A Glimpse into Virtual Reality and Medicine
Virtual reality is growing. In a report conducted by SuperData Research, annual virtual reality revenue in 2018 reached $3.6 billion, nearly 10% higher than the 2018 forecast. Extended reality revenue is expected to increase by 442% by 2022. In Q4 alone, approximately 1.545 million virtual reality units were sold, and this momentum does not appear to be slowing down.
“2019 is poised to be an important year for VR with the introduction of the Oculus Quest,” says Stephanie Llamas, Head of Research and Strategy and VR/AR at SuperData (qtd. in SuperData XR Update). “Likewise, the introduction of new headset technology like eye tracking in the HTC VIVE Pro Eye is likely to accelerate growth of enterprise usage.” In the business world, Ms. Llamas’ phrase “enterprise usage” is referring to the investment of technology and creative talent by companies into the field of virtual reality.
The Oculus Quest is expected to sell 1.3 million units in 2019.
Video games play a prominent role in virtual reality’s success, accounting for 43% of its software revenue. Adrenaline-pumping experiences such as Beat Saber, which has sold over 1 million copies, and Blood & Truth, the first virtual reality title to top the UK physical games sales chart, further demonstrate this notion.
Even with the predominance of gaming in the virtual reality market, the medium holds another, arguably more valuable purpose: medicine.
Virtual reality technology has the ability to impact nearly every facet of health care, from provider training to actual surgical intervention. In a study by Dr. Xueni Pan et. al, for example, twelve general practitioners and nine trainees meet an increasingly aggressive woman who requests prescription antibiotics for her mother, all within a virtual world. These demands clash with the actual necessity of these medications, as the risk of bacterial resistance to antibiotics remains an urgent threat. The study was an attempt to observe two reactions: whether or not general practitioners are more prone to prescribing medication than trainees, and whether or not these health care providers would evoke serious consideration towards this virtual event.
The results are fascinating: eight of nine trainees prescribed the requested antibiotics while only seven of the twelve general practitioners did so. Given these findings, statistical inference supports the assumption that general practitioners are more likely than trainees to withstand the pressure to prescribe unnecessary antibiotics. Furthermore, the combined findings of a post-study questionnaire and observation of the participants’ body language and feedback demonstrate the tendency for them to take the illusion of the virtual consultation room seriously, regardless of the rudimentary character models and dated graphical capabilities.
The results demonstrate the capacity of virtual reality as a medical education tool, as there exist a variety of situations in which virtual patients may be preferable to human actors. For example, in pediatrics, it is unethical for child actors to be used as abuse victims for teaching purposes. Younger child actors are also unpredictable, challenging the full capacity of students to learn. Dr. Xueni Pan et. al’s study demonstrates the potential of virtual reality to alleviate such educational challenges, allowing students to feel better prepared in real-world medical cases and emergencies.
And yet, there are variations on the virtual reality model. Augmented reality, a type of extended reality that overlays imagery onto the user’s real world without fully altering it, provides numerous medical applications. At the Mayo Clinic Multidisciplinary Simulation Center, for example, augmented reality is used to teach students how to interpret ultrasound imaging. It allows students to see additional images — ranging from blood vessels to bone structures — on top of the standard ultrasound image. Additionally, augmented reality grants students the ability to interact with each other and their instructor because the real world remains intact.
“With augmented reality, the capability is greater for having multiple users experiencing something together [to] interact collaboratively in a clinical scenario during simulation training,” says Thomas Belda, MS, Enterprise Simulation Technology Architect at Mayo Clinic (qtd. in AAMC).
Across the country, an augmented reality pilot project was launched at the UC Irvine School of Medicine. Here, a holographic patient is overlaid onto a manikin, creating a more realistic and interactive training experience: the manikin can turn blue from hypoxia, for instance. All of this leads to a more realistic, safer, and relatively portable medical education.
An intriguing and emerging utilization is the use of extended reality in actual medical treatment. Take augmented reality, which can assist with a variety of laparoscopic and endoscopic surgeries. It allows for the visualization of regions of interest — tumors, nerves, blood vessels, etc. — that are often obscured during surgical intervention. Augmented reality can thus improve the perception of surgeons with regards to hidden organs, while still allowing them to interact with the real world.
Virtual reality in the medical field is not without its critics. Virtual reality simulations known as “empathy machines” are carefully crafted scenarios designed to make users more empathetic towards the virtual character they become, from hospice patients to Syrian refugees. In October 2018, for example, a Stanford University Virtual Human Interaction Lab study found that participants who participated in a “Becoming Homeless” empathy machine were more likely to sign an affordable housing petition than other participants. Simulations not only assist with empathy, but they can also treat PTSD through therapy and assist victims of burning and phantom pain as well.
But there can exist bias and manipulation in these simulations.
“Empathy technology seems to be incredibly exciting, so I have nothing against that for pleasure. But if a lot of people want to use empathy technology as a tool of political advocacy, that’s different,” says Dr. Paul Bloom, a Professor of Psychology and Cognitive Science at Yale University (qtd. in The Verge).
