Education Center - SimAv, University of Genoa, Genoa, Italy
| | - Andrea Calandrino
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Neonatal Intensive Care Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | - Giulia Addiego Mobilio
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
| | - Maura Casadio
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- Simulation and Advanced Education Center - SimAv, University of Genoa, Genoa, Italy
| | - Serena Ricci
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- Simulation and Advanced Education Center - SimAv, University of Genoa, Genoa, Italy
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Mitsea E, Drigas A, Skianis C. Digitally Assisted Mindfulness in Training Self-Regulation Skills for Sustainable Mental Health: A Systematic Review. Behav Sci (Basel) 2023; 13:1008. [PMID: 38131865 PMCID: PMC10740653 DOI: 10.3390/bs13121008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/27/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
The onset of the COVID-19 pandemic has led to an increased demand for mental health interventions, with a special focus on digitally assisted ones. Self-regulation describes a set of meta-skills that enable one to take control over his/her mental health and it is recognized as a vital indicator of well-being. Mindfulness training is a promising training strategy for promoting self-regulation, behavioral change, and mental well-being. A growing body of research outlines that smart technologies are ready to revolutionize the way mental health training programs take place. Artificial intelligence (AI); extended reality (XR) including virtual reality (VR), augmented reality (AR), and mixed reality (MR); as well as the advancements in brain computer interfaces (BCIs) are ready to transform these mental health training programs. Mindfulness-based interventions assisted by smart technologies for mental, emotional, and behavioral regulation seem to be a crucial yet under-investigated issue. The current systematic review paper aims to explore whether and how smart technologies can assist mindfulness training for the development of self-regulation skills among people at risk of mental health issues as well as populations with various clinical characteristics. The PRISMA 2020 methodology was utilized to respond to the objectives and research questions using a total of sixty-six experimental studies that met the inclusion criteria. The results showed that digitally assisted mindfulness interventions supported by smart technologies, including AI-based applications, chatbots, virtual coaches, immersive technologies, and brain-sensing headbands, can effectively assist trainees in developing a wide range of cognitive, emotional, and behavioral self-regulation skills, leading to a greater satisfaction of their psychological needs, and thus mental wellness. These results may provide positive feedback for developing smarter and more inclusive training environments, with a special focus on people with special training needs or disabilities.
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Affiliation(s)
- Eleni Mitsea
- Net Media Lab & Mind & Brain R&D, Institute of Informatics & Telecommunications, National Centre of Scientific Research ‘Demokritos’ Athens, Agia Paraskevi, 15341 Athens, Greece;
- Department of Information and Communication Systems Engineering, University of Aegean, 82300 Mytilene, Greece;
| | - Athanasios Drigas
- Net Media Lab & Mind & Brain R&D, Institute of Informatics & Telecommunications, National Centre of Scientific Research ‘Demokritos’ Athens, Agia Paraskevi, 15341 Athens, Greece;
| | - Charalabos Skianis
- Department of Information and Communication Systems Engineering, University of Aegean, 82300 Mytilene, Greece;
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Aderinto N, Olatunji G, Abdulbasit MO, Edun M, Aboderin G, Egbunu E. Exploring the efficacy of virtual reality-based rehabilitation in stroke: a narrative review of current evidence. Ann Med 2023; 55:2285907. [PMID: 38010358 PMCID: PMC10836287 DOI: 10.1080/07853890.2023.2285907] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Stroke rehabilitation presents a complex challenge, necessitating innovative approaches to optimise functional recovery. Virtual Reality-Based Rehabilitation (VRBR) has emerged as a promising intervention that capitalises on immersive technology to engage stroke survivors in their recovery journey. This review aims to examine the efficacy of VRBR in stroke rehabilitation, focusing on its advantages and challenges. METHODS A comprehensive search of relevant literature was conducted to gather evidence on the efficacy of VRBR in stroke survivors. Studies that investigated the impact of VRBR on patient engagement, functional recovery, and overall rehabilitation outcomes were included. The review also assessed the ability of VRBR to simulate real-life scenarios and facilitate essential daily activities for stroke survivors. RESULTS The review highlights that VRBR offers a unique immersive experience that enhances patient engagement and motivation during rehabilitation. The immersive nature of VRBR fosters a sense of presence, which can positively impact treatment adherence and outcomes. Moreover, VRBR's capacity to replicate real-world scenarios provides stroke survivors with opportunities to practice vital daily activities, promoting functional independence. In contrast, conventional rehabilitation methods lack the same level of engagement and real-world simulation. CONCLUSION VRBR holds promise as an efficacious intervention in stroke rehabilitation. Its immersive nature enhances patient engagement and motivation, potentially leading to better treatment adherence and outcomes. The ability of VRBR to simulate real-life scenarios offers a unique platform. However, challenges such as cost, equipment, patient suitability, data privacy, and acceptance must be addressed for successful integration into stroke rehabilitation practice.
