Evolving Virtual Reality Simulation in Neurosurgery

The use of human cadavers and virtual reality simulation in endovascular training: A questionnaire of patient and professional opinion

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

Researchers (Lampert, et al., 2013; Zeichner, 2010; Grossman, et al., 2009a) recommend the use of rehearsals in teacher education classrooms to help preservice teachers (PST) bridge theory to practice. Rehearsals enable PSTs to practice teacher moves, such as asking purposeful questioning and engaging students in mathematical discourse during an episode of teaching a lesson (NCTM, 2014). During a rehearsal, the PST’s teacher education instructor provides coaching that helps the PST make flexible adjustments to their instruction. Using a phenomenological approach, this research investigates the use of Virtual Reality (VR) simulations to support PSTs learning to teach mathematics through rehearsals. The presentation will include samples of PSTs’ mathematics teaching episodes with attention to successes, challenges, and lessons learned from the use of VR simulations in teacher education classrooms.

BackgroundEffective interprofessional teamwork is vital for ensuring high-quality patient care, especially in emergency medicine. However, interprofessional education often fails to facilitate meaningful interaction among health care disciplines. It is therefore imperative to afford early opportunities for cultivating interprofessional teamwork skills. While in-person simulation-based training has been shown to improve performance, this is resource-intensive, especially if it involves multiple professions. Virtual reality (VR)–based training is an innovative instructional approach that demands fewer resources and offers the flexibility of location-independent learning.ObjectiveThis study aimed to develop and evaluate the acceptance, learning outcome, and feasibility of an interprofessional team (INTEAM) training course that included a VR simulation of a neurological emergency case.MethodsThis 1-group study used a pre- and posttest design to evaluate the 2-hour INTEAM training course for nursing and medical students. The course included an e-learning part, VR simulation, and debriefing. The main learning objectives were derived from the entrustable professional activity 6, namely to handle a common problem in emergency medicine (headache due to subarachnoid hemorrhage and epileptic seizure) that requires interprofessional collaboration, including a structured handover. We used validated and self-constructed questionnaires, pre- and posttests, and open questions to assess the acceptance, learning outcome, and feasibility of the course.ResultsThe data of 42 students (21 nursing and 21 medical students) were analyzed and showed good usability in the System Usability Scale (median 72.5, IQR 65‐80). The perception of usefulness (median 6, IQR 5.8‐6.9) and ease of use (median 5.9, IQR 5.1‐6.3) was good among all students. There was a significant increase in the handover performance from pre- (median 8, IQR 6‐9) to posttraining (median 8, IQR 7‐9; z=−2.01; P=.045; r=0.33) and of the confidence in caring for patients with seizures (median 3, IQR 2‐3 and median 3.5, IQR 3‐4, respectively; z=−3.8; P<.001; r=0.60). In 67% (14/21) of the simulations, technical issues occurred, but all simulations could be carried out completely.ConclusionsThe new INTEAM training course was well received by nursing and medical students. The handover skills and confidence in caring for patients with seizures were improved after the course. Despite technical challenges with the VR simulations, none required termination, and this demonstrates that our approach is feasible. These promising results encourage the use of VR simulations for team training in the education of nursing and medical students.

The rapid development of virtual and augmented reality technologies is currently taking place in almost all spheres of activity. Elements of virtual and augmented reality are used in such areas as education, medicine, transport, gaming, tourism and others. The active spread of these technologies causes the emergence of special competencies in the IT labor market and, as a result, the formation of new professions.Many Russian universities are training students in IT training areas. Specialization in the development of computer games and virtual reality applications has begun recently. The provision of practical classes is accompanied by specific tasks, which gives students the opportunity to improve the use of software and technical devices.The relevance of the research is determined by the current demand for the use of the latest technologies by IT developers in the field of creating computer games. Today, technologies that provide a player’s immersion in virtual reality are becoming more and more popular. One of these technologies is a suit with wearable sensors that track a person’s position in space in real time. However, there are quite a few real described projects in the literature and on the Internet. This study examines the process of developing a task for creating a game application using virtual reality technology: a suit with wearable sensors for teaching students.Materials and methods of research. Timely identification of the needs of the IT market in personnel training allows educational organizations to form new training programs of different levels of training. This approach makes it possible to target the educational and methodological materials being developed to use the latest achievements in the development of the field under study.Using a systematic approach, the study characterizes virtual reality suits and sensors for monitoring the position in the user’s space. Thus, the goal of the task was to ensure the immersiveness and convenience of interaction between the player and the game environment.Based on materials on software, position sensors in space, the approach of pedagogical design was applied and the procedure was formed for a practical task, reflecting the relevant competencies.Results. The study was conducted on the basis in the framework of laboratory and practical work of students, as well as at a real enterprise. Training in the new profile of the direction of training “Applied informatics” is fully equipped with all the latest technologies in this field. As a result of the work, the content of the practical task was developed.Real development of virtual and augmented reality applications is conducted jointly with students. Almost all projects used a suit with body sensors.Conclusion. Our study examines in detail the process of developing an application using a suit with wearable sensors for further training of students. Based on the results, work can be carried out on real projects for any field. Based on the research materials, it is planned to issue a textbook for students with the profile of developing computer games and virtual / augmented reality applications.

