Virtual Reality Training Tool Research Articles

Virtual and augmented reality gamification of visuospatial neglect treatment: therapists’ user experience

BackgroundVisuospatial neglect (VSN) is a cognitive disorder after stroke in which patients fail to consciously process and interact with contralesional stimuli. Visual Scanning Training (VST) is the recommended treatment in clinical guidelines. At the moment, several mixed reality versions of Visual Scanning Training (VST) are being developed. The aim of this study was to explore the opinions of end-users (i.e., therapists) on the use of Virtual Reality (VR) and Augmented Reality (AR) in VSN treatment.MethodsTherapists played one VR and two AR Serious Games, and subsequently filled out a questionnaire on User Experience, Usability, and Implementation.ResultsSixteen therapists (psychologists, occupational, speech, and physiotherapists) played the games, thirteen of them evaluated the games. Therapists saw great potential in all three games, yet there was room for improvement on the level of usability, especially for tailoring the games to the patient’s needs. Therapists’ opinions were comparable between VR and AR Serious Games. For implementation, therapists stressed the urgency of clear guidelines and instructions.DiscussionEven though VR/AR technology is promising for VSN treatment, there is no one-size-fits-all applicability. It may thus be crucial to move towards a plethora of training environments rather than a single standardized mixed reality neglect treatment.ConclusionAs therapists see the potential value of mixed reality, it remains important to investigate the efficacy of AR and VR training tools.

Evaluation of a virtual reality training tool for firefighters responding to transportation incidents with dangerous goods

AbstractAccess to dangerous goods training for firefighters in remote areas is limited for financial and logistical reasons. Virtual reality (VR) is a promising solution for this challenge as it is cost-effective, safe, and allows to simulate realistic scenarios that would be dangerous or difficult to implement in the real world. However, rigorous evaluations of VR training tools for first responders are still scarce. In this exploratory user study, a simple VR training tool involving two dangerous goods scenarios was developed. In each scenario, trainees learned how to safely approach a jackknifed truck with a trailer and how to collect and communicate information about the transported materials. The tool was tested with a group of 24 professional firefighter trainees (n = 22) and instructors (n = 2), who each completed the two training scenarios. The main goal of the study was to assess the usability of the VR tool in the given scenarios. Participants provided feedback on cybersickness, perceived workload, and usability. They also filled out a knowledge test before and after the VR training and gave feedback at the end of the study. The VR tool recorded task completion duration and participants’ navigation and use of tools events. Overall, the tool provided good usability, acceptance, and satisfaction. However, a wide range in individuals’ responses was observed. In addition, no post-training improvement in participants' knowledge was found, likely due to the already high level of knowledge pre-training. Future directions for improving the VR tool, general implications for other VR training tools, and suggestions for future research are discussed.

New Highly Portable Simulator (SECMA) Based on Virtual Reality for Teaching Essential Skills in Minimally Invasive Surgeries

This study presents a new minimal access surgery training system, SECMA, and its constructive validation to determine its usefulness for training basic laparoscopic skills. SECMA is an affordable, highly portable, mobile virtual reality training tool for laparoscopic techniques that integrates the Oculus Quest with a mechanical interface for surgeon simulation of forceps using the hand controllers of these devices. It allows the execution of structured activities (supported by virtual scenarios simulating operating rooms developed in Unity), performance evaluation, and real-time data capture. Two experiments were carried out: 1) coordination; and 2) capture and transport, with a total of 21 individuals divided into two groups: a novice group (inexperienced) of 10 participants and an expert group (>100 endoscopic procedures) of 11 participants. Total task time score, right-hand speed, path length, and other metrics from several consecutive runs on the simulator were compared between experts and novices. Data automatically recorded by SECMA during the experiments were analyzed using hypothesis tests, linear regressions, analysis of variance, principal component analysis, and machine learning-supervised classifiers. In the experiments, the experts scored significantly better than the novices in all the parameters used. The tasks evaluated discriminated between the skills of experienced and novice surgeons, giving the first indication of construct validity for SECMA.

