Development of an interactive virtual reality hepatobiliary system for preclinical medical education

Abstract

Background: Virtual reality (VR) has been shown to improve retention and student satisfaction in the realm of medical education. Mastery of gastrointestinal pathophysiology often poses a challenge to preclinical medical students due to the complex anatomy of the hepatobiliary system. This difficulty may lead to decreased interest in the field of hepatobiliary surgery during clerkships and residency selection. In order to change this paradigm, we decided to utilize VR to “gamify” the hepatobiliary portion of the preclinical gastroenterology curriculum. This study aimed to determine the feasibility of development of an interactive, 3-dimensional (3D), VR environment involving hepatobiliary anatomy, physiology, and pathophysiology. Methods: 3D anatomical models were edited using Blender, an open source graphics software, and Oculus Medium, a VR sculpting platform. Pathophysiologic processes were created utilizing the Unity gaming engine, which employed the C# coding language. Physiologic processes include bile synthesis and flow, gallbladder wall contraction, and Sphincter of Oddi constriction. Pathophysiologic processes include obstruction by gallstones and tumors at various portions of the biliary tree. As seen in the video, students are not only able to view the normal and pathologic disease states, but are also able to create obstructions in the anatomy, allowing them to observe the Results of their changes in real time. Additionally, virtual office visits allow students to apply their diagnostic and decision making capacities in an interactive clinical setting. Results: Development and beta testing of our interactive VR hepatobiliary curriculum has proven the feasibility of this project. Various surgeons, clinicians, and medical education professionals have advised and oversaw the specifics of the curriculum and its goals. This model is currently being implemented into our preclinical curriculum for use by medical students and will be evaluated for construct validity against traditional teaching methods, such as didactic lectures, textbooks, and videos. Conclusion: We propose that this novel, interactive learning environment will significantly improve student engagement and retention in hepatobiliary anatomy, physiology, and pathophysiology. The combination of enthusiasm and competence in this area of preclinical medical education may lead students to consider hepatobiliary surgery as a future career choice.