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Affiliation(s)
- Nicholas Aderinto
- Department of Medicine and Surgery, LadokeAkintola University of Technology, Ogbomoso, Nigeria
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | | | - Mariam Edun
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Gbolahan Aboderin
- Department of Medicine and Surgery, LadokeAkintola University of Technology, Ogbomoso, Nigeria
| | - Emmanuel Egbunu
- Department of Medicine and Surgery, Federal Medical Centre Bida, Niger, Nigeria
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Ghlichi Moghaddam N, Namazinia M, Hajiabadi F, Mazlum SR. The efficacy of phase I cardiac rehabilitation training based on augmented reality on the self-efficacy of patients undergoing coronary artery bypass graft surgery: A randomized clinical trial. BMC Sports Sci Med Rehabil 2023; 15:156. [PMID: 37978403 PMCID: PMC10656834 DOI: 10.1186/s13102-023-00770-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Open-heart surgery is considered one of the primary treatments for severe coronary artery stenosis, but it comes with its own set of complications. However, these complications can be reduced through the implementation of proper cardiac rehabilitation during phase I. This study aimed to examine the impact of phase I cardiac rehabilitation training, using augmented reality, on the self-efficacy of cardiac management in patients undergoing coronary artery bypass grafting. METHODOLOGY This randomized clinical trial study involved 60 patients who were admitted to the Cardiac Surgery Intensive Care Unit at Ghaem Hospital in Mashhad. The software used in this study consisted of various videos and educational images demonstrating physical exercises for cardiac rehabilitation. The software was developed to train the patients in the intervention group on the rehabilitation program, starting from their admission to the Intensive Care Unit until their discharge from the hospital. The collected data were analyzed using statistical tests such as independent t-test, Mann-Whitney test, paired t-test, chi-square test, as well as descriptive indicators. Cohen's d was also used to evaluate the magnitude of the effect size. RESULTS The findings of this study revealed that the total mean score for cardiovascular management self-efficacy significantly increased during the transfer to the Intensive Care Unit and at the time of discharge. Notably, the increase observed in the intervention group was significantly greater than that of the control group (P < 0.001). CONCLUSION The results of this study indicated that implementing early rehabilitation programs, using innovative educational technology like augmented reality, enhanced the self-efficacy of patients undergoing coronary artery bypass grafting. These findings suggest that such programs can be effectively employed as educational tools throughout different stages of cardiac rehabilitation. TRIAL REGISTRATION This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20200203046361N1) on 16/02/2020.
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Affiliation(s)
- Neda Ghlichi Moghaddam
- Department of Medical - Surgical Nursing, School of Nursing and Midwifery (MSC Student), Mashhad University of Medical Sciences, Mashhad, Iran
- Nursing and Midwifery Care Research Center, Mashhad University Medical of Medical Sciences, Mashhad, Iran
| | - Mohammad Namazinia
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Fatemeh Hajiabadi
- Department of Medical - Surgical Nursing, School of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran.
- Nursing and Midwifery Care Research Center, Mashhad University Medical of Medical Sciences, Mashhad, Iran.
| | - Seyyed Reza Mazlum
- Department of Medical - Surgical Nursing, School of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran
- Nursing and Midwifery Care Research Center, Mashhad University Medical of Medical Sciences, Mashhad, Iran
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Goldsworthy A, Chawla J, Birt J, Baumann O, Gough S. Use of extended reality in sleep health, medicine, and research: a scoping review. Sleep 2023; 46:zsad201. [PMID: 37498981 PMCID: PMC10636250 DOI: 10.1093/sleep/zsad201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/04/2023] [Indexed: 07/29/2023] Open
Abstract
STUDY OBJECTIVES This scoping review explores the use of extended reality (virtual, augmented, and mixed reality) within sleep health, sleep medicine, and sleep research. It aims to provide insight into current uses and implementation considerations whilst highlighting directions for future research. METHODS A systematic scoping review was undertaken informed by the preferred reporting items for systematic reviews and meta-analyses for scoping reviews and Johanna Briggs Institute. RESULTS The use of virtual reality (VR) as a research tool in the investigation of areas such as dreaming and memory reactivation is growing. Thirty-one articles were identified in total with 20 utilizing VR to improve sleep as a clinical intervention. CONCLUSIONS Research exploring the utility of VR as a clinical intervention in various patient populations and clinical settings is therefore warranted. Researchers and clinicians should ensure that extended reality interventions are developed based on clinical reasoning and informed by evidence of both sleep medicine and the effects of virtual and augmented reality. Where possible future research should utilize up-to-date technology and reporting frameworks to assist in the translation of research into clinical practice.