Determination of skill and knowledge requirements of an instrument nurse working in major vascular surgery for the development of a virtual reality training tool

BackgroundAn open abdominal aortic aneurysm (AAA) repair is a complex high-risk procedure, with limited opportunities for an instrument nurse to gain experience and develop the necessary skills to assist the surgeon in caring for the patient during surgery. The aim of the study was to inform the content for a virtual reality (VR) training tool to develop the skills of an instrument nurse when working in major vascular surgery. MethodsAn exploratory, descriptive qualitative design using focus groups and semistructured interviews was selected for this study to explore and understand the perceptions of consultant vascular surgeons and expert vascular instrument nurses about the skills required by an instrument nurse when caring for a patient undergoing major vascular surgery. Expert vascular instrument nurses (n = 9) and consultant vascular surgeon (n = 4) were recruited via the Australian College of Perioperative Nurses (ACORN) and the Australian and New Zealand Society for Vascular Surgery (ANZSVS), respectively. ResultsData were analyzed using thematic analysis (Braun & Clarke, 2012). Four themes emerged from the data analysis. These were: preparation for surgery, essential psychomotor skills, nontechnical skills, and the virtual reality training tool design and content. ConclusionExpert vascular instrument nurses and consultant vascular surgeons provided a detailed compilation of the knowledge and skills required by an instrument nurse which will inform the content and design of the proposed virtual reality training tool. Whilst this study is based on open AAA repair, it also provides a valuable insight into what surgeons and nurses consider important for an instrument nurse when assisting with a surgical procedure.

An innovative virtual reality training tool for the pre-hospital treatment of cranialmaxillofacial trauma

Virtual reality (VR) surgery using the High Technology Computer Corporation Very Immersive Virtual Experience professional 2(HTC VIVE Pro2) suite is a multi-sensory, holistic surgical training experience. A multimedia combination including videos and three-dimensional interaction in VR has been developed to enable trainees to experience a realistic battlefield environment. The innovation allows trainees to interact with the individual components of the cranialmaxillofacial(CMF) anatomy and apply surgical instruments while watching close-up stereoscopic three-dimensional videos of the surgery. In this study, a novel training tool for the pre-hospital treatment of CMF trauma based on immersive virtual reality (iVR) was developed and validated. Twenty-five CMF surgeons evaluated the application for face and content validity. Using a structured assessment process, the surgeons commented on the content of the developed training tool, its realism and usability and the applicability of VR surgery for CMF trauma rescue simulation training. The results confirmed the applicability of VR for delivering training in the pre-hospital treatment of CMF trauma. Modifications were suggested to improve the user experience and interactions with the surgical instruments. This training tool is ready for testing with surgical trainees.

Workforce Development and Multiagency Collaborations: A Presentation of Two Case Studies in Child Welfare

Background: Two disciplines that work in the child welfare arena, social welfare and healthcare, are crucial for addressing families’ and children’s needs in social, emotional, and physical healthcare situations. How child welfare workers are trained and how healthcare teams collaborate with other stakeholders in the child welfare system is crucial in meeting and sustaining the needs of families and children. Methods: We demonstrate two case examples, one focusing on enhanced learning tools through virtual reality (VR) and the other on strengthening collaborations between healthcare teams and the child welfare system. Results: For the VR training tool, 79% of participants indicated they would recommend the VR learning tool as effective in developing skills in the child welfare workforce. In response to the learning collaborative project, child welfare participants reported positive impressions regarding collaborative practices while identifying system-level barriers to implementation. Conclusion: Findings from these two case studies provide insights from which to consider system development for designing and implementing sustainable improvements in child welfare approaches to families and children referred for suspected maltreatment.

A VR training system for learning and skills development for construction workers

There is a looming shortage of well-trained professionals in the wood construction workforce. To challenge this shortage, we developed a simulated learning environment that leverages a novel Virtual Reality (VR) system to train novice workers in wooden wall construction. A comprehensive task analysis was first used to best identify training requirements. Then, a virtual building site was modeled and a 3D video tutorial was implemented using a VR Head-Mounted Display (HMD). To evaluate the effectiveness of this tool, participants who learned via the VR training tool were compared with participants who instead only had simple 2-D instructional video training. VR training resulted in better retention, task performance, learning speed, and engagement than the video training counterpart, maintaining system usability. This demonstrates that VR is a viable training tool for the construction sector and can produce benefits beyond those of traditional video training.

