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  • Ankita Mishra

Application of virtual reality technology in clinical medicine and medical education

"Feeding our senses a stimulus that is so similar to what we see in reality, that we interpret it as reality. In all other mediums, your consciousness is interpreting a medium to go to my site. But in VR there is no gap. You aren’t internalizing it. You are internal in it. It’s a quantum leap in mediums because the medium is disappearing." - Chris Milk, Founder of VRSE

Image by Vinicius "amnx" Amano from Unspalsh



What is virtual reality?

In simple terms, it can be described as a technology that allows users to experience a three-dimensional simulated environment. Immersion, presence, and interaction are 3 essential characteristics of Virtual Reality (VR).

It uses a series of different technologies, including a head-mounted display (HMD) with head-tracking systems, headphones for sound/music, and noise-canceling headphones along with a navigation system.

Initially, it was used only for the entertainment and gaming industry but now it is also widely being used in the medical field for treating patients, robotic surgery, medical education, and also for medical marketing.

Virtual Reality and Clinical Medicine

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Virtual Reality for Pain Management

Pain is the most common presenting symptom in patients. And Virtual Reality offers a no-drug treatment for pain management. Any pain because of an injury, operation, or burn wound needs both physical and psychological treatment together. While Pain killer medications and opioids are used widely for this which also have a lot of side effects, researchers have concluded that VR technology provided pain relief or analgesia with very less side effects and very little impact on the physical hospital environment.

How does it work?

Basically, it provides a distraction to the brain. The patient has to put on the HMD and with a high-resolution video, headphones, and game software it provides an immersive experience. The outside world changes and the patient can move around and do things just like in the real world. And the brain starts to believe what it sees and enhances distraction by blocking the pain signals. The patient focus shifts from pain.

Virtual Reality for Psychological Therapy and Anxiety

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VR provides a new way of treating common psychological disorders like phobia and anxiety.

To treat phobias, the patients need exposure therapy that is confronting the things that they fear. For example, In Acrophobia or fear of heights, with VR the patient can experience fear-inducing situations like climbing a stiff hill in a realistic virtual environment. This can benefit both the patient and the therapist. Similarly, it can also be used for other diseases like Autism, mood disorders, and social anxiety by providing an improvised behavioral therapy with VR.

Not just this, but VR can also help reduce the anxiety produced during minor invasive procedures done in hospitals. Instead of being stuck with a view of the hospital, patients can put on a headset and find themselves on a beach. Children can be engaged in VR games while giving an injection and they wouldn't even notice.

Virtual Reality in Surgery

Virtual Reality in surgery is already quite popular. It allows the surgeons to decide the safest surgical approach and plan alternate approaches to reduce complications during and after the operation. The surgeon can explore and learn about the patient's individual anatomy beforehand which reduces the duration of surgery.

The patient can also be made to see the disease site using VR. It helps them to understand better about the surgical procedure and reduces their apprehension and anxiety.

Virtual Reality for Physical Therapy, Rehabilitation, and Fitness

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Following surgery or stroke, patients often need physiotherapy for early rehabilitation. They are required to do certain exercises to increase the mobility of their limbs. VR can divert the patient's mind off the pain increasing their exercise efficiency and also helping the expert to choose software that targets individual problems to help guide the patient. This not only motivates the patient but also makes them feel confident when it comes to actually move around in their real-life setting. These days, the fitness industry is also using VR to improve the workout experience by combining cardio routines with virtual reality.



Virtual Reality in Medical Education and Surgical Training



VR can help overcome the shortcomings of traditional medical training methods. In such methods, the only way of learning medical methods and acquiring surgical skills for junior residents and doctors was via observing the senior doctors and surgeons. They don't get to have any direct hands-on experience during the initial training period. And with recent advancements in surgery, only observation is not enough for learning necessary technical skills. This is the reason behind the long learning curve for surgeons.

VR provides simulations that are realistic and interactive. It gives 3D graphics of anatomical structures and allows trainee doctors to interact with them. This changes the whole non-holistic way of rote learning and brings into the light an experimental hands-on learning experience. Furthermore, in traditional teaching methods, it requires constant supervision of seniors and patients' consent which can be totally omitted with VR.

Using VR for laparoscopic surgical training is gaining popularity swiftly. It is not possible for trainees to practice basic surgical and laparoscopic skills directly on the patient since this would expose patients to the potential risk of injury. With VR simulations and haptic experiences, a controlled risk-free virtual environment can be provided outside the operation room with usability feedback mimicking the real experience and flattening the learning curve. It helps the surgeons to acquire the required motor and decision-making skills easily. There are several subjects using VR technology assisting teaching at present, for example, radiotherapy, emergency medicine, surgery, and nursing.

VR and AI can also be used to assess the competence of the trainees. Automated scoring with numerous objective metrics can be provided which serves as a promising alternative to the laborious and subjective ratings usually performed by experts during live or videotaped procedures. AI system can record the number and analyze the behaviors of students after learning and provide additional corresponding training and help the students to review their weaknesses.

The benefits of virtual reality can be summarized as:

  • Hands-on surgical experience during the training period

  • More trainees can be trained at once

  • A better understanding of complex 3D body structures and handling of instruments

  • Changes rote-learning to experimental learning

  • Provides a risk-free surgical environment

  • Assessing Competence and improving surgical skills with AI feedback

  • Reviewing of weaknesses

Future of VR in healthcare

VR software is still in the developmental phase. Most software has quality problems, such as definition and contrast. Adaptations and improvements of in-depth perception to make virtual reality more similar to reality are still needed. Another limitation is the cost of establishing the VR systems. But with the rise in popularity, it is anticipated that VR technology will get better with newer technologies and faster internet services. With new developments, Virtual Reality can be given new directions in the field of medicine.


 

References

  1. Li L, Yu F, Shi D, Shi J, Tian Z, Yang J, Wang X, Jiang Q. Application of virtual reality technology in clinical medicine. Am J Transl Res. 2017 Sep 15;9(9):3867-3880. PMID: 28979666; PMCID: PMC5622235.

  2. Wenjing Yu, Liang Wen, Li-Ang Zhao, Xin Liu, Bo Wang and Huazhe Yang. The applications of virtual reality technology in medical education: a review and mini-research Journal of Physics: Conference Series, Volume 1176, Issue 2 [Link]

  3. Virtual Reality in Medicine, WebMD [Link]


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