Adding immersive virtual reality laboratory simulations to traditional teaching methods enhances biotechnology learning outcomes

Objectives: There is an increasing number of complex and varied surgical techniques and implants in orthopedic trauma. As the paradigm shift in orthopedic surgical education is turning to competency-based curricula and technology is becoming more affordable, new immersive virtual reality (IVR) simulation systems are emerging. The main objective of this study was to evaluate the utility of IVR simulation for learning a complex surgical technique; the application of a Trochanteric Femoral Nail Advanced (TFNA™). Methods: Ten residents participated in the evaluation of the application of TFNA™ in a Synbone® model during an advanced fractures treatment course. Five of them had a previous practice session using a VR simulator to learn the technique. All of them applied a TFNA™ during the course and were then asked to repeat it. Time to completion and the number of steps completed by each group were compared between both groups. Results: The VR group took 25.84 min to complete (standard deviation [SD] 6.14) and the control group 31.6 min to complete (SD 19.3). There was no statistically significant difference between both groups, but there was a tendency for the VR group to complete more steps and finish earlier than the control group (P = 0.554). Conclusion: IVR simulation could be a more accessible way to provide a safe environment where participants can learn a new surgical technique. It is important to develop proficiency-based progressive training programs with specific educational goals that incorporate simulation and emerging technology as a tool. Larger, randomized, internal and external validation studies are needed.

A scoping review identified a significant growth in research with immersive technology in healthcare education. However, there are few validated measures that capture the user experience of participants [1]. This study aims to investigate the use of an immersive virtual reality (VR) simulation on sepsis management and measure user experience using a validated tool, the Immersive Technology Evaluation Measure (ITEM) [2]. ITEM was formulated on a learning theory called Model for Immersive Technology in Healthcare Education (MITHE), which borrows cognitive and behavioural theories to help explain our level of immersion and enjoyment that can be facilitated by technology (see Model of immersive technology in healthcare education (MITHE) This single-study quasi-experimental investigation was conducted at a single site. Nine participants were recruited, consisting of medical students and healthcare professionals. Participants were trained on varied immersive devices: sepsis management using an immersive VR simulation developed by Gogglemind, and augmented reality (AR) holographic patient with respiratory distress, which included realistic patient scenarios and interactive decision-making. User experience was measured using the ITEM, which assesses user; immersion, cognitive load, intrinsic motivation, debrief and technology usability. Nine participants had high levels of immersion (mean 39.6, total 50), high levels of intrinsic motivation (mean 39.6, total 50), high technology score (mean 79.4, total 100), optimum cognitive load (average 59.5, optimum 39–61) and moderate score on debrief (mean 18.1, total 25). ITEM subscores indicated an enjoyable and immersive experience with good technology interface on usability scores. Self-directed debrief in VR had lower scores with emotional considerations and identifying domains of performance and learning. The use of the ITEM provided valuable insights into the user experience of the VR simulation, which can be used to improve the design and implementation of future simulations. This contributes to an ongoing ITEM validation process. This study highlights the importance of training in healthcare and the potential benefits of using immersive technologies such as VR and AR simulations. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Simulation-based medical education has been shown to be more effective but also logistically demanding and costly compared to other educational strategies in developing medical skills. Immersive virtual reality is an emerging technology enabling learners to train without a facilitator through computer-generated feedback, offering the potential for increased flexibility in the timing and location of the training and reduced costs. However, little is known about whether immersive virtual reality simulation yields similar results with and without a facilitator. The aim of this study is to compare the effects of self-guided compared to facilitator-guided debriefing for immersive virtual reality simulation-based pediatric emergency team training. We will conduct a randomized, controlled, single-blinded non-inferiority study with a parallel group, pretest-post-test design. 88 medical students (44 teams) will be randomized to undergo immersive virtual reality simulation-based pediatric emergency team training with either self-guided or facilitator-guided debriefing. We will assess the teams before and after the virtual reality intervention in a mannequin-based simulation. The mannequin-based simulation will be videorecorded, and two independent raters, blinded to group allocation, will assess the recordings using validated scales measuring teamwork skills (primary outcome), ABCDE adherence, and time to critical actions. We will further collect data on perceptions of debriefing quality, motivation, workload, usability, and cybersickness. To account for repeated measures and clustering within teams, we will apply a linear mixed model for data analysis. This study aims to provide insight into the effects of self-guided versus facilitator-guided debriefing in immersive virtual reality simulation, with implications for the future development and implementation of immersive virtual reality simulation in medical education. We have registered the trial on ClinicalTrials.gov (identifier: NCT06956833).

