Virtual Reality Medical Training for Emergency Training

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Sunnybrook Health Sciences Centre

Disqualifiers: Unwillingness, Simulator experience, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

40 Participants Needed

Trial Summary

What is the purpose of this trial?

The current pandemic has revealed in-person simulation training and evaluation is vulnerable to disruption, and alternatives are needed which allow remote evaluation. The recently developed Microsoft Hololens headset device allows interactable holograms to be inserted into a user's workspace (mixed reality) - permitting the augmentation of existing clinical and training spaces with holographic (i.e. virtual) patients via the prototype HoloSIM software. This study is the first known research initiative aiming to demonstrate the feasibility and effectiveness of mixed reality for acute medicine training and assessment at a distance. Space, time, personnel, pandemic, and cost constraints limit opportunities for high-fidelity simulation exercises for post-graduate trainees at Sunnybrook. By developing and demonstrating the effectiveness of this new training modality, increased simulation exercises will lead to a higher quality education experience, better functioning teams, and better patient outcomes.

Do I need to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment HoloSIM Software via Hololens 2 for emergency training?

Research shows that using mixed reality headsets like the Hololens can make training more engaging, improve task performance time, and boost confidence in providing emergency care. Additionally, virtual and augmented reality have been found to enhance disaster medicine training, suggesting they can be effective tools for emergency skills education. ^{1 2 3 4 5}

Is virtual reality medical training safe for humans?

Research on virtual reality medical training, including the use of HoloLens, suggests it is generally safe, with low perceived workload and satisfactory performance. However, some users may experience postural discomfort and visual fatigue during extended use. ^{2 5 6 7 8}

How does the Virtual Reality Medical Training using HoloSIM Software via Hololens 2 differ from other emergency training treatments?

This treatment is unique because it uses virtual reality and augmented reality technology to create an immersive and interactive training environment, allowing medical professionals to practice emergency scenarios with realistic simulations. Unlike traditional methods, it provides a high level of medical fidelity and experiential learning, which can enhance skills acquisition and motivation. ^{2 9 10 11 12}

Research Team

Julian Wiegelmann, Dr.

Principal Investigator

Sunnybrook Health Science Centre

Eligibility Criteria

This trial is for resident or fellow level volunteers from acute care postgraduate programs like Internal Medicine, Emergency Medicine, Anesthesiology, and Critical Care at Sunnybrook Health Sciences Centre. It's not for those who have previously used simulators to learn about anaphylaxis.

Inclusion Criteria

Resident or fellow level volunteers from acute care postgraduate training programs (Internal Medicine, Emergency Medicine, Anesthesiology, Critical Care Medicine at Sunnybrook Health Sciences Centre)

Exclusion Criteria

Previous experience with simulator based teaching on anaphylaxis

I do not want to participate in the study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Development and Usability Testing

Iteratively develop and usability test the HoloSIM software with acute care medicine specialties

8-12 weeks

Training and Assessment

Determine if the HoloSIM platform is non-inferior to the current teaching and assessment standard of high-fidelity mannequin-based crisis simulation

4-6 weeks

Follow-up

Participants are monitored for effectiveness and usability of the training solution

4 weeks

Treatment Details

Interventions

• HoloSIM Software via Hololens 2
• Training by Mannequin Based Simulation

Trial Overview The study tests the HoloSIM software on Microsoft Hololens 2 against traditional mannequin-based simulation training. The goal is to see if this mixed reality technology can improve medical training during situations where in-person sessions are disrupted.

Participant Groups

Group I: Group A: HoloSIM (intervention) Experimental Treatment 1 Intervention

Training by Mixed Reality Simulation

Group II: Group B: Mannequin (control) Active Control 1 Intervention

Training by Mannequin Based Simulation

Who Is Running the Clinical Trial?

Sunnybrook Health Sciences Centre

Lead Sponsor

Trials

693

Recruited

1,569,000+

Findings from Research

Training caregivers using a mixed reality head-mounted display (HMD) significantly enhances engagement and confidence in performing emergency medical tasks compared to traditional training methods.

In a study with 20 participants, those trained with the HMD completed tasks more quickly and retained skills better over a three-week period, suggesting that this technology could improve critical care training outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can Mixed-Reality Improve the Training of Medical Procedures? Azimi, E., Winkler, A., Tucker, E., et al.[2020]

The HoloLens has shown promise in supporting physicians during medical procedures that typically lack image guidance, but its accuracy and reliability are not yet sufficient to fully replace traditional guidance systems.

There is a significant focus on using the HoloLens for medical education, particularly in AR-enhanced simulators for medical students, although the validation of these applications is hindered by a lack of standardized evaluation protocols.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The HoloLens in medicine: A systematic review and taxonomy. Gsaxner, C., Li, J., Pepe, A., et al.[2023]

A systematic review of 32 articles found that virtual reality (VR) and augmented reality (AR) training significantly improves healthcare providers' confidence and satisfaction in disaster medicine (DM) education.

The review indicates that VR and AR can enhance traditional disaster training methods, but further research is needed to standardize their use and assess their impact on patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Reality Training in Disaster Medicine: A Systematic Review of the Literature. Brown, N., Margus, C., Hart, A., et al.[2023]

A systematic review of 34 studies on virtual reality (VR) in emergency skills training suggests that VR can enhance knowledge retention and skill performance, making it a promising tool for medical education.

