Making a VR (Virtual Reality) Hypoglycemia sequence for medical training
Written by Md Shamiul Haque on 25.10.2022
Extended Reality has revolutionized training and education in numerous ways [1], which includes medical training as well. Virtual Reality in general nursing education is quite efficient. Without putting patients in danger, it allows students to gain experience in clinical decision-making, teamwork, communication, critical thinking, management, and problem-solving. VR training also has the advantage of being cost and time efficient [2]. It can also put students in situations which they cannot possibly be in the real world. Such a situation can be experiencing symptoms of hypoglycemia in diabetes.
Glucose is the main energy source of our body. Hypoglycemia is a condition where the blood sugar (Glucose) level falls below the standard range. Hypoglycemia can affect everyone differently. Yet, there are some common symptoms and effects that appear when hypoglycemia starts to occur. Some of these include:
Blurred vision
Dizziness
Trembling or Shaky hands
Fast / pounding heartbeat
Difficulty in concentration
It is difficult for people in general or healthcare personnel to comprehend this feeling who actually do not have hypoglycemia. With this in mind, a VR sequence has been developed for nursing students to give them a glimpse on how it feels to have low blood sugar. To simply put it, the user needs to perform some considerably basic activities with induced hypoglycemia symptoms.
In cooperation with Mr. Manuel Reitberger who is a M.Sc. student of Vocational Pedagogy – Health & Care in Technische Hochschule Deggendorf, a storyboard for a VR application was developed. This application was conceptualized initially with the intention to assist his master thesis which is titled “Virtual reality in general nursing education: Opportunities and challenges using the example of the learning unit hypoglycemia in type 1 diabetes mellitus”.
Initially, the user is put into a room where everything is normal for the first 30 seconds and is allowed to explore and move around in the environment to get themself adjusted. After that blurry vision sets in and the user is prompted to guess the time from a wall clock. The second activity includes counting some objects on the kitchen counter where the blurry vision is even increased. Then, the feeling of dizziness is induced by adding some vibrations to the camera and then the user is prompted to read a piece of text on the wall with the blurry vision prevailing. A fast heart beating audio clip is added into the background at this point to simulate the symptom of pounding heartbeats. The last task introduces the symptom of shaky hands. Vibrations/shakes are added to the VR hand objects inside the game world and periodic vibrations are also programmed into the VR controllers which somehow simulates trembling or shaky hands. The last task is to pick up a few beer bottles and put them on the table while the hands are shaking.
The application has been developed using Unity and the XR Interaction ToolKit plugin from Unity. Target device was Oculus Quest 2. Since voice recognition and speech-to-text plugins are not available in Unity for android platforms (Oculus Quest 2 being an android device), a special plugin called “Recognissimo” was used from the asset store to conduct the 3rd task of reading a text.
The main objective was for the nursing students or participants to test the VR sequence themselves and then data is collected in form of a follow up survey. The application also gives out a result at the end which mentions how many tasks were successfully completed. The participant is thus put in the position of the patient by the VR sequence and should ideally be able to empathize with the symptoms of hypoglycemia on a phenomenological level.
A recording of the application can be found here: https://youtu.be/6_AUdw3QlBw
References:
[1] https://www.xrtoday.com/virtual-reality/the-state-of-xr-in-education-and-training-in-2022/
[2] https://axonpark.com/how-effective-is-vr-training-13-case-studies-and-examples/