Motor learning in hemi-Parkinson using VR-manipulated sensory feedback

Aims Modalities for rehabilitation of the neurologically affected upper-limb (UL) are generally of limited benefit. The majority of patients seriously affected by UL paresis remain with severe motor disability, despite all rehabilitation efforts. Consequently, extensive clinical research is dedicated to develop novel strategies aimed to improve the functional outcome of the affected UL. We have developed a novel virtual-reality training tool that exploits the voluntary control of one hand and provides real-time movement-based manipulated sensory feedback as if the other hand is the one that moves. The aim of this study was to expand our previous results, obtained in healthy subjects, to examine the utility of this training setup in the context of neuro-rehabilitation. Methods We tested the training setup in patient LA, a young man with significant unilateral UL dysfunction stemming from hemi-parkinsonism. LA underwent daily intervention in which he intensively trained the non-affected upper limb, while receiving online sensory feedback that created an illusory perception of control over the affected limb. Neural changes were assessed using functional magnetic resonance imaging (fMRI) scans before and after training. Results Training-induced behavioral gains were accompanied by enhanced activation in the pre-frontal cortex and a widespread increase in resting-state functional connectivity. Discussion Our combination of cutting edge technologies, insights gained from basic motor neuroscience in healthy subjects and well-known clinical treatments, hold promise for the pursuit of finding novel and more efficient rehabilitation schemes for patients suffering from hemiplegia. Implications for rehabilitation Assistive devices used in hospitals to support patients with hemiparesis require expensive equipment and trained personnel – constraining the amount of training that a given patient can receive. The setup we describe is simple and can be easily used at home with the assistance of an untrained caregiver/family member. Once installed at the patient's home, the setup is lightweight, mobile, and can be used with minimal maintenance . Building on advances in machine learning, our software can be adapted to personal use at homes. Our findings can be translated into practice with relatively few adjustments, and our experimental design may be used as an important adjuvant to standard clinical care for upper limb hemiparesis.

An innovative virtual reality training tool for orthognathic surgery

Virtual reality (VR) surgery using Oculus Rift and Leap Motion devices is a multi-sensory, holistic surgical training experience. A multimedia combination including 360° videos, three-dimensional interaction, and stereoscopic videos in VR has been developed to enable trainees to experience a realistic surgery environment. The innovation allows trainees to interact with the individual components of the maxillofacial anatomy and apply surgical instruments while watching close-up stereoscopic three-dimensional videos of the surgery. In this study, a novel training tool for Le Fort I osteotomy based on immersive virtual reality (iVR) was developed and validated. Seven consultant oral and maxillofacial surgeons evaluated the application for face and content validity. Using a structured assessment process, the surgeons commented on the content of the developed training tool, its realism and usability, and the applicability of VR surgery for orthognathic surgical training. The results confirmed the clinical applicability of VR for delivering training in orthognathic surgery. Modifications were suggested to improve the user experience and interactions with the surgical instruments. This training tool is ready for testing with surgical trainees.

Examining Changes to Center of Pressure During the First Trials of Wii Gameplay.

Use of the Nintendo Wii™ as a balance assessment and rehabilitation tool continues to grow. One advantage of the Wii is that games can serve as a virtual reality training tool; however, a disadvantage of the Wii is the human-machine interface and the learning effect over multiple trials. The purpose of this study was to assess changes in postural control during Wii gameplay over a series of trials in novice players. Thirty-one university athletes (aged 18-25 years) completed four trials of the Nintendo Wii Fit™ soccer heading (SH) balance game. Center of pressure (COP) was calculated in the anterior-posterior (AP) and medial-lateral (ML) directions for each 70-second time trial at 1000 Hz. COP was assessed using six linear and two nonlinear measures. Repeated measures analysis of variances compared COP measures over the four trials. Significant differences in COP magnitude and velocity were found between trials 1 and 2 in the ML direction. No significant effects of trial were found in the AP direction. In contrast, a measure of the overall area of COP using an ellipse method revealed a significant reduction to COP area between trials 3 and 4. No significant differences between trials were observed in nonlinear measures. These results demonstrate how magnitude and velocity measures of COP control stabilize after the first trial of Wii SH game play in novice young adults. As Wii rehabilitation focuses on individuals with balance difficulties, an important consideration when using the game as an assessment tool is that more than four trials may be required to capture learning in these populations. In addition, contrasting results from ellipse measurement methods point to the use of multiple measures for robust description of COP behavior. This work provides understanding of normative postural control responses with further research in clinical populations needed.

