Rick Channing

Virtual Reality (VR) can provide huge benefits in medicine. There are many aspects of VR that make it suitable for both medical students and experienced doctors, both in educating and training. A Virtual Environment (VE) could even be customized for each patient so that the doctor could virtually perform each procedure before doing it on the patient. This has the potential to revolutionize the entire field of medicine.

First of all, VR can help speed and improve the education of health care practitioners. Medical students can learn about the body in a VE. They could "fly" around the body to get a view from any perspective. They could also zoom in and out to fully understand the body in detail. Any part of the body could be made transparent to see what is behind it. Also, they could pick out any organ or system and study it individually. This VE would provide a very advanced and powerful tool that would help a great deal with the study of anatomy, giving the student a much more robust knowledge than pictures alone.

Also, a surgeon can be trained in a VE, instead of using cadavers or animals. Cadavers may be in short supply, and one can only be used for a certain operation a limited number of times. Once a certain part is cut up, it would be difficult to restore it to its original condition and try again. Also, a cadaver is stiff and lifeless. It does not have a beating heart and pulsating arteries, and it does not breathe. Many people may deem the use of animals for surgical training immoral. In the past, large animals have been shot and severely wounded to train military doctors. This would obviously be very painful for the animal.

On the other hand, a VE would allow a student or surgeon to practice a given procedure as many times as necessary to get the experience needed. Any given part of the operation could be saved and practiced over and over. Each time it is performed the student would be more ready to perform it in a real person. Also, the VE could be more realistic than the cadaver as it could have arteries that pulse when the heart beats, and breathing, etc. Crisis drills could be created in a VE and the results could be stored for group analysis later. Overall, the use of VR in surgical training could shorten the training period required.

Another benefit of a VE used for surgery is that it could be used to judge the performance of the operator. Traditionally, a new surgeon would be trained and judged as an apprentice for a period of 5 to 7 years² by an experienced surgeon. Thus the performance judgement given would be subjective as the master and apprentice got to know each other. A VE combined with something like fuzzy logic could evaluate the performance without bias.

The VE would be used by a select group of people, probably one at a time so sociability and connectivity is not that crucial. However, a VE could be designed that has multiple surgeons participating in an operation. One of the most crucial issues is that each user has gloves that fit perfectly. These gloves would have to be tracked with the utmost precision and accuracy to ensure good training.

The veridicality of the VE is also extremely important. For example, if someone is training for heart surgery in a VE, it had better seem like a real heart. The haptic sensations that are experienced by the user must also be very real. If cutting through muscle is different than cutting through fat, then it better also be different in the VE. Thus the glove must provide varied amounts of resistance to the user.

The student should be engaged by what they are doing in the VE. Ultimately, it should almost seem as though they are operating on a real person. The user could be immersed pretty well with a head-mounted display, and very good gloves. Also, responsiveness and stability are key in making the operation seem real. The VE must react instantaneously in real time in order to simulate medical situations, and there can be no jitter or oscillation while operating on someone. The slightest movement by the user must be registered in the VE, as there may be very precise operations to be done.

An egocentric viewpoint would be required for medical training, although the ability to switch to a Godís eye view or a split screen would be useful in some training situations. The user would need to at least see both hands, although more could be useful as the technology is enhanced. The physics of the environment should simulate the real world as much as possible. Different organs of the body would have different densities, and may also have different textures and malleability. Some of these aspects would be difficult to simulate.

Another important issue is the size and weight of the apparatus. The physician must be able to move freely and feel comfortable wearing the apparatus in order to perform the procedure to the best of his or her abilities. Also, the apparatus must be robust and fault tolerant. It must not break or malfunction during an operation, and plans must be made in case it does. These features of the device would probably keep the cost quite high.

It seems clear that Virtual Reality has changed and will continue to change many aspects of the world as we know it. Medicine will be affected by VR in many ways as well. Certainly the way our health care practitioners are educated and trained will be much different as a result.

Bibliography:

1. "Virtual Environments for Health Care." 1995 http://www.itl.nist.gov/div894/ovrt/projects/health/vr-envir.htm (23-28 Sep 1997).  

2. "Virtual Reality in Surgery." http://www.vetl.uh.edu/surgery/surpage.html (23-28 Sep 1997).

3. Stuart, Rory. "The Design of Virtual Environments." McGraw Hill, New York, 1996.