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Affiliation(s)
- Adrian Goldsworthy
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Jasneek Chawla
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia
- Department of Paediatric Respiratory and Sleep Medicine, Queensland Children’s Hospital, South Brisbane, QLD, Australia
| | - James Birt
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Oliver Baumann
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Suzanne Gough
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
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Nazzal EM, Zsidai B, Hiemstra LA, Lustig S, Samuelsson K, Musahl V. Applications of Extended Reality in Orthopaedic Surgery. J Bone Joint Surg Am 2023; 105:1721-1729. [PMID: 37713502 DOI: 10.2106/jbjs.22.00805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
➤ Extended reality is a term that encompasses different modalities, including virtual reality, augmented reality, and mixed reality.➤ Although fully immersive virtual reality has benefits for developing procedural memory and technical skills, augmented and mixed reality are more appropriate modalities for preoperative planning and intraoperative utilization.➤ Current investigations on the role of extended reality in preoperative planning and intraoperative utilization are still in the early stages, but preliminarily show that extended reality technologies can help surgeons to be more accurate and efficient.
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Affiliation(s)
- Ehab M Nazzal
- Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bálint Zsidai
- Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Laurie A Hiemstra
- Banff Sport Medicine, Banff, Alberta, Canada
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Sébastien Lustig
- Department of Orthopaedic Surgery and Sports Medicine, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France
| | - Kristian Samuelsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Volker Musahl
- Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, Pennsylvania
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Prabhu AV, Peterman M, Kesaria A, Samanta S, Crownover R, Lewis GD. Virtual reality technology: A potential tool to enhance brachytherapy training and delivery. Brachytherapy 2023; 22:709-715. [PMID: 37679242 DOI: 10.1016/j.brachy.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Arpan V Prabhu
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Melissa Peterman
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Anam Kesaria
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Santanu Samanta
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Richard Crownover
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Gary D Lewis
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR.
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Chaisson N, Johnson-Agbakwu CE, Finch A, Salad M, Connor JJ, Chen M, Robinson BBE. Beautiful vulvas: expanding illustrative visual imagery of female genital cutting types. J Sex Med 2023; 20:1301-1311. [PMID: 37721173 PMCID: PMC10627781 DOI: 10.1093/jsxmed/qdad102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/18/2023] [Accepted: 06/04/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Visual imagery has been used to educate healthcare providers, patients, and the lay public on female genital cutting (FGC) typology and reconstructive procedures. However, culturally inclusive, diverse, and anatomically accurate representation of vulvas informed by women possessing lived experience of FGC is lacking. AIM We sought to apply World Health Organization (WHO) FGC typology to the development of type-specific visual imagery designed by a graphic artist and culturally informed by women with lived experience of FGC alongside a panel of health experts in FGC-related care. METHODS Over a 3-year process, a visual artist created watercolor renderings of vulvas with and without FGC across varying WHO types and subtypes using an iterative community-based approach. Somali women possessing lived experience of FGC were engaged alongside a team of clinician experts in FGC-related care. Women and clinicians provided descriptive input on skin color variation, texture, and skin tone, as well as the visual depiction of actions necessary in conducting a genital examination. OUTCOMES A series of vulvar anatomic illustrations depicting WHO FGC typology. RESULTS FGC types and subtypes are illustrated alongside culturally informed descriptors and clinical pearls to strengthen provider competency in the identification and documentation of FGC WHO typology, as well as facilitate patient education, counseling, shared decision making, and care. CLINICAL IMPLICATIONS Ensuring equitable representation of race, gender, age, body type, and ability in medical illustrations may enhance patient education, counseling, and shared decision making in medical and/or surgical care. FGC provides a lens through which the incorporation of patient-informed and culturally relevant imagery and descriptors may enhance provider competency in the care of FGC-affected women and adolescents. STRENGTHS AND LIMITATIONS The strengths of this study include the development of visual imagery through an iterative community-based process that engaged women with lived experience of FGC alongside clinicians with expertise in FGC-related care, as well as the representation of historically underrepresented bodies in the anatomical literature. Study limitations include the lack of generalizability to all possible forms or practices of FGC given the focus on one geographically distinct migrant community, as well as the reliance on self-report given the inability to clinically verify FGC status due to the community-based methodology employed. CONCLUSION Patient-informed and culturally representative visual imagery of vulvas is essential to the provision of patient-centered sexual health care and education. Illustrations developed through this community-engaged work may inform future development of visual educational content that advances equity in diverse representation of medical illustrations.
