Vital Times 2019 - 97

Laboratory, recreated full scale replicas of our emergency
rooms and operating rooms. Using VR, we transport
users to any real-world environment. Of particular
interest is training users to work in disaster-zones.
Several vendors and start-ups have created virtual
environments that provide users with the opportunity to
learn resuscitation in realistic situations mimicking prehospital disaster settings. Detailed rendering recreates
sounds and sites, including the placement of medical
equipment, whether in the virtual spaces or the hospital
settings.

individuals (members of the public attending a music
festival). The VR training resulted in a non-inferior chest
compression rate, but participants demonstrated inferior
compression depth. Despite the inferiority of the VR
alone group, a significant proportion of participants
still fulfilled guideline-endorsed compression depth
recommendations. In another application, the Royal
College of Surgeons in Ireland designed a VR app for
trauma resuscitation: the RCSI VR Medical Training
Sim app. In this app, freely downloadable on the
Oculus Virtual Reality store, users can play the role
of an anesthesiologist, surgeon, or nurse during the
management of a patient in the emergency department.
The app requires users to follow established trauma
guidelines and provides feedback.
Feedback plays a vital role in the learning experience.
Our group created an advanced trauma management VR
app where participants use virtual renderings of realworld airway equipment while making clinical decisions
that lead to immediate deleterious patient outcomes.
Data generated in the IR environment include user
actions/inactions, gaze data, decisions, time spent using
airway equipment, and number of attempts at intubation.
Our group investigates how such data most effectively
organizes into actionable feedback, particularly as
compared to non-immersive training. A significant
limitation of the IR based CPR training is the absence of
tactile feedback which may reduce fidelity and may limit
generalizability to actual patient care.

Figure 1. An advanced airway VR scenario (CHISIL lab)

Several groups have demonstrated that IR can teach
technical aspects of cardio-pulmonary resuscitation
(CPR). Bailin et al. (2019), demonstrated the feasibility
of CPR training using a mannequin integrated with
a commercial AR device (Microsoft HoloLens).
Participants were provided with real-time audiovisual feedback via a holographic overlay of blood
flow to vital organs that reflect chest compression
quality. The majority of participants reviewed this
experience positively and felt it enhanced the training.
A randomized non-inferiority trial compared faceto-face in-class training versus VR alone among 381

Effective communication, a non-technical skill, remains
the cornerstone of successful crisis management.
Virtual reality has been used to train interdisciplinary
teams of healthcare students with the goal of improving
communication. Nas et al. (2019) at Tufts University,
demonstrated the ease of IR technology use, and the
performance improvement in healthcare professionals'
communication who participated in crisis management
training. In a separate study, Lok et al. (2017),
demonstrated how mixed-reality, human, healthcare
providers influenced communication during medication
delivery. These findings may suggest utility in the design
of IR environments whose goal is to improve the team
performance and communications during resuscitations.

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Vital Times 2019

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