Dr. Bloom argues empathy can be manipulated.
“One thing is that you’re only going to lock yourself into the machine if you already are sort of a believer in the cause. But more to the point, when liberals think about empathy, they only think it’s on their side, thinking, ‘If we had good empathy technology, more people would agree with what we’re arguing,’” says Dr. Bloom. “In reality, empathy can go both ways” (qtd. in The Verge).
It’s not just empathy simulations. Virtual reality can also lead to inaccurate medical education. Take Dr. Arielle Michal Silverman, a former postdoctoral fellow at the University of Washington, and her work regarding “blindness simulations.” Here, participants may use a headset, or even just simply a blindfold, to create an empathy machine for blindness. Doing this is incredibly misleading, as only the initial trauma of becoming blind is experienced, rather than the lifelong reality of being blind.
And so, virtual reality is growing. While market revenue has been steadily on-the-rise, the practicality of extended reality in the medical field is being tested, redesigned, and criticized. Graphical improvements and interactivity are constantly being improved upon. It all demonstrates not only the vast implications of such an infant technology, but the constant evolution of medical treatment and education.
“Antibiotic Resistance Questions and Answers | Community | Antibiotic Use | CDC.” Centers for Disease Control and Prevention, U.S. Department of Health & Human Services, 25 Sept. 2017, www.cdc.gov/antibiotic-use/community/about/antibiotic-resistance-faqs.html.
Breining, Greg. “Future or Fad? Virtual Reality in Medical Education.” AAMCNews, 2019 AAMC, 28 Aug. 2018, news.aamc.org/medical-education/article/future-or-fad-virtual-reality-medical-education/.
Burge, Kathleen. “Dress Rehearsal For Death: Using Virtual Reality To Foster Empathy For Dying Patients.” Dress Rehearsal For Death: Using Virtual Reality To Foster Empathy For Dying Patients | CommonHealth, WBUR, 16 Nov. 2018, www.wbur.org/commonhealth/2018/11/16/virtual-reality-dying-palliative.
Chen, Angela. “Paul Bloom on Why VR Empathy Projects Won't Save the World.” The Verge, Vox Media, Inc., 6 Dec. 2016, www.theverge.com/2016/12/6/13857268/paul-bloom-psychology-against-empathy-virtual-reality-politics.
Ha, Ho-Gun & Hong, Jaesung. (2016). Augmented Reality in Medicine. Hanyang Medical Reviews. 36. 242. 10.7599/hmr.2016.36.4.242.
Hayden, Scott. “'Beat Saber' Sells Over One Million Copies.” Road to VR, Road to VR, 16 Mar. 2019, www.roadtovr.com/beat-saber-sells-one-million-copies/.
Labs, Embodied, director. Embodied Labs Clay Ending Clip. YouTube, YouTube, 15 Nov. 2018, www.youtube.com/watch?time_continue=61&v=RQvtEos98Po.
Motomatsu, H. (2014). Virtual Reality in the Medical Field. UC Merced Undergraduate Research Journal, 7(1). Retrieved from https://escholarship.org/uc/item/0bs5p31h
“Oculus Expected to Sell 1.3M Quest Units in 2019; XR Revenue Reached $6.6B in 2018 and Is Projected to Increase 442% by 2022.” SuperData, SuperData Research Holdings, Inc., 24 Jan. 2019, www.superdataresearch.com/xrupdate/.
“Oculus Quest.” Oculus, Facebook Technologies, LLC, www.oculus.com/quest/?locale=en_US.
Pan, X., Slater, M., Beacco, A., Navarro, X., Swapp, D., Hale, J., et al. (2016). The responses of medical general practitioners to unreasonable patient demand for antibiotics – a study of medical ethics using immersive virtual reality. PLoS ONE 11:e0146837. doi:10.1371/journal.pone.0146837
Parkin, Simon. “How Virtual Reality Is Helping Heal Soldiers Suffering with PTSD.” NBCNews.com, NBCUniversal News Group, 16 Mar. 2017, www.nbcnews.com/mach/features/how-virtual-reality-helping-heal-soldiers-ptsd-n733816.
Reeves, Brianna. “Blood & Truth Is the First VR Game to Take the UK Sales Charts’ Top Spot at Launch.” PlayStation LifeStyle, Evolve Media, LLC, 3 June 2019, www.playstationlifestyle.net/2019/06/03/blood-and-truth-sales-uk-charts/#/slide/1.
Shashkevich, Alex. “Virtual Reality Can Help Make People More Empathetic.” Stanford News, Stanford University, 15 Oct. 2018, news.stanford.edu/2018/10/17/virtual-reality-can-help-make-people-empathetic/.
Silverman, A. (2015). The perils of playing blind: Problems with blindness simulation and a better way to teach about blindness. Journal of Blindness Innovation and Research, 5(2)
“SuperData Research.” SuperData Research | Games Data and Market Research, SuperData Research Holdings, Inc., www.superdataresearch.com/.