Despite the educational benefits observed, there is currently insufficient evidence to show that VR training leads to improved patient outcomes or cost-effectiveness in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality in simulation-based emergency skills training: A systematic review with a narrative synthesis. Abbas, JR., Chu, MMH., Jeyarajah, C., et al.[2023]

Mixed Reality (MR) devices can effectively teach surgical skills by providing 3D holographic representations, which allow for better visualization and interactivity compared to traditional learning methods like videos and apprenticeships.

In evaluations, participants using MR models for learning complex hand motions scored similarly to those trained through traditional methods, indicating that MR can be a viable alternative for skill acquisition in surgical training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Building Your Future Holographic Mentor: Can We Use Mixed Reality Holograms for Visual Spatial Motor Skills Acquisition in Surgical Education? Leung, R., Shi, G.[2023]

The use of the Microsoft HoloLens 2 extended reality headset for international grand rounds significantly enhanced the bedside learning experience for 325 participants, with 99% valuing the ability to visualize clinical findings and results in real-time.

Participants overwhelmingly preferred the XR format over traditional grand rounds, with 96% recognizing its importance for modern medical education, indicating that XR technology could be a valuable tool for surgical teaching and telerounding.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

International Mixed Reality Immersive Experience: Approach via Surgical Grand Rounds. Mahajan, AP., Inniss, DA., Benedict, MD., et al.[2023]

A mixed-reality training system using HoloLens for hip arthroplasty was developed, combining virtual and physical components to create an immersive surgical training environment, which showed promising accuracy in target positioning.

User feedback indicated low perceived workload and satisfactory performance during 40-minute simulation sessions, although some postural discomfort and visual fatigue were noted, highlighting the need for optimal design to enhance user comfort.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How to Build a Patient-Specific Hybrid Simulator for Orthopaedic Open Surgery: Benefits and Limits of Mixed-Reality Using the Microsoft HoloLens. Condino, S., Turini, G., Parchi, PD., et al.[2019]

The slow adoption of virtual simulation technologies in surgical training is largely due to a focus on advanced technology rather than understanding the needs of users, highlighting the importance of human factors in design.

Three case studies show that achieving psychological fidelity—where simulations effectively replicate the skills and behaviors needed in real-world scenarios—can be more important than striving for complete realism in simulations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The (human) science of medical virtual learning environments. Stone, RJ.[2021]

A novel virtual reality (VR) training program for public health emergency responders was positively received by 61 participants, with 98% rating their skills above neutral, indicating high perceived effectiveness of the training.

Participants found the VR training immersive and relevant to real-life scenarios, suggesting it could be a valuable tool for enhancing the skills of emergency responders, although further research is needed to assess its impact on those with less experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training the public health emergency response workforce: a mixed-methods approach to evaluating the virtual reality modality. Bugli, D., Dick, L., Wingate, KC., et al.[2023]

The rapid evolution of medical knowledge and procedures necessitates ongoing education for healthcare professionals, with Virtual Reality (VR) emerging as a powerful tool to enhance training and skills acquisition.

VR training offers an interactive and engaging learning environment that supports experiential learning, which can improve motivation and effectiveness in acquiring complex medical skills, ranging from surgical techniques to mental health treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality training for health-care professionals. Mantovani, F., Castelnuovo, G., Gaggioli, A., et al.[2022]

The integration of gaming technologies with medical training aims to create realistic simulations for mass casualty incidents, allowing medical professionals to practice in scenarios that reflect complex, real-life situations.

This program, developed in collaboration with Forterra Systems and Stanford University, focuses on enhancing the physiological realism of computer-generated avatars, which will help improve the training and preparedness of healthcare teams in emergency situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Avatars alive! The integration of physiology models and computer generated avatars in a multiplayer online simulation. Kusumoto, L., Heinrichs, WL., Dev, P., et al.[2008]

Virtual reality (VR) technology has been effectively used in training medical professionals, with 48% of the reviewed studies focusing on laparoscopic surgery, demonstrating its specific application in surgical education.

The majority of studies (74%) reported improved learning outcomes and 87% noted higher accuracy in medical practice among those trained with VR, highlighting its efficacy in enhancing medical training and performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Applications of Virtual Reality Technology in Medical Groups Teaching. Samadbeik, M., Yaaghobi, D., Bastani, P., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Can Mixed-Reality Improve the Training of Medical Procedures? [2020]

2. Netherlands pubmed.ncbi.nlm.nih.gov

The HoloLens in medicine: A systematic review and taxonomy. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Virtual Reality Training in Disaster Medicine: A Systematic Review of the Literature. [2023]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Virtual reality in simulation-based emergency skills training: A systematic review with a narrative synthesis. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Building Your Future Holographic Mentor: Can We Use Mixed Reality Holograms for Visual Spatial Motor Skills Acquisition in Surgical Education? [2023]

6. United States pubmed.ncbi.nlm.nih.gov

International Mixed Reality Immersive Experience: Approach via Surgical Grand Rounds. [2023]

7. England pubmed.ncbi.nlm.nih.gov

How to Build a Patient-Specific Hybrid Simulator for Orthopaedic Open Surgery: Benefits and Limits of Mixed-Reality Using the Microsoft HoloLens. [2019]

8. England pubmed.ncbi.nlm.nih.gov

The (human) science of medical virtual learning environments. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Training the public health emergency response workforce: a mixed-methods approach to evaluating the virtual reality modality. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Virtual reality training for health-care professionals. [2022]

11. Netherlands pubmed.ncbi.nlm.nih.gov

Avatars alive! The integration of physiology models and computer generated avatars in a multiplayer online simulation. [2008]

12. Iran pubmed.ncbi.nlm.nih.gov

The Applications of Virtual Reality Technology in Medical Groups Teaching. [2022]