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Affiliation(s)
- Nicole Chaisson
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Crista E Johnson-Agbakwu
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, UMass Chan Medical School and UMass Memorial Health, Worcester, MA, United States
| | - Ashley Finch
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Munira Salad
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Jennifer Jo Connor
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Muzi Chen
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Beatrice Bean E Robinson
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
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Birrenbach T, Wespi R, Hautz WE, Berger J, Schwab PR, Papagiannakis G, Exadaktylos AK, Sauter TC. Development and usability testing of a fully immersive VR simulation for REBOA training. Int J Emerg Med 2023; 16:67. [PMID: 37803269 PMCID: PMC10559413 DOI: 10.1186/s12245-023-00545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potentially life-saving procedure for bleeding trauma patients. Being a rare and complex procedure performed in extreme situations, repetitive training of REBOA teams is critical. Evidence-based guidelines on how to train REBOA are missing, although simulation-based training has been shown to be effective but can be costly and complex. We aimed to determine the feasibility and acceptance of REBOA training using a fully immersive virtual reality (VR) REBOA simulation, as well as assess the confidence in conducting the REBOA procedure before and after the training. METHODS Prospective feasibility pilot study of prehospital emergency physicians and paramedics in Bern, Switzerland, from November 2020 until March 2021. Baseline characteristics of trainees, prior training and experience in REBOA and with VR, variables of media use (usability: system usability scale, immersion/presence: Slater-Usoh-Steed, workload: NASA-TLX, user satisfaction: USEQ) as well as confidence prior and after VR training were accessed. RESULTS REBOA training in VR was found to be feasible without relevant VR-specific side-effects. Usability (SUS median 77.5, IQR 71.3-85) and sense of presence and immersion (Slater-Usoh-Steed median 4.8, IQR 3.8-5.5) were good, the workload without under-nor overstraining (NASA-TLX median 39, IQR 32.8-50.2) and user satisfaction high (USEQ median 26, IQR 23-29). Confidence of trainees in conducting REBOA increased significantly after training (p < 0.001). CONCLUSIONS Procedural training of the REBOA procedure in immersive virtual reality is possible with a good acceptance and high usability. REBOA VR training can be an important part of a training curriculum, with the virtual reality-specific advantages of a time- and instructor-independent learning.
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Affiliation(s)
- T Birrenbach
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland.
| | - R Wespi
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| | - W E Hautz
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| | - J Berger
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| | - P R Schwab
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
- Schutz und Rettung Bern, Sanitätspolizei Bern, Bern, Switzerland
| | - G Papagiannakis
- ORamaVR SA, Geneva, Switzerland
- Institute of Computer Science, Foundation for Research and Technology, Hellas, Heraklion, Greece
- Department of Computer Science, University of Crete, Heraklion, Greece
| | - A K Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| | - T C Sauter
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
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Magi CE, Bambi S, Iovino P, El Aoufy K, Amato C, Balestri C, Rasero L, Longobucco Y. Virtual Reality and Augmented Reality Training in Disaster Medicine Courses for Students in Nursing: A Scoping Review of Adoptable Tools. Behav Sci (Basel) 2023; 13:616. [PMID: 37504063 PMCID: PMC10376463 DOI: 10.3390/bs13070616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023] Open
Abstract
Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including virtual reality (VR) and augmented reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR and AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full texts were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR and AR and immersive simulation generally show promising evidence in enhancing practical skills and knowledge in MCI management. VR and AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experiential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.
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Affiliation(s)
- Camilla Elena Magi
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Khadija El Aoufy
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy
| | - Carla Amato
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Chiara Balestri
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