Immersive virtual reality (VR) simulations are gaining prominence in undergraduate nursing education because they (a) can mimic the dynamism of clinical settings for students, (b) enable educators to scaffold theory-practice integration and multiple skill development, and (c) provide programs with a costeffective curricular solution for supporting clinical practice-readiness. In this paper, we investigate first- and second-year nursing students’ experiences with Simulation Learning System with Virtual Reality (SLS with VR) during a 7-week study in Fall 2020 and assess change in their self-efficacy from pre-post. An inductive thematic analysis of students’ responses revealed that they experienced a heightened sense of engagement in VR, and SLS with VR afforded roleplaying in authentic clinical situations. A statistically significant improvement was found in students’ ratings of self-efficacy variables such as their understanding of content, ability to make clinical judgments, caring for patients, working in teams, and ensuring safety and quality in clinical situations. These findings contribute to a growing body of literature that is focused on supporting nursing education stakeholders to understand and embrace the effectiveness of VR in preparing future nurses for patient well-being and the complexities of health care settings.

Collaborative AI & immersive VR simulation for workplace layout optimization in manufacturing applications

Extended-Reality Technologies: An Overview of Emerging Applications in Medical Education and Clinical Care.

Objective To minimize loss of life, mass casualty response requires swift identification, efficient triage categorization, and rapid hemorrhage control. Current training methods remain suboptimal. Our objective was to train first responders to triage a mass casualty incident using Virtual Reality (VR) simulation and obtain their impressions of the training’s quality and effectiveness. Methods We trained subjects in SALT Triage then had them respond to a terrorist bombing of a subway station using a fully immersive VR simulation. We gathered learner reactions to their VR experience and post-encounter debriefing with a custom electronic survey. Results Nearly 400 subjects experienced the VR encounter and completed evaluation surveys. Most participants (95%) recommended the experience for other first responders and rated the simulation (95%) and virtual patients (91%) as realistic. Ninety-four percent of participants rated the VR simulator as “excellent” or “good.” We observed no differences between those who owned a personal VR system and those who did not. Conclusions Our VR simulator (go.osu.edu/firstresponder) is an automated, customizable, fully immersive virtual reality system for training and assessing personnel in the proper response to a mass casualty incident. Participants perceived the encounter as effective for training, regardless of their prior experience with virtual reality.

ObjectiveMany industries struggle with training dynamic risk assessment, and how to bridge the gap between safety training and behavior in real life scenarios. In this article, we focus on dynamic risk assessment during a mooring operation and investigate the potential value of using immersive virtual reality (VR) simulations compared to standard training procedures in an international maritime training organization.MethodsIn a pilot study, we compared two ways of implementing a VR simulation (stand‐alone or with post‐simulation reflection) to a manual and a personal trainer condition in a between‐subjects design with 86 students in a maritime school. Based on the results we compared the stand‐alone VR simulation to the personal trainer condition in a between‐subjects design in a non‐Western, Educated, Industrialized, Rich, and Democratic (WEIRD) sample of 28 seafarers from the Kiribati Islands at an international maritime training organization.ResultsThe VR simulation group reported significantly higher perceived enjoyment (d = 1.28), intrinsic motivation (d = 0.96), perceived learning (d = 0.90), and behavioral change (d = 0.88), and significantly lower extraneous cognitive load (d = 0.82) compared to the personal trainer group, but the differences in self‐efficacy, and safety attitudes were not significant.DiscussionThe results support the value of using VR to train procedures that are difficult to train in the real world and suggest that VR technologies can be useful for providing just in time training anywhere, anytime, in a global market where employees are increasingly cross‐cultural and dislocated.

The issues of bias and racism require that nursing students and healthcare leaders are competent and confident to recognize and effectively address situations that arise in the work setting and community. The American Organization for Nursing Leadership (AONL) stated it is the responsibility of all nurse leaders to address issues related to diversity, equity, inclusion, and belonging (AONL, 2023). To meet this challenge, nurse leaders need to develop the knowledge and skills to manage issues of bias and racism. A 360-degree immersive virtual reality (IVR) simulation was created to provide graduate nursing leadership students and nurse leaders in the health system (n=36) with the opportunity to learn and practice these skills in a safe environment. Effectiveness and acceptability of the IVR simulation were assessed quantitatively and qualitatively through participants’ subjective evaluation of their IVR experience, awareness, and confidence to identify and address bias and racism. This innovative simulation demonstrated that the IVR education was impactful, increased participants’ confidence, and reinforced the organization’s values and commitment to diversity, equity, inclusion, belonging (DEIB), and anti-racism. The IVR experience inspired participants’ desire to change behaviors, role model inclusive practices, and influence others to create a culture of inclusion and belonging. Keywords: Virtual Reality, Simulation, DEI, Anti-Racism, Nurse, Leadership

In this demo we present an immersive virtual reality (VR) simulator to measure risk perception in realistic working environments. It provides the ideal environment to expose people to danger with no chances to cause them any harm. However, whereas in the physical work environment workers have to perform their jobs (primary task) and be safe (secondary task), in a VR simulator they still have to deal with an additional source of cognitive load: the user interface.

