When it comes to healthcare, simulated experiences are not exactly new. Artificial situations used as training scenarios have long been a common practice, as well as the use of devices such as training dummies for resuscitation procedures as a single example.

According to research by GlobalData, the global virtual reality (VR) market is set to grow to be worth $51bn by 2030, with companies such as Meta’s Oculus Rift or HTC’s Vive undergoing widespread adoption in several markets. However, VR is only one aspect of the use of stimulatory experiences to train medical staff.

The increasing pace of VR and other technologies such as robotics has allowed for much more in-depth training scenarios that have led to the growth of several companies that are dedicated to the use of modern simulation in healthcare training.

At MEDICA 2023, the use of Oculus Rift’s Metaverse took the central focus of an expert panel that saw the CEO of XRhuman, an avatar as-a-services platform for realistic and interactive virtual B2B environments, give a demonstration of what the Metaverse hub for healthcare could potentially look like. During the demonstration, the audience saw a virtual tour showcasing the tools medical professionals could use in training.

At the same time, national bodies across the world are starting to pay attention to the emerging technology. One such example is the UK’s National Health Service (NHS) developing a national strategy to "ensure the equity of access to simulation education and training across England".

Anytime, anywhere

One company working firmly within this area is FundamentalVR, which recently sought to blend two pillars of simulation, VR and robotics, by announcing that it would be adding several surgical robotic specialists to its expert board.

Speaking with Hospital Management, FundamentalVR CEO Richard Vincent detailed how the company was addressing what it calls “soft skills” and “hard skills” when it comes to medical training.

Vincent said: “The process and learning curve that these people have to go through to acquire skills in new techniques, it's an ongoing process. But of course, the world is changing, and as robotics is coming in, as image-guided therapies come in, these are more complex and more involved, requiring staff to relearn their skills.

“Traditionally the model for learning has been slightly slow because it requires senior staff to give their time to train someone new and it is restricted by their time schedules. What we are hoping to do with our VR platform is help to accelerate some of those points.”

Vincent detailed how the versatile nature of VR and simulation means that it can be applied across a wide range of disciplines across a hospital setting, from surgeons to ancillary staff, as a means of producing a unified outcome.

He added: “Just the technical process of understanding how a robot is used in, for example, an operating room is involved. That itself is a learning curve before you have even gotten to the procedure. So we have a live system now for CMR Surgical, and it is intended to address that part of the problem.

“The technical set-up of that robot, traditionally they would bring people to a physical location, spend a few days in that location going through technical scenarios, which takes staff out of the clinical environment and puts them into another one.

“Today, instead of that what happens is VR headsets are shipped to those people in their location where they are able to undertake that training at their own discretion, in their own time-zone, in their own timeframe, making the onboarding of that process much more seamless.”

Fewer regulatory hurdles

The use of simulation within training has many challenges when it comes to regulation. However, in the area of training surgical staff, there are fewer requirements placed on the implementation of devices such as VR headsets than there would be if the same technology was implemented on the patient side.

David Rosen, former US Food and Drug Administration (FDA) adviser and partner for the legal company Foley & Lardner, detailed some of the concerns regulators may have with the emerging tech.

Rosen said: “As long as it’s just for training purposes and it is [VR] not used to do the actual surgery, so long as it shows the appropriate anatomy and that sort of thing if it's just an educational tool that’s a lot less regulated than if you are doing a procedure in real-time with a real patient.

“Any tool like this just needs to make sure that it’s accurate and appropriate and provides the correct instructions for a physician so that they can learn the technology or do a new surgery or something like that.

“The informational types of procedures are a lot different than things that are guiding clinical treatment or diagnosis in real-time situations. Again, we still want everything to be accurate and make sure that the physicians get the right information and are trained appropriately but it is very different from something like a diagnostic tool that evaluates various bits of data and spits out a diagnosis and a treatment regimen or something like that.”

Rosen went on to elaborate how despite the increasing accuracy and immersion of VR, “there is nothing like the real thing”.

He added: “The virtual world is an ideal world. Although you can simulate lots of different types of real-world conditions, we need to make sure that it’s not just the ideal conditions. It should provide the ability to create issues or problems and see how the physician reacts to those potentially very stressful situations.”

Rosen also elaborated how the FDA is currently putting together a lot of information on areas such as machine learning alongside AI, but that this area of concern is seen as separate from the use of devices such as VR headsets in the field of training. The use of new and emerging tech in terms of training sees the least amount of regulation, according to Rosen. Adding that this is because the direct impact on the patient is often minimal.

Rosen concluded: “I think the public expects their physicians to be appropriately trained in the kind of services they provide, how they get there, the public doesn’t really know for sure. At least the medical community with continuing education, board certifications and things of that sort is trying to at least put in appropriate standards for physicians who practise in this area.”