Award Candidate Poster Presentation


Virtual reality immersive simulation in pediatrics

Tuesday, May 15
09:45 - 10:45
Location: Neptune 1&2

Abstract : *Background*

The increasing commercial availability of virtual reality headsets allows delivery of completely immersive, interactive simulation experiences. These systems can increase learner throughput, simulation accessibility and reduce cost of delivering pediatric simulation.

Here we describe an approach to the design of fully immersive virtual reality pediatric simulation and provide an opportunity for further discussion to shape the future of immersive VR simulation.

*Educational goal*

Using the Unity games platform we designed a virtual reality scenario focused around sepsis in the emergency dept. The educational focus was on decision making under pressure, using deliberate practice to impact technical and non-technical skills.

*Prototype and user journey*

In our system the user puts on an Oculus Rift headset and can interact with everything in the virtual ED, taking a history, investigating and treating against the clock. As well as realistic characters with full 3D animations, vitals adapt dynamically to fluids and medications and you can manage your team in allocating them tasks.

At the end of each scenario users enters a period of guided reflection and structured feedback comparing their actions to best practice - identifying strengths and areas for improvement. The system is gamified with the generation of a score to encourage scenario repetition and reinforcement of learning.

*Unanswered questions and discussion points*

Initial independent research using our system demonstrated significant performance improvement between scenarios and highly positive user feedback, both in terms of usability and perceived improves in patient safety and care. However, as this is a fledgling industry with little research on immersive virtual reality in pediatrics, many questions remain.

We would explore these in five themes followed by a summary.

1. Target audience
What areas of pediatric simulation would be most suited to VR simulation? Why?
1.1 Users
- Medical students, pediatricians, nurses? Public-facing?
1.2 Setting
- ED, ward, NICU, community?
1.3 Scenario choice
- Common (high impact) to rare (so infrequently trained). Discuss the value of each of these approaches along a spectrum

2. Presence (why VR?)
What is psychological presence and what contributes to presence and immersion in VR?
2.1 Hardware
- Immersive: High-end HMD vs phone/tablet vs screen-based
- Value of immersive (‘true VR’) vs screen-based simulation – discussion of evidence of learning transfer
2.2 Interaction
- There are many ways to interact in a virtual environment. Discussion would be structured in terms of usability, cost and accessibility.

3. Fidelity
What is fidelity in simulation? How does this apply to virtual reality. What is the value of different types of fidelity:
3.1 Graphical and animation fidelity
4.1 Emotional and situational fidelity

4. Gamification
Ability to encourage engagement and repetition and therefore reinforce learning vs infantilization and a simulation’s inherent utility should encourage users to repeat
4.1 Type of gamification and relative value:
- Score
- Peer comparison

5. Barriers to integration
5.1 Cost
- How to keep costs low? Value of ROI and best ways to demonstrate ROI in virtual simulation
5.2 Novel technology
- How to increase tech acceptance
- Relative lack of VR research and what research is needed in VR pediatric simulation

6. Summary and future
Drawing together of discussion, touching on future directions and other forms of immersive technology.

Jack Pottle, BMBCh, MRCP

Clinical lead
Oxford Medical Simulation

Dr Jack Pottle, BSc, BMBCh, MRCP
Oxford Medical Simulation

Jack is a physician, simulation instructor, virtual reality simulation designer and medical director of Oxford Medical Simulation - a medical training company expanding access to simulation through immersive, interactive virtual reality scenarios.

He intially trained in psychology, then worked in nursing for two years before entering medicine. He has now been a hospital physician in the UK for seven years, and has been involved in medical education for most of those - founding the non-profit medical education company Oxford Medical Education before setting up Oxford Medical Simulation, where he is currently medical director.


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Jo Hegarty, MD, PhD

Starship Child Health, Auckland, New Zealand

Dr Jo Hegarty MB BCh BAO, MRCPCH, FRACP, PhD is a Neonatologist at Starship NICU in Auckland, New Zealand and Co-Chair of the IPSS Education Committee. She is a member of the Starship Hospital Simulation faculty and leads the simulation programme in Starship NICU. Recent initiatives include development of a hospital wide ‘hot debriefing’ project and an interdisciplinary ‘difficult conversations workshop’. Her key simulation interests include education, communication and patient safety.


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