Changes to Training Practices during a Pandemic - The Experience of the Irish National Trauma & Orthopaedic Training Scheme

Computational thinking (CT) skills are increasingly important in education to prepare students for the challenges of the digital age. Augmented Reality (AR) and Virtual Reality (VR) have been introduced as immersive technologies that have the potential to enhance CT skills through more interactive learning experiences. However, there is still a gap in understanding the effectiveness of these technologies in supporting the development of CT, particularly in different levels of education and disciplines. Although several studies have highlighted the benefits of AR and VR in education, no systematic review integrates these findings to identify advantages, challenges, and opportunities for further implementation. Therefore, this study conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by analyzing 25 empirical studies (AR=17, VR=8) obtained from the Scopus database (2008-2024). The analysis addresses four key research questions: (1) the current state of AR/VR in CT development, (2) their advantages, (3) implementation challenges, and (4) future research directions. The results show that AR is more widespread than VR at various levels of education, with dominance in higher education followed by secondary and primary schools. Computer science is the main field of application of AR and VR, while AR is also widely applied in mathematics to increase interest and problem-solving. A total of 11 studies reported significant impacts of these technologies on CT, with AR being superior in increasing student motivation and engagement, as well as aiding in problem-solving and debugging. In contrast, VR provides a more immersive learning experience by strengthening concept understanding, especially in programming and recursion. However, several obstacles in the application of AR and VR, such as hardware limitations, costs, and user skills, affect the effectiveness of these technologies in the learning environment. This study also identified potential future research, including the exploration of VR in primary and kindergarten education, the application of VR in non-computer science fields, and the efficient use of these technologies in supporting the CT process. This study provides more precise insights into the optimal ways of utilizing AR and VR in developing CT skills. It is a reference for educators, policymakers, and researchers in supporting CT learning.

Virtual reality (VR) applications are used in many areas of academic and industrial research areas including engineering, bio-medical &amp; geo-sciences, among others. These applications generally focus on creating a VR environment to enhance user experience. One of the main challenges VR application developers face is to make objects within the environment move in a natural, realistic manner. Many commercial packages and programming libraries exist to help generate complex animations, including physics engines, game engines and modeling software such as Autodesk Maya. All of these tools are very useful, but have many disadvantages when applied to VR applications, as they were not designed for VR development. To address these issues, a VR application programming interface (API) was developed to help VR developers create and visualize natural, complex animations for VR-based systems utilizing OpenSceneGraph. This API, called the Animation Engine 2.0, was built in a manner animators and developers are already familiar with by integrating control points and keyframes for controlling animations. The system is time-based to scale to any size of VR system, which enabled the ability to support different time interpolations as well to incorporate acceleration into animations to create behavioral events such as a boing, bounce, or surge. In this paper, the Animation Engine API is presented along with its integration into a VR aircraft carrier application.

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

Purpose Virtual reality (VR) can be used as an alternative mean for viewing collections at home when it is not possible to visit museums due to COVID-19. This study took the development process of VR at Taiwan's National Palace Museum (NPM) as a case to discuss the characteristics of VR developed there in different periods and how NPM transforms the contents of its collections into VR. Design/methodology/approach This study used a case study to analyze the development process of VR at NPM from 2014 to 2019 and summarized the characteristics of the development and application of VR. Findings The authors find that the history of VR application in NPM is a process from exploring the technology to gradually getting familiar with the potential of its application. Its development can be divided into the exploration and experiment stage from 2014 to 2015, the single collection interpretation stage in 2016 and the multipurpose application stage from 2017 to 2019. It is suggested that museums should adopt a long-term strategy to introduce VR, make plans carefully and pay attention to the limitations of VR application. Research limitations/implications The results of this study are suitable for art and history museums. Originality/value Many research studies on the application of VR in museums mostly focused on the benefits and technologies of adopting VR in museums as well as specific museum VR projects. There is still scant literature on the development process of museum VR from the perspective of museum organizations.