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De Miguel-Rubio A, Alba-Rueda A, Millán-Salguero EM, De Miguel-Rubio MD, Moral-Munoz JA, Lucena-Anton D. Virtual Reality for Upper Limb Rehabilitation in Patients With Obstetric Brachial Palsy: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Med Internet Res 2023; 25:e47391. [PMID: 37389922 PMCID: PMC10365570 DOI: 10.2196/47391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/09/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Obstetric brachial palsy (OBP) is a pathology caused by complications during childbirth because of cervical spine elongation, affecting the motor and sensory innervation of the upper limbs. The most common lesion occurs on the C5 and C6 nerve branches, known as Erb-Duchenne palsy. The least common lesion is when all nerve roots are affected (C5-T1), which has the worst prognosis. Virtual reality (VR) is commonly used in neurological rehabilitation for the evaluation and treatment of physical deficits. OBJECTIVE This systematic review aims to assess the efficacy of VR in the rehabilitation of upper limb function in patients with OBP. METHODS A search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines in several scientific databases-PubMed, Web of Science, PEDro, Cochrane, MEDLINE, Scopus, and CINAHL-without language or date restrictions and including articles published up to April 2023. The inclusion criteria were established according to the population, intervention, comparison, outcome, and study (PICOS) design framework: children aged <18 years diagnosed with OBP, VR therapy used in addition to conventional therapy or isolated, VR therapy compared with conventional therapy, outcomes related to OBP rehabilitation therapy, and randomized controlled trials (RCTs). The PEDro scale was used to assess the methodological quality of the RCTs, and the Cochrane Collaboration tool was used to assess the risk of bias. The Review Manager statistical software (version 5.4; The Cochrane Collaboration) was used to conduct the meta-analysis. The results were synthesized through information extraction and presented in tables and forest plots. RESULTS In total, 5 RCTs were included in this systematic review, with 3 (60%) providing information for the meta-analysis. A total of 138 participants were analyzed. All the studies used semi-immersive or nonimmersive VR systems. The statistical analysis showed no favorable results for all outcomes except for the hand-to-mouth subtest of the Mallet scoring system (functional activity; standardized mean difference -0.97, 95% CI -1.67 to -0.27; P=.007). CONCLUSIONS The evidence for the use of VR therapy for upper limb rehabilitation outcomes in patients with OBP was insufficient to support its efficacy and strongly recommend its use. Nevertheless, scientific literature supports the use of VR technologies for rehabilitation as it provides several advantages, such as enhancing the patient's motivation, providing direct feedback, and focusing the patient's attention during the intervention. Thus, the use of VR for upper limb rehabilitation in patients with OBP is still in its first stages. Small sample sizes; limited long-term analysis; lack of testing of different doses; and absence of International Classification of Functioning, Disability, and Health-related outcomes were present in the included RCTs, so further research is needed to fully understand the potential of VR technologies as a therapeutic approach for patients with OBP. TRIAL REGISTRATION PROSPERO CRD42022314264; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=314264.
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Affiliation(s)
| | - Alvaro Alba-Rueda
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, Córdoba, Spain
| | | | | | - Jose A Moral-Munoz
- Departamento de Enfermería y Fisioterapia, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Facultad de Enfermería y Fisioterapia, Universidad de Cádiz, Cádiz, Spain
| | - David Lucena-Anton
- Departamento de Enfermería y Fisioterapia, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Facultad de Enfermería y Fisioterapia, Universidad de Cádiz, Cádiz, Spain
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Maloca PM, Zarranz-Ventura J, Valmaggia P, Faludi B, Zelechowski M, Tufail A, Zentai NZ, Scholl HPN, Cattin PC. Validation of collaborative cyberspace virtual reality oculometry enhanced with near real-time spatial audio. Sci Rep 2023; 13:10076. [PMID: 37344554 DOI: 10.1038/s41598-023-37267-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/19/2023] [Indexed: 06/23/2023] Open
Abstract
Currently, most medical image data, such as optical coherence tomography (OCT) images, are displayed in two dimensions on a computer screen. Advances in computer information technology have contributed to the growing storage of these data in electronic form. However, the data are usually processed only locally on site. To overcome such hurdles, a cyberspace virtual reality (csVR) application was validated, in which interactive OCT data were presented simultaneously to geographically distant sites (Lucerne, London, and Barcelona) where three graders independently measured the ocular csVR OCT diameters. A total of 109 objects were measured, each three times, resulting in a total of 327 csVR measurements. A minor mean absolute difference of 5.3 µm was found among the 3 measurements of an object (standard deviation 4.2 µm, coefficient of variation 0.3% with respect to the mean object size). Despite the 5 h of online work, csVR was well tolerated and safe. Digital high-resolution OCT data can be remotely and collaboratively processed in csVR. With csVR, measurements and actions enhanced with spatial audio communication can be made consistently in near real time, even if the users are situated geographically far apart. The proposed visuo-auditory framework has the potential to further boost the convenience of digital medicine toward csVR precision and collaborative medicine.
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Affiliation(s)
- Peter M Maloca
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031, Basel, Switzerland.
- Department of Ophthalmology, University Hospital Basel, 4031, Basel, Switzerland.
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK.
