SIZE OF THE HEALTHCARE TRAINING INDUSTRY: GLOBALLY, THE HEALTHCARE INDUSTRY EMPLOYS OVER 6.4 MILLION PEOPLE. THE LARGEST HEALTHCARE EMPLOYER IN THE UK IS THE NHS, WITH 1.6 MILLION EMPLOYEES. IN 2013, THERE WERE 40,000 MEDICAL STUDENTS IN THE UK AND 58,000 DOCTORS IN POST-QUALIFICATION TRAINING.
TRAINING SPEND PER ANNUM: THE HEALTHCARE AND PHARMACEUTICAL INDUSTRIES SPEND AN AVERAGE OF £1,000 PER EMPLOYEE ON 24 HOURS’ TRAINING PER YEAR. MEANWHILE, INITIAL TRAINING COSTS FOR MEDICAL OFFICERS AND DOCTORS ARE HIGH: UP TO £270,000 TO TRAIN A FOUNDATION OFFICER, JUST UNDER £500,000 TO TRAIN A GENERAL PRACTITIONER, AND AROUND £564,000 TO TRAIN A CONSULTANT.
KEY TRAINING AREAS: MEDICAL PROFESSIONALS IN GENERAL AND SPECIALIST PRACTICE (THE LARGEST SPECIALISATIONS ARE DENTISTRY, NURSING AND MIDWIFERY); PHARMACEUTICAL RESEARCH, DEVELOPMENT AND MANUFACTURE; LABORATORY AND PUBLIC HEALTH WORKERS; CARE AND SOCIAL WORKERS; SPECIALIST ADMINISTRATORS.
Initial training and continuous professional development (CPD) are inconsistent in quality: some professionals engage in rigorous CPD while others engage in none, and some health authorities are more or less up to date in their training practices. In the UK, the exact route into medical practice is changing: in particular, the graduate roles, such as those of doctors and nurses, are being placed under the authority of a new overseeing body. The emphasis of reform is on flexibility and breadth, allowing doctors, nurses and carers to handle a greater range of cases and roles.
There is also a perceived deficit in the ‘soft skills’ necessary for clinical care. Training regimes in healthcare must build theoretical knowledge and practical technique, but also develop leadership and care skills.
The healthcare industry adopted VR tech early on: simulations have been used in psychotherapy since 1997, and VR already plays a role in the most advanced medical training programs. Trainees in surgery and dentistry use VR environments, such as HapTEL (based at King’s College London) or Osso VR’s bone implant suite, to practice hands-on techniques without risk to real patients and with the advantage of detailed, instantaneous feedback. The simulations work: HapTEL won the Medical Futures award in 2011, opening the door for training options like the Asian Institute of Technology’s new virtual dentistry tool. Watch this video to see how AIT have developed the realism and feedback potential of VR simulations:
Haptic (touch) feedback is especially important for trainee dentists, who must be exacting in their use of force. Repeated practice on virtual teeth using real tools allows them to become confident and careful without setting real patients’ teeth on edge.
In a similar way, paramedics can be trained to handle high-pressure emergency situations through VR simulation. In VR, they have the opportunity to make and remake decisions, building up a bank of experience which ensures confidence in a real emergency.
Technical specialisms, such as radiography, are also beginning to embrace VR training. A trial at Queensland University of Technology revealed that training in VR improved proficiency with real equipment, and allowed up to 40 trainees to participate in sessions at the same time – much more than could use a real X-ray machine.
VR training is taking off in healthcare, driven by the falling cost of implementation. Cheaper, more reliable hardware is a must for such a cash-conscious industry. VR is now reaching a point where it can be rolled out more extensively, used in more institutions and context. More widespread use of VR could lead to a much-needed paradigm shift in training. Passive, memory-driven learning and written examinations may be superceded by more hands-on learning and assessment, focused on practical care.
So far, most of the investment in VR healthcare training tech has been directed toward improving surgical simulations and developing mobile VR apps for specific procedures, including catheter insertion and tracheal surgery. Operations carried out by leading surgeons are being recorded and streamed as 360-degree VR training experiences, overcoming the barriers presented to training in the developing world by distance, facilities and lack of access to skilled mentors.
Massive Open Online Courses (MOOCs) allow medical professionals to study alongside patients, clients, service users and researchers in other fields. This direct contact with others helps to develop perspective and soft skills, avoiding the isolation that often results from traditional workplace training. The most successful MOOCs offer a breadth of resources which results in higher engagement and retention: from video, text and interactive activities, VR is the next logical step. As VR headsets become more affordable and commonplace in the domestic market, they’ll become a viable option for MOOC content and thus play a greater role in CPD.
VR also affords possibilities in developing soft skills, building on the existing use of VR to treat phobias, OCD and PTSD through safe and monitored exposure therapy. Patients do not always understand the terminology being used by medical professionals, and medical professionals do not always know how to deliver an accessible explanation. A VR exploration of a medical problem or procedure allows patients to visualise the situation, deepening the understanding between carer and patient.
As simulation quality improves, VR interactions with virtual patients will allow soft skills to be developed in much the same way as surgical and dentistry techniques are currently being taught. Trials funded by the Wellcome and Leverhulme Trusts have demonstrated that trainees and experienced doctors alike engage with VR simulations of ethically demanding scenarios – for instance, an angry patient demanding a prescription medicine, against the trainee doctor’s advice. This test environment is a step away from becoming a training scenario – all it needs is feedback through simulated consequences, and the opportunity for live tutor input.
Healthcare trainers already use VR to reduce risk, offer detailed feedback, and improve access to machinery. The future is likely to see VR deployed for soft skills education, improving communication between patients and professionals, and potentially replacing passive learning and written examination with a more practical and realistic training environment.