Background:Simulation is the most effective and safe way to train laparoscopic surgeons in an era of limited work hours, lack of funding, and increasing malpractice costs. However, the costs associated with the use of virtual reality simulators are significant, and although very technically sophisticated they still lack tactile feedback. We are proposing a physical reality simulator, the LTS 2000, as a reliable and effective alternative to virtual reality. This study was carried out to establish how reliably the simulator was able to differentiate between different levels of laparoscopic experience and to analyze the detection of skills improvement after simulation and clinical training.Methods:This study was carried out, between July 2002 and August 2003, in the departments of Surgery and Obstetrics and Gynecology at 2 separate institutions. We enrolled 40 individuals in the study who had experience ranging from postgraduate year-1 to full-time faculty level. Five postgraduate year-3 residents were subsequently retested after rotating on clinical services, performing advanced laparoscopic procedures to assess whether the simulator was sensitive enough to detect improvements in laparoscopic skills at the intermediate level. Six tasks were included in the test, and they were scored for speed and precision with the McGill system. Two scores were obtained: a coordination score and a suturing score combined in a total score. Other variables analyzed were handedness, specialty, number of laparoscopic procedures performed, and hours spent on the simulator.Results:Forty-five tests were performed. The number of subjects in each group based on level of experience was equally distributed. No difference occurred in scores between institutions, specialty, and right- or left-handed surgeons. A significant increase occurred in the coordination score and suturing score combined in the total score with increasing experience (P<0.05) at each level. Furthermore, the simulator was sensitive enough to detect a significant difference in all 3 scores between subjects who had practiced with the simulator before being tested (P<0.05). The scores of the 5 postgraduate year-3 participants doubled when tested, without reaching statistical significance due to the small sample size.Conclusions:Our study shows that the LTS 2000 reliably and reproducibly detects different levels of laparoscopic expertise and progression of the learning curve. LTS 2000 as a model of physical reality simulation should be considered a reliable alternative to virtual reality simulation.

BackgroundExtended reality, which encompasses virtual reality (VR), augmented reality (AR), and mixed reality (MR), is increasingly used in medical education. Studies assessing the effectiveness of these new educational modalities should measure relevant outcomes using outcome measurement tools with validity evidence.ObjectiveOur aim is to determine the choice of outcomes, measurement instruments, and the use of measurement instruments with validity evidence in randomized controlled trials (RCTs) on the effectiveness of VR, AR, and MR in medical student education.MethodsWe conducted a systematic mapping review. We searched 7 major bibliographic databases from January 1990 to April 2020, and 2 reviewers screened the citations and extracted data independently from the included studies. We report our findings in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.ResultsOf the 126 retrieved RCTs, 115 (91.3%) were on VR and 11 (8.7%) were on AR. No RCT on MR in medical student education was found. Of the 115 studies on VR, 64 (55.6%) were on VR simulators, 30 (26.1%) on screen-based VR, 9 (7.8%) on VR patient simulations, and 12 (10.4%) on VR serious games. Most studies reported only a single outcome and immediate postintervention assessment data. Skills outcome was the most common outcome reported in studies on VR simulators (97%), VR patient simulations (100%), and AR (73%). Knowledge was the most common outcome reported in studies on screen-based VR (80%) and VR serious games (58%). Less common outcomes included participants’ attitudes, satisfaction, cognitive or mental load, learning efficacy, engagement or self-efficacy beliefs, emotional state, competency developed, and patient outcomes. At least one form of validity evidence was found in approximately half of the studies on VR simulators (55%), VR patient simulations (56%), VR serious games (58%), and AR (55%) and in a quarter of the studies on screen-based VR (27%). Most studies used assessment methods that were implemented in a nondigital format, such as paper-based written exercises or in-person assessments where examiners observed performance (72%).ConclusionsRCTs on VR and AR in medical education report a restricted range of outcomes, mostly skills and knowledge. The studies largely report immediate postintervention outcome data and use assessment methods that are in a nondigital format. Future RCTs should include a broader set of outcomes, report on the validity evidence of the measurement instruments used, and explore the use of assessments that are implemented digitally.

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.

The current study explores whether different stressors in a virtual reality (VR) military training scenario cause increases in physiological stress. This would validate the use of VR simulation for stress training, as well as the physiological monitoring of trainees for educational purposes. Military cadets (n = 63) performed a patrol scenario (military convoy) in which they answered questions about their surroundings. Stressors (task difficulty, noise, lighting changes, social evaluations, electric muscle stimulation, and a simulated attack on the convoy) were stepwise added in four phases. Electrocardiogram, blood pressure, electrodermal activity, cortisol, and the cadets’ subjective threat/challenge appraisal were measured. We found that only the first phase caused a significant increase in physiological stress, as measured with heart rate, heart rate variability, and electrodermal activity. Physiological stress appeared to stay high in the second phase as well, but decreased to baseline level in the third and fourth phases, even though these phases were designed to be the most stressful. Cadets classified as threat responders based on physiological data (n = 3) scored significantly higher on subjective threat/challenge appraisal than those classified as challenge responders (n = 21). It seems that in the tested VR training scenario, the novelty of the scenario was the only effective stress stimuli, whereas the other implemented stressors did not cause a measurable physiological response. We conclude that if VR training scenarios are to be used for stress training, these should confront trainees with unpredictable but context-specific demands.

Metaverse + Realverse: In Search Of Harmony