Virtual patients training doctors


The year was 1996 and Associate Professor Martin Brown, a junior doctor in the heart of regional WA, was tasked with a daunting procedure he had never faced before. His heartbeat pounded like a primal drum, sending waves of sensation through his entire body. His hands were slick with sweat, a constant reminder of the stakes at hand. The weight of the unknown bore down on him as he scrambled his thoughts, preparing for a lifesaving procedure that would test his skills and courage.

“I remember being very, very out of my depth and very scared. I was in a rural community in Kalgoorlie, and it was only myself and a nurse in the emergency department. So, whoever came through that door, it was you or no one,” he says.

That day child who’d been brought in had stopped breathing, their life hanging in the balance, and he was the only hope for salvation. In a race against time, Professor Brown knew he had to intubate the child quickly, and with the clock ticking, every second counted. He knew there was no time to waste, no room for error.

Describing the moment, he says: “I knew I was going to have to put a tube down their throat and intubate them and put them on life support ventilator. I’d never done it before; I’d never seen it. I rang an anesthetist in Perth, and basically asked them what I needed to do.”

Working fast, Professor Brown swiftly transcribed the anesthetist’s counsel on a scrap of paper and stuck it to the wall with tape.

“I thought at that time, there must be a way of teaching these kinds of procedures so that people like me would have more confidence and familiarity with the procedure, should it ever be required. It’s taken 25 years to get the technology to do it.”

Over the years, experts have developed new cutting-edge technology to help prepare health workers with experience in life and death situations. The powerful Virtual Reality tool will take junior doctors to another world, simulating real-life medical procedures, without the risk of fatal consequences.

The VR training is like a flight simulator for healthcare and, at first glance, it looks like a video game. But the technology allows users to perform virtual medical procedures like cannulation, chest drain insertion, and right heart catheterisation from anywhere.

“Any procedure in medicine that you can think of can potentially be done in the VR world. The aim of developing the technology was so we could teach people in rural communities from the comfort of our own offices, and there is no requirement for either us or the trainees to travel,” he says.

Brown says even the most inexperienced doctors can now perform surgeries like heart catheterisation in a fraction of the time: “After four attempts at using the VR program, we now can reduce that procedure time to 15 minutes.”

But does it really work?

Research by the University of Wollongong found students who underwent VR training made 40 per cent fewer mistakes than those who didn’t.

Research Fellow from the University of Wollongong Dr Shiva Pedrum says medical students can practice different scenarios and procedures, and they can afford to make mistakes without putting a patient at risk.

“Healthcare is a complex and rapidly evolving field and medical students need to be prepared to work in a wide range of environments and situations, and they need the practical experience to develop their soft skills, clinical skills, and judgement. But then there are limitations to how much hands-on training can be provided in physical real-world settings, especially when it comes to delicate or high-risk procedures,” she says.

Dr Shiva says another issue is the aftermath of the COVID-19 pandemic, which has put a strain on the healthcare system, and has resulted in fewer experienced medics available to mentor medical students.

“Medical schools need to start thinking about using a more comprehensive and effective training methods that can complement the existing training and education solutions in order to prepare students for the demands of the future,” she says.

“Virtual reality has great potential to offer a promising solution by providing a highly immersive, and realistic environment where medical students can practice different scenarios and procedures, which is very important.”

She says the program is also beneficial for experienced doctors who are already practicing at hospitals or clinics. Doctors can use the virtual reality training as a refresher training platform for procedures they don’t usually perform, enabling them to be ready when needed.

Vantari VR, a virtual reality platform, reached out to Dr Shiva and requested her help to validate their platform, as no validation had been done previously to confirm its functionality or whether students were learning from the VR training.

“We looked at the learning process, experience, and outcome, and we measured a student’s performance based on completion, including success rate, error rate, and following the safety and hygiene procedures, feeling confident and self-care when they were performing the task, and the number of times that they raised their hand and asked for help and support from the lecture in the room,” she says.

Following the research trial, Dr Pedrum provided several recommendations, one of which is the incorporation of a multiplayer mode to help students practice their soft skills. She says this would be highly beneficial as it will allow patients to communicate their concerns and allow students to find the best way for managing patients who may be distressed and uncooperative.

So, the next time you see a doctor sporting a VR headset, know that they’re not just playing around. They could be training to save lives.