Students at Imperial College London have been given VR headsets to immerse themselves in life-or-death scenarios, such as a cardiac arrest or an asthma attack.
These experiences can often be difficult for trainee medics to obtain before their first shift. It means that many doctors begin their career with little experience of dealing with a patient who becomes acutely unwell.
The VR headsets simulate an emergency situation and trainee medics are given multiple choice questions on how to proceed. This creates “branched scenarios” which follow a different path according to the choices made by the student, helping them to see the consequences of their decisions.
All of the scenarios are filmed using actors who break the fourth wall to ask medics questions about what to do next. Participants are then given 10 seconds to answer a question.
Each experience lasts between 10 to 15 minutes — the rough timing of an emergency situation.
Professor Amir Sam, head of Imperial College’s School of Medicine, said the process was vital as it enabled students to become “active participants” rather than passive observers.
“As a medical student you are never put in a position where you are in a team resuscitating a patient who has had a cardiac arrest. But after you graduate you have to do it, so there is a big gap between preparedness and practice in medicine that we have to grapple with,” he said.
“You can imagine how daunting it is to resuscitate a patient just after you finish your training, so we want to bridge this gap.”
It is hoped that the experience will leave medics feeling slightly less nervous before their first shift on the wards.
“I was petrified on my first day about someone becoming acutely unwell,” said Professor Sam.
“This at least gives people exposure to a difficult situation. You can plan a maths class; you can’t plan people becoming dangerously sick.”
The VR training was developed in-house by Imperial College’s digital media lab, aided by funding from Health Education England. Dr Risheka Walls, a consultant at Charing Cross Hospital and a digital development lead at Imperial, said that simulation helped better prepare students for “disorientating” emergency scenarios.
“My husband is an airline pilot so I’m aware of the amount of simulation that he does. It’s a stark contrast to what doctors do, we tend to train by observation,” she told the Standard.
“Even the most diligent medical student can’t guarantee that they will see an emergency up close before they begin their career. Sometimes the first time you see one unfolding is as a fully qualified doctor, when you’re expected to manage it.”
Imperial piloted the VR training in May and June this year but it has now been fully integrated into its curriculum following positive feedback from students. They have also simulated non-emergency situations which can be difficult for junior doctors, such as dealing with an angry family.
Dr Walls said that the training would also benefit patient care, as junior doctors would feel more empowered to deal with tough situations on their first shift.
“As a patient you want your doctor to have experienced an emergency before. We aren’t talking about something that’s rare; these are bread and butter emergencies that have an immediate threat to life.”
Imperial has also developed a version of the VR scenarios that can run on a desktop computer in case a student is ill or can’t attend training in person.
“These videos are also time-proof because the management of emergencies won’t change,” Dr Walls said. “They are shareable and reusable for quite some time.”
While there are only two scenarios being used by students at the moment, Dr Walls said that about 30 would be added in the near future. These include sepsis, life-threatening epilepsy and diabetic emergencies.