| | | | - Philippe Valmaggia
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, 4031, Basel, Switzerland
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
| | - Balázs Faludi
- Centre for Medical Image Analysis & Navigation, University of Basel, 4123, Allschwil-Basel, Switzerland
| | - Marek Zelechowski
- Centre for Medical Image Analysis & Navigation, University of Basel, 4123, Allschwil-Basel, Switzerland
| | - Adnan Tufail
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
| | - Norbert Z Zentai
- Centre for Medical Image Analysis & Navigation, University of Basel, 4123, Allschwil-Basel, Switzerland
| | - Hendrik P N Scholl
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, 4031, Basel, Switzerland
| | - Philippe C Cattin
- Centre for Medical Image Analysis & Navigation, University of Basel, 4123, Allschwil-Basel, Switzerland
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Rickenbacher-Frey S, Adam S, Exadaktylos AK, Müller M, Sauter TC, Birrenbach T. Development and evaluation of a virtual reality training for emergency treatment of shortness of breath based on frameworks for serious games. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc16. [PMID: 37361243 PMCID: PMC10285370 DOI: 10.3205/zma001598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/07/2023] [Accepted: 02/06/2023] [Indexed: 06/28/2023]
Abstract
Background Virtual reality (VR) can offer an innovative approach to providing training in emergency situations, especially in times of COVID-19. There is no risk of infection, and the procedure is scalable and resource-efficient. Nevertheless, the challenges and problems that can arise in the development of VR training are often unclear or underestimated. As an example, we present the evaluation of the feasibility of development of a VR training session for the treatment of dyspnoea. This is based on frameworks for serious games, and provides lessons learned. We evaluate the VR training session with respect to usability, satisfaction, as well as perceived effectiveness and workload of participants. Methods The VR training was developed using the established framework (Steps 1-4) for serious games of Verschueren et al. and Nicholson's RECIPE elements for meaningful gamification. Primary validation (Step 4) was performed at the University of Bern, Switzerland, in a pilot study without control group, with a convenience sample of medical students (n=16) and established measurement tools. Results The theoretical frameworks permitted guided development of the VR training session. Validation gave a median System Usability Scale of 80 (IQR 77.5-85); for the User Satisfaction Evaluation Questionnaire, the median score was 27 (IQR 26-28). After the VR training, there was a significant gain in the participants' confidence in treating a dyspnoeic patient (median pre-training 2 (IQR 2-3) vs. post-training 3 (IQR 3-3), p=0.016).Lessons learned include the need for involving medical experts, medical educators and technical experts at an equivalent level during the entire development process. Peer-teaching guidance for VR training was feasible. Conclusion The proposed frameworks can be valuable tools to guide the development and validation of scientifically founded VR training. The new VR training session is easy and satisfying to use and is effective - and is almost without motion sickness.
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Affiliation(s)
| | - Selina Adam
- University Hospital Bern, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | | | - Martin Müller
- University Hospital Bern, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | - Thomas C. Sauter
- University Hospital Bern, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | - Tanja Birrenbach
- University Hospital Bern, Inselspital, Department of Emergency Medicine, Bern, Switzerland
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Qingfu H, Zongkai Y, Zhenhua W, Zhenshuang D. Knowledge atlas analysis of virtual vascular interventional studies. Vascular 2023:17085381231162157. [PMID: 36927163 DOI: 10.1177/17085381231162157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To examine the research status, hot spots, and development trend of virtual vascular intervention simulation training in order to organize the knowledge and support its practice. METHODS Publications on virtual vascular intervention and respective teaching evaluation (2001-2021) were retrieved from Web of Science. Citespace 5.2.R2 and Carrot2 software was used to perform the bibliometric and visual analysis on virtual vascular intervention research networks. RESULTS Of the 1543 articles retrieved, 1520 were relevant to virtual vascular intervention research. Studies on vascular intervention emerged from 2002 with an upward trend being observed from 2010. The trend peaked between 2019 and 2020 with ∼140 published articles (9.21%) during the period. Spain published most studies (n = 146) followed by USA (n = 99) and England (n = 49). COMPUT EDUC (n = 177; 14.47%) journal publishing the highest number of articles. Among 705 authors, GARRISON D R, MAYER RE, DEDE C, COOK DA had highest publications. The frequent keywords used were "Virtual reality" (n = 105) and "education" (n = 105). Low cooperation between countries, authors' networks, and relatively stable academic team was noted making clinical application of virtual vascular intervention weak. CONCLUSION Considerable growth was observed in vascular intervention therapy using VR technology in the last 20 years. With consistent efforts like strengthening cross-institutional and multidisciplinary collaboration networks, VR based simulation training capability can be increased that in turn can improve the outcomes of complex vascular interventions.
