Virtual Reality

How a university uses virtual reality to train its medical students in cardiac arrest

Once per term, 60 medical students from imperial college london gather in a large ward at Charing Cross Hospital to witness the scene of cardiac arrest. There’s blood – lots of it – and a bedside nurse is performing chest compressions.

One doctor furiously takes notes, while another stands anxiously in front of the heart rate monitor.

“What should we do next?” they ask medical students.

Except that there is no victim. The torso receiving the PCR is rubber, and the concerned doctors are all actors. Unusually, there isn’t a drop of blood on the floor, despite the numerous strips of red-soaked gauze that are shuffled in and out of sight.

This is because the 60 medical students each wear a virtual reality (VR) headsetwaving their hands around the room and stumbling slightly – like a swarm of zombie doctors.

Students are quizzed on how they would apply their medical training to a real emergency with questions that arise during training (Picture: Imperial College London)

“It’s a bit like a silent disco,” says Dr Risheka Walls, head of digital development at Imperial’s School of Medicine. “Except with a few yelps here and there.”

Imperial is the first medical school in the world to use virtual reality to train future doctors. Although the university is often ranked in the top ten in the UK for medicine, professors sparked an upheaval several years ago after noticing that many of their graduate students felt unprepared for the practice.

More than Education

“You just can’t guarantee they’ll see these kinds of emergencies in real life – you have to be in the right place at the right time,” says Professor Amir Sam, director of the Imperial School of Medicine. .

“We welcome around 700 medical students each year. But you wouldn’t be able to send 700 students into 700 cardiac arrests – you would have to wake up every day praying for something terrible to happen.

With funding from Health Education England, an independent government body, Imperial recruited Dr Walls in 2019 to develop an in-house VR alternative. Dr Walls says she was inspired by the frequent simulations used on the airline pilot trainingwhich led her to wonder why virtual reality is largely overlooked in medicine.

Three years into the project, Imperial’s new digital media lab has launched three virtual reality training videos and has several more in the works, including an epileptic seizure simulation. And now, for the first time, the university is integrating technology into its assessments.

Trainee doctors are told what they would do next if a patient suffered a cardiac arrest (Picture: Imperial College London)

Virtual reality allows teachers to “gamify” tests and lessons, Prof Sam says, providing a more valuable experience for students than many real-life emergencies.

“You can pause in the middle of a resuscitation using virtual reality. You can’t do that in real life,” he says. take nothing.”

The university has also started simulating non-emergency situations that are difficult to learn from a textbook, such as dealing with an angry family.

Anyone who has ever watched 24 hours in A&Eor found themselves in the emergency room on a busy day at the hospital, will know that half of a doctor’s job is to keep people calm.

So how do you learn this without being thrown into a room full of frustrated patients? You can’t – but it helps if these patients are actors.

In Imperial’s VR simulation of an angry family, students are ushered into a hospital room full of people with their arms crossed. A woman shakes your fist explaining that her elderly husband with dementia is not swallowing properly, which means he can’t eat or take his usual pills. His son steps in to tell you that the family has been left unattended for several hours as his father’s health deteriorates. It feels like we’ve been summoned to the principal’s office for a proper reprimand.

“This kind of anger-provoking situation is very common, especially on weekends when there is often a breakdown in communications,” says Dr. Walls.

“It’s very rare for someone to be negligent, it’s more because the situation is emotionally charged. And more often than not, the doctor who enters the room has inherited the notes of the person on the team who preceded him.

But, as Imperial students quickly learn, making excuses won’t help defuse a tense situation. As in other university simulations, the angry family scenario is punctuated by a series of questions that students have 10 seconds to answer. The remotes transform their hands into a pair of blue plastic gloves to select an answer from a selection that appears inside the hospital room. The worse their choice, the angrier the family.

The simulation is 360°, meaning students can walk around the room, the sounds of voices twisting as they turn their heads away. “The whole point of virtual reality is that it’s realistic,” says Professor Sam. to a real situation.”

But students want to get their hands dirty more and more, he explains. Feedback forms have consistently revealed that medical trainees at Imperial want to use their virtual gloves to perform blood tests and dissections – things the university is currently exploring.

This means virtual reality could soon replace anatomy – the traditional grizzly method of dissecting a real human body. A virtual alternative could not only be a silver lining for the faint-hearted, but could also significantly reduce costs for universities and enable them to attract more students.

In the UK, it is illegal to buy or sell human remains, which means medical schools must rely entirely on the goodwill of people to donate their bodies to science. But corpses can still cost universities between £2,000 and £3,000 to transport, preserve and store each body.

“The main thing that virtual reality gives us is scalability,” says Dr. Walls. Before Imperial started developing the technology, students would go off on internships one by one and report on the sporadic emergencies they witnessed during their shifts. Now the university can ensure that the whole class has suffered a cardiac arrest in one week.

According to Professor Sam, virtual reality could provide a solution to the UK’s deep-rooted struggle to train enough doctors, while making those doctors more confident in the process.

It emerged last week that NHS England spends £3billion a year on agency doctors to fill staffing gapswith a hospital trust paying over £5,200 for a doctor for a single shift.

“If you want to increase the number of medical students you can take, which we desperately need to do, then this is the way,” says Professor Sam. “Virtual reality is really the future.”

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