Interactive fire spread simulations with extinguishment support for Virtual Reality training tools

Virtual Reality training for fire fighters and managers has two main advantages. On one hand, it supports the simulation of complex scenarios like big cities, where a fire cannot be simulated in the real world. On the other hand, fire fighting VR simulators allow trainees to experience situations as similar as possible to real fire, reducing the probability of accidents when they are practising exercises with real fire.The success of the Virtual Reality training tools also depends on how close to reality the simulation process is. This work provides fire spread algorithms for forest and urban environments, which can be used at interactive rates. Due to the interactive nature of the algorithms, the users are able to fight the fire by throwing extinguishing agents.Although the algorithms assume many simplifications of the problem, their behaviour is satisfactory. This is due to the efficient management of the cell states in a 3m×3m cell grid. Also the variables that have more influence on fire propagation constitute the core of the algorithms. The overall system deals with user extinguishment actions, natural and artificial firebreaks, variable wind conditions (even at a cell level) and non-contiguous fire propagation (embers and spotting fires). The unified forest/urban model leads to an object oriented architecture which supports the fire propagation algorithms. This also allows the system to compute efficiently mixed forest–urban environments.

Evaluation of Spatial Processing in Virtual Reality Using Functional Magnetic Resonance Imaging (fMRI)

While the ecological validity of virtual reality (VR) applications is usually assessed by behavioral data or interrogation, an alternative approach on a neuronal level is offered by brain imaging methods. Because it is yet unclear if 3D space in virtual environments is processed analogically to the real world, we conducted a study investigating virtual spatial processing in the brain using functional magnetic resonance imaging (fMRI). Results show differences in VR spatial brain processing as compared to known brain activations in reality. Identifying differences and commonalities of brain processing in VR reveals limitations and holds important implications for VR therapy and training tools. When VR therapy aims at the rehabilitation of brain function and activity, differences in brain processing have to be taken into account for designing effective VR training tools. Furthermore, for an evaluation of possible restoration effects caused by VR training, it is necessary to integrate information about the brain activation networks elicited by the training. The present study provides an example for demonstrating the benefit of fMRI as an evaluation tool for the mental processes involved in virtual environments.

MO‐D‐230A‐02: An Immersive Virtual Environment for Training of Radiotherapy Students and Developing Clinical Experience

Purpose: Radiotherapy equipment and techniques are rapidly developing and so efficient training is invaluable. However, the demands on clinical systems and the lack of trained personnel make it difficult to achieve. As an alternative approach we have developed virtual reality training tools, fully interactive and operating on a life size scale these can provide valuable experience for students and staff. We designed a study for 42 first year therapist students to investigate the usefulness of our training environment for learning a clinical technique that typically causes problems. Method and Materials: We have created a virtual environment that simulates an actual radiotherapy treatment machine, controlled via an actual handheld control pendant. The study was developed to simulate a “skin apposition” electron beam treatment. A virtual patient, based on the visible human female dataset, complete with rectangular markings for a range of different treatment sites, provided a range of treatment scenarios. At the Hull Immersive Visualization Environment (HIVE) we are able to project our graphics display onto a 5.3 m by 2.5 m ‘Power Wall’ utilizing stereoscopic visualization enabled via LCD shutter glasses. Such immersive interaction techniques (including the use of the Linac hand pendant) add to the user's sense of reality. To provide feedback, we have implemented a ‘scoring algorithm’ to assess how well the user has set up the beam/ patient. Results: The students reported the training environment to be realistic and following its use 93% perceived an improvement in their understanding of this clinical technique and 69% found the control system easy to master. Conclusion: Having implemented such training software and hardware we are beginning to perform academic studies to assess the impact of its use in the educational forum. We wish to understand which areas of multi‐discipline training will benefit from such an approach.