There has been limited literature on immersive virtual reality (VR) simulation in orthopaedic education. The purpose of this multicenter, blinded, randomized controlled trial was to determine the validity and efficacy of immersive VR training in orthopaedic resident education. Nineteen senior orthopaedic residents (resident group) and 7 consultant shoulder arthroplasty surgeons (expert group) participated in the trial comparing immersive VR with traditional learning using a technical journal article as a control. The examined task focused on achieving optimal glenoid exposure. Participants completed demographic questionnaires, knowledge tests, and a glenoid exposure on fresh-frozen cadavers while being examined by blinded shoulder arthroplasty surgeons. Training superiority was determined by the outcome measures of the Objective Structured Assessment of Technical Skills (OSATS) score, a developed laboratory metric, verbal answers, and time to task completion. Immersive VR had greater realism and was superior in teaching glenoid exposure than the control (p = 0.01). The expert group outperformed the resident group on knowledge testing (p = 0.04). The immersive VR group completed the learning activity and knowledge tests significantly faster (p < 0.001) at a mean time (and standard deviation) of 11 ± 3 minutes than the control group at 20 ± 4 minutes, performing 3 to 5 VR repeats for a reduction in learning time of 570%. The immersive VR group completed the glenoid exposure significantly faster (p = 0.04) at a mean time of 14 ± 7 minutes than the control group at 21 ± 6 minutes, with superior OSATS instrument handling scores (p = 0.03). The immersive VR group scored equivalently in surprise verbal scores (p = 0.85) and written knowledge scores (p = 1.0). Immersive VR demonstrated substantially improved translational technical and nontechnical skills acquisition over traditional learning in senior orthopaedic residents. Additionally, the results demonstrate the face, content, construct, and transfer validity for immersive VR. This adequately powered, randomized controlled trial demonstrated how an immersive VR system can efficiently (570%) teach a complex surgical procedure and also demonstrate improved translational skill and knowledge acquisition when compared with a traditional learning method.

Minimally invasive laparoscopic surgery requires intensive training due to challenges such as loss of haptic feedback and depth perception. Traditional training methods include box trainers (BT), which offer realistic haptic feedback but lack objective performance assessment, and virtual reality (VR) simulators, which provide automated feedback but lack haptic feedback. This review, conducted at the Barts Cancer Institute, Queen Mary University, examines the learning outcomes of VRsimulators with haptic feedback compared to BT. A systematic review and meta-analysis was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines from December 2023 to April 2024. Research databases, such as PubMed, EMBASE, CINAHL, and Web of Science, were searched for randomized controlled trials (RCTs) comparing VR simulators with haptic feedback to BT in training medical students. Seven RCTs met the inclusion criteria, and four were included in the meta-analysis. The primary outcomes were learning curves and learning effectswhile secondary outcomes included skill transfer to a surgical environment. The review analysed data from 125 participants across the studies. Results indicated that BTs demonstrated a superior learning curve, with participants achieving proficiency faster than those using VR. Both simulators showed significant learning effects; however, BTs resulted in greater improvements across more performance parameters. Regarding skill transfer to surgical environments, there was no significant difference between the two groups, suggesting both approaches effectively support surgical skill transfer. Overall, BT has a more effective learning curve and marginally better performance in skill acquisition. While VR with haptic feedback offers enhanced realism, it does not fully replicate the natural haptic feedback provided by BT. Further studies are needed to improve VR haptic feedback and its integration into training programs to enhance learning outcomes.

Virtual reality simulation in training endoscopic skills: A systematic review

Can virtual reality simulation be used for advanced bariatric surgical training?

Virtual reality (VR) and head mount displays (HMDs) have been advanced for multimedia and information technologies but have scarcely been used in surgical training. Motion sickness and individual psychological changes have been associated with VR. The goal was to observe first experiences and performance scores using a new combined highly immersive virtual reality (IVR) laparoscopy setup. During the study, 10 members of the surgical department performed three tasks (fine dissection, peg transfer, and cholecystectomy) on a VR simulator. We then combined a VR HMD with the VR laparoscopic simulator and displayed the simulation on a 360° video of a laparoscopic operation to create an IVR laparoscopic simulation. The tasks were then repeated. Validated questionnaires on immersion and motion sickness were used for the study. Participants' times for fine dissection were significantly longer during the IVR session (regular: 86.51s [62.57s; 119.62 s] vs. IVR: 112.35s [82.08s; 179.40 s]; p = 0.022). The cholecystectomy task had higher error rates during IVR. Motion sickness did not occur at any time for any participant. Participants experienced a high level of exhilaration, rarely thought about others in the room, and had a high impression of presence in the generated IVR world. This is the first clinical and technical feasibility study using the full IVR laparoscopy setup combined with the latest laparoscopic simulator in a 360° surrounding. Participants were exhilarated by the high level of immersion. The setup enables a completely new generation of surgical training.