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Affiliation(s)
- Hu Qingfu
- 117889The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yu Zongkai
- 117889The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Wang Zhenhua
- 117889The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Du Zhenshuang
- 442537Quanzhou Medical College, Quanzhou, China.,People's Hospital Affiliated of Quanzhou Medical College, Quanzhou, China
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Gudadappanavar AM, Hombal P, Benni JM, Patel S, Tubaki BR. Evaluation of Virtual Reality High-Fidelity Adult Mannequin-based Simulation of Real-Life Clinical Scenarios in Teaching Clinical Pharmacology to Medical Students. J Pharmacol Pharmacother 2023. [DOI: 10.1177/0976500x231159456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Background Presently, competency-based medical (CBME) curriculum challenges the medical educators to provide continuing education with new approaches to make learning more stimulating, motivating, and entertaining, fostering excellence in clinical practice. To address these issues, educators have advocated the use of virtual reality and mannequins to teach clinical pharmacology. Aims and Objectives To study the effect, perception, and feedback of virtual reality high-fidelity adult mannequin-based (VHFM) simulation of real-life clinical scenarios over conventional tutorials in teaching clinical pharmacology to medical students. Material and Methods An interventional study was designed for 2nd year MBBS students for a period of 6 months. The enrolled students were randomly assigned to the test group (VHFM) or control group (tutorials). The CAE Healthcare Ltd. maestro, high-fidelity prehospital mannequin (APOLLO) was used in the test group. Three sessions consisting of six different cases were discussed, and multiple-choice questions (MCQs)-based pre-test, post–test, and retest after a month were conducted in both groups and compared. The perception and feedback of faculty and students were obtained by using a modified and revalidated questionnaire. Results The test group outperformed the control group ( p <.001) in all sessions based on pre-test, post-test, and retest scores, and within-group comparisons revealed significant improvements in both groups. Students’ perceptions and feedback regarding VHFM were more enthusiastic and promising than in the tutorial group. Conclusions VHFM is student-centered, provides an active learning environment, and aids in skill development. We strongly suggest VHFM-based learning as a complement to traditional teaching strategies in pharmacology, especially for teaching clinical reasoning to medical students.
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Affiliation(s)
| | - Prashant Hombal
- Department of General Surgery, KAHER, JNMC, Belagavi, Karnataka, India
| | - Jyoti M. Benni
- Department of Pharmacology, KAHER JGMM Medical College, Hubballi, Karnataka, India
| | - Sachin Patel
- Department of Pharmacology, KAHER J.N. Medical College, Belagavi, Karnataka, India
| | - Basavaraj R. Tubaki
- Department of Kayachikitsa, KLE Ayurveda Mahavidyalaya, Belagavi, Karnataka, India
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Grilo AM, Almeida B, Rodrigues C, Isabel Gomes A, Caetano M. Using virtual reality to prepare patients for radiotherapy: A systematic review of interventional studies with educational sessions. Tech Innov Patient Support Radiat Oncol 2023; 25:100203. [PMID: 36873800 PMCID: PMC9982317 DOI: 10.1016/j.tipsro.2023.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/06/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose To understand the impact of radiotherapy educational sessions with virtual reality on oncologic adult patients' psychological and cognitive outcomes related to the treatment experience. Methods This review was performed according to the Preferred Reporting Items for Systematic Reviews guidelines. A systematic electronic search in three databases, MEDLINE, Scopus, and Web of Science, was conducted in December 2021 to find interventional studies with adult patients undergoing external radiotherapy who received an educational session with virtual reality before or during the treatment. The studies that provided qualitative or quantitative information about the impact of educational sessions on patients' psychological and cognitive dimensions related to RT experience were retained for analysis. Results Of the 25 records found, eight articles about seven studies were analysed that involved 376 patients with different oncological pathologies. Most studies evaluated knowledge and treatment-related anxiety, mainly through self-reported questionnaires. The analysis showed a significant improvement in patients' knowledge and comprehension of radiotherapy treatment. Anxiety levels also decreased with virtual reality educational sessions and throughout the treatment in almost all the studies, although with less homogeneous results. Conclusion Virtual reality methods in standard educational sessions can enhance cancer patients' preparation for radiation therapy by increasing their understanding of treatment and reducing anxiety.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC − Health & Technology Research Center, ESTeSL − Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
- CICPSI − Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Corresponding author.
| | - Bárbara Almeida
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Carolina Rodrigues
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Ana Isabel Gomes
- CICPSI − Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Marco Caetano
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
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Ntakakis G, Plomariti C, Frantzidis C, Antoniou PE, Bamidis PD, Tsoulfas G. Exploring the use of virtual reality in surgical education. World J Transplant 2023; 13:36-43. [PMID: 36908307 PMCID: PMC9993190 DOI: 10.5500/wjt.v13.i2.36] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/14/2022] [Accepted: 01/04/2023] [Indexed: 02/16/2023] Open
Abstract
Virtual reality (VR) technologies have rapidly developed in the past few years. The most common application of the technology, apart from gaming, is for educational purposes. In the field of healthcare, VR technologies have been applied in several areas. Among them is surgical education. With the use of VR, surgical pathways along with the training of surgical skills can be explored safely, in a cost-effective manner. The aim of this mini-review was to explore the use of VR in surgical education and in the 3D reconstruction of internal organs and viable surgical pathways. Finally, based on the outcomes of the included studies, an ecosystem for the implementation of surgical training was proposed.
