Medicine is one of the most complex sciences. It requires extended, deep, and multi-step learning, including studying complex physiological systems, developing adaptation skills, and acquiring collaborative experience necessary in interdisciplinary medical practice. However, with the classical approach of medical education, all of this is rather difficult to organize. Many potential new directions in medical education are emerging, offering a completely different type of learning. At the same time, the fields of virtual reality (VR), augmented reality (AR), and Haptic feedback technologies are rapidly developing.
In this article, we’ll talk about XR learning as an entirely new type of medical education, the opportunities it offers students and educators today, and what the future holds.
Medical education today
Medical training is not just about the theoretical study of material but also about practical knowledge to a greater extent. In most countries, however, this is not always possible. For example, for an inexperienced surgical student, practicing on a live patient can be too risky. In addition, access to actual operating rooms is difficult to arrange, and medical education takes 7 to 10 years and is quite expensive. Meanwhile, according to a U.S. National Library of Medicine study, the current surgical training system does not provide the required qualifications, as up to 30% of general surgery residency graduates cannot work independently. Moreover, the issues of training effectiveness are so pressing that Stanford University, along with Stanford’s Lucille Packard Children’s Hospital, is conducting a study on “Assessing Medical Staff Using Augmented Reality Technology.” The final results of the survey will be completed in August 2022.
Using virtual (VR) reality in medical training
VR and AR technology allows inexperienced professionals to learn practice in parallel with theory with minimal risk to patients and students. The most outstanding value of this type of training is for complex medical fields – diagnostics and surgery.
(Image: Fundamental VR)
With VR training, the teacher can fully immerse the student in a virtual computer world. The student can study in detail the body’s structure from the inside and practice surgical skills an unlimited number of times without risk to the actual patient. VR dramatically enhances learning and promotes the memorization process.
Using augmented (AR) reality in medical education
AR technology allows the instructor to present educational material in three-dimensional volume holograms to visualize actual patient medical data. Using holograms makes it possible to visually show the structure and movement of organs and body parts of “patients” from different sides, in other sections, changing sizes, revealing layers, breaking them down into separate elements and components. With the help of augmented reality glasses, a teacher can simultaneously display different types of information: photos, videos, “patient” indicators, treatment protocols, which improves the perception and memorization of students. According to medical research, AR technology 4 times improves students’ perception and memorization of information.
Students and faculty use augmented reality glasses and experience interacting with holograms. They can also practice independent and collaborative skills, which they will then use to diagnose, plan and perform surgery. In addition, trainees can explore the structure of human body parts on a training hologram. This interactive presentation of theoretical and practical information gives students a clear understanding of their future work, improves memorization, and reduces the risk of poor perception of information.
In surgery using VR technology, students practice surgical manipulation with a virtual patient immersed in a virtual reality world. In this way, skills are practiced with minimal risk to the actual patient.
There is also a positive relationship between VR/AR in surgical training and skill acquisition in terms of increased speed of surgical skill acquisition, the surgeon’s ability to perform multiple tasks simultaneously and accurately, hand-eye coordination, and bimanual surgery. This will be useful for trainees and students in developing intuition and the ability to make good decisions.
Today, such technology allows broadcasting surgeries worldwide and enables medical students to be in the operating room and connect to the surgical process using their AR glasses.
In addition, AR visualization does not always require expensive equipment. For a more budget-friendly option, students can use their smartphones, which reduces training many times over. Augmented reality can be easily integrated even into current training programs as an additional source of information. When hovering over an illustration in a textbook, a smartphone screen can display a three-dimensional and interactive 3D model of the organ in question, healthy or with pathology.
All of this allows medical students to thoroughly study human organs, bones, and internal systems in volume and practice planning and performing surgeries, as well as for post-operative monitoring. The AR environment provides a significant experience to transfer the typical classroom learning process to the actual work. For example, into the operating room in the case of surgical training. Study results show that AR learning provides independent, collaborative, and situational understanding. It gives a sense of presence, immediacy, and immersion. The possibilities of such a learning environment can stimulate meaningful learning.
According to scientific research published in the Journal of Health Engineering: Compared to VR simulators, where simulated learning takes place in a virtual computer environment, the main advantage of AR simulators is the ability to combine computer images with real-life objects. As a result, tactile feedback is formed, which is not present in VR learning. Also, research proves that AR training increases student satisfaction with basic surgical training. Thus, it is possible to simulate surgeries (including surgery planning and post-operative monitoring) when training surgical students. Dedicated simulators are used to enhance surgeons’ skills in a variety of scenarios and to assess their technical skills objectively. This is particularly useful for trainees and students in developing intuition and the ability to make good decisions.
XR technologies incorporating VR/AR products can be used in all areas of medical education, involving world-renowned professors in the learning process. In augmented reality, the real world is enhanced by holograms that look like three-dimensional objects perceived through special glasses. The user interacts with holograms that can be placed anywhere: in the air, on a patient, or a training dummy. And the user can manipulate the hologram in various ways: enlarge, rotate, cut out, or work only with a part of it. For example, in surgery, a training surgeon wearing special goggles can suggest or correct the actions of his students regardless of the distance in real-time (even if they are thousands of kilometers away from each other).
Haptiс technology creates a sense of touch and is used for virtual world objects, including augmented reality. According to its programmed properties, haptic feedback allows one to feel “touch” a hologram. This makes it possible to consider the thickness, curvature, density, and porosity of the bone based on CT scans of the hologram. When simulating surgical manipulations using instruments, tactile skills can be practiced—for example, muscle memory by forming force of pressure, etc. Special tactile sensors or gloves can be used as tactile devices.
According to the U.S. National Library of Medicine report on the study “Improving Medical Education: Simulating Changes in Patient Anatomy Using Dynamic Haptics,” haptic devices are the most optimal method for practicing surgical skills. The rate of surgical error after completing the course, in this case, is only 0.05%.
Also, in the last two years, the case-based approach has become widespread in medical education. This method involves learning from accurate clinical case materials obtained from hospitals or after physicians have performed authentic surgical treatments on live patients. The use of case studies helps students gain a deeper understanding of the actual workflow. Students can practice the necessary surgical skills best suited to the specific surgical case. This method shapes clinical thinking most favorably and dramatically reduces the time it takes to acquire it. At the same time, training based on actual clinical cases shows higher results of students, their more significant interest in learning after the direct completion of the course. Thus, creating VR/AR clinical case libraries will be a new way of presenting material and serve as a basis for case-based learning for surgical residents.
XR (VR/AR) Market Forecast in Medical Education
Virtual and augmented reality (VR / AR) is projected to grow dynamically in medical education. The figure below forecasts the dynamics of VR and AR use in medical education from 2014-2025 (with approximately $28 million in revenue by 2025) [Strategy Analytics Report: “Total Global XR Revenue”].
Results of XR learning
Findings from studies show that students who are trained using XR technology:
– 275% more confident in the workplace after training;
– 4 times more focused than those learning online;
– Learning is 4 times faster than learning in the classroom;
– 3.75 times more likely to remember material than traditional classroom instruction.
Based on the statistics results, we can conclude that XR technology benefits treatment and medical education. Augmented Reality (XR) increases the effectiveness of medical training by a factor of 4 and improves the application of acquired skills.
XR technology appears to be a powerful tool capable of revolutionizing medicine through rational use in today’s world. Numerous studies show that XR technologies are already becoming on par with traditional teaching methods with accuracy and safety for daily clinical practice. In the future, XR will be an advanced technology that will help us achieve even better results and soon supplant classical classroom teaching altogether.