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Affiliation(s)
- Georgios Ntakakis
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Christina Plomariti
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Christos Frantzidis
- School of Computer Science, University of Lincoln, Lincoln LN6 7TS, United Kingdom
| | - Panagiotis E Antoniou
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Panagiotis D Bamidis
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Georgios Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
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Lie SS, Helle N, Sletteland NV, Vikman MD, Bonsaksen T. Implementation of Virtual Reality in Health Professions Education: Scoping Review. JMIR MEDICAL EDUCATION 2023; 9:e41589. [PMID: 36692934 PMCID: PMC9906320 DOI: 10.2196/41589] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/07/2022] [Accepted: 12/23/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Virtual reality has been gaining ground in health professions education and may offer students a platform to experience and master situations without endangering patients or themselves. When implemented effectively, virtual reality technologies may enable highly engaging learning activities and interactive simulations. However, implementation processes present challenges, and the key to successful implementation is identifying barriers and facilitators as well as finding strategies to address them. OBJECTIVE This scoping review aimed to identify the literature on virtual reality implementation in health professions education, identify barriers to and facilitators of implementation, and highlight gaps in the literature in this area. METHODS The scoping review was conducted based on the Joanna Briggs Institute Evidence Synthesis methodologies. Electronic searches were conducted in the Academic Search Elite, Education Source, and CINAHL databases on January 5, 2022, in Google Scholar on February 2 and November 18, 2022, and in PubMed database on November 18, 2022. We conducted hand searches of key items, reference tracking, and citation tracking and searches on government webpages on February 2, 2022. At least 2 reviewers screened the identified literature. Eligible studies were considered based on predefined inclusion criteria. The results of the identified items were analyzed and synthesized using qualitative content analysis. RESULTS We included 7 papers and identified 7 categories related to facilitators of and barriers to implementation-collaborative participation, availability, expenses, guidelines, technology, careful design and evaluation, and training-and developed a model that links the categories to the 4 constructs from Carl May's general theory of implementation. All the included reports provided recommendations for implementation, including recommendations for careful design and evaluation, training of faculty and students, and faculty presence during use. CONCLUSIONS Virtual reality implementation in health professions education appears to be a new and underexplored research field. This scoping review has several limitations, including definitions and search words, language, and that we did not assess the included papers' quality. Important implications from our findings are that ensuring faculty's and students' competence in using virtual reality technology is necessary for the implementation processes. Collaborative participation by including end users in the development process is another factor that may ensure successful implementation in higher education contexts. To ensure stakeholders' motivation and potential to use virtual reality, faculty and students could be invited to participate in the development process to ensure that the educational content is valued. Moreover, technological challenges and usability issues should be resolved before implementation to ensure that pedagogical content is the focus. This accentuates the importance of piloting, sufficient time resources, basic testing, and sharing of experiences before implementation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/37222.
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Affiliation(s)
- Silje Stangeland Lie
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | - Nikolina Helle
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | - Nina Vahl Sletteland
- Department of Nursing, Faculty of Health Studies, VID Specialized University, Bergen, Norway
| | - Miriam Dubland Vikman
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | - Tore Bonsaksen
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
- Department of Health and Nursing Science, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Guo X, Nerella KK, Dong J, Qian Z, Chen Y. Understanding Pitfalls and Opportunities of Applying Heuristic Evaluation Methods to VR Training Systems: An Empirical Study. INTERNATIONAL JOURNAL OF HUMAN-COMPUTER INTERACTION 2023; 40:2168-2184. [PMID: 38863735 PMCID: PMC11164547 DOI: 10.1080/10447318.2022.2161238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/24/2022] [Indexed: 06/13/2024]
Abstract
The usability of virtual reality (VR) training applications is crucial for their success, but examining the usability in the early development stages remains challenging. A realistic and plausible solution would be revisiting and reconciling Heuristics Evaluation (HE) methods among the most widely used usability inspection methods in the human-computer interaction (HCI) domain. While research on studying and using HE methods is growing within the VR domain, few studies have considered the novel VR environment challenges new requirements for fitting HE methods to the context and applying them effectively. To this end, we conducted a user study with 14 evaluators using the standard HE methods to complete two HE sessions for a VR training application. We identified five critical challenges that evaluators encountered in the HE process by observing and interviewing them. Based on our findings, we discuss the importance of considering an easy-to-use heuristic set, how we can facilitate the HE procedures in the VR context, and the opportunities for developing HE-supporting tools.
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Affiliation(s)
- Xiaolei Guo
- Department of Computer Graphics Technology, Purdue University, West Lafayette, USA
| | - Kushal Kumar Nerella
- Department of Computer Graphics Technology, Purdue University, West Lafayette, USA
| | - Jiahui Dong
- Department of Computer Graphics Technology, Purdue University, West Lafayette, USA
| | - Zhenyu Qian
- Department of Art and Design, Purdue University, West Lafayette, USA
| | - Yingjie Chen
- Department of Computer Graphics Technology, Purdue University, West Lafayette, USA
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