Degraded reality: Using VR/AR to simulate visual impairments

The effects of eye disease cannot be depicted accurately using traditional media. Consequently, public understanding of eye disease is often poor. We present a VR/AR system for simulating common visual impairments, including disability glare, spatial distortions (Metamorphopsia), the selective blurring and filling-in of information across the visual field, and color vision deficits. Unlike most existing simulators, the simulations are informed by patients' self-reported symptoms, can be quantitatively manipulated to provide custom disease profiles, and support gaze-contingent presentation (i.e., when using a VR/AR headset that contains eye-tracking technology, such as the Fove0). Such a simulator could be used as a teaching/empathy aid, or as a tool for evaluating the accessibility of new products and environments

Inducing empathy towards upper limb impairments using a physical device and virtual reality

Abstract. Empathy is the ability to understand concepts deeply and intimately from the perspective of another person. Having this empathetic understanding of different medical conditions will help make more informed decisions when designing for a particular condition and increase the motivation for providing higher quality results. However, it can be quite challenging for people to easily gain this kind of empathetic knowledge without fully comprehending the extent to which a particular impairment affects someone’s day-to-day life. One of the most popular and effective methods of inducing empathy towards impairments is the use of empathy simulations. The basic concept of empathy simulations is to realistically simulate the limitations posed by an impairment so that the participant can gain a first-hand experience of what it is like to live with the impairment. Traditionally, these simulations were created using various physical means, but lately the use of virtual reality devices in these simulations has become more common. Virtual reality is essentially technology that allows the user to embody another persons perspective, which makes it exceptionally suitable for empathy simulations. The aim of our study was to investigate the generation of empathy towards upper extremity motor impairments using a mixture of physical and virtual means. For the purposes of this study, we built an arm mobility restricting harness to mimic an upper extremity motor impairment and a virtual reality environment of a home kitchen where the simulations took place. Two groups of volunteer participants experienced the simulation by performing simple tasks in the virtual reality environment while being limited by the mobility restricting harness. The difference between the groups was in having to recite different backstories for their simulated characters. Backstory for group 1 was in first-person, and group 2 for group in third-person. The stories were thought to target affective and cognitive empathy differently. The participants’ level of empathy was measured once before the simulation and once after the simulation using a collection of standardized questionnaires. The study showed significant increase in the level of emotional contagion over all participants (p < 0.044*) suggesting that the simulation increased the participants’ level of empathy in that category. No significant difference was measured between backstories, however, the results suggest the first-person story to assist cognitive empathy. The study also showed that the group with the backstory in first-person had better scores in all categories of embodiment suggesting that the first-person backstory enabled participants to better relate to their virtual character. Despite some promising results, further studies are needed to investigate empathy generation using a mixed physical and virtual empathy simulations

Validation of the GUESS-18 for the Usability of a Virtual Reality Racing Game

Virtual reality (VR) technology has been in development for many decades, with recent strides in the consumer market. Head-mounted displays (HMDs) provide an immersive VR experience by inserting users into an artificially constructed digital world. However, there is currently no standardized tool for measuring the usability of a VR system or environment. The GUESS-18 is a validated usability questionnaire designed for measuring the usability of video games with 9 factors present in video games. The objective of this study was to validate the GUESS-18 for measuring the usability of VR in a gaming environment. Participants played Assetto Corsa, a racing game, with an HMD in VR and with a traditional monitor. The best lap times were recorded as a performance measure. Errors were also recorded, which included driving off the track or colliding with a wall. Users answered the GUESS-18 and the System Usability Scale (SUS) after their experience. They also answered the Simulator Sickness Questionnaire (SSQ) before and after using VR. Confirmatory Factor Analysis (CFA) was performed to determine the validity of the GUESS-18’s measurements for usability of the racing game in VR. The GUESS-18 is an accurate and effective tool for measuring usability of the game in VR. The Comparative Fit Index (CFI) and Root Mean Square Error of Approximation (RMSEA) values indicate appropriate model fit, with values of 0.967 and 0.056, respectively. VR yielded significantly faster lap times by about 5%. No other differences were found for performance. Usability scores from the GUESS-18 were significantly higher in the VR condition than the traditional monitor by about 6.4%. SSQ scores were significantly higher after engaging with VR by 282.5%. No differences were found for SUS scores between display conditions. We also found that playing the game in VR resulted in greater immersion and personal gratification than playing with the monitor. Future research should focus on the development and validation of a generalized VR usability tool that captures the latent factors when using a VR system

Immersive virtual reality and education: a study into the effectiveness of using this technology with preservice teachers.

Immersive virtual reality (IVR) is a rapidly advancing technology utilized across varying education fields for learning and educational applications. IVR provides the capabilities of computer simulations and embodied cognition experiences through a hands-on activity, making it a natural step to improve learning. Creating educational applications in IVR for use with students and preservice teachers could be a laborious and costly endeavor and require teacher belief in its effectiveness, so research is essential to investigate whether these applications are useful in advancing prekindergarten through Grade 12 (P-12) student learning. Research in this field is new, limited, and practically void of its use in P-12 learning environments. This inquiry expanded upon the literature on IVR technology in education and preservice teacher use of technology. Specifically, the purpose of this study was to investigate the impact of IVR technology on preservice teachers through an experience focused on the American Civil Rights Movement, specifically on knowledge attainment, lesson planning effectiveness, and motivation for future use in their instructional practice. Participants were 21 elementary preservice teachers in a diverse metropolitan university. Results indicated participants in the IVR group significantly increased scores on a content test, reported engagement with the experience, and indicated likelihood to use IVR with their future students

Immersive Visualization in Biomedical Computational Fluid Dynamics and Didactic Teaching and Learning

Virtual reality (VR) can stimulate active learning, critical thinking, decision making and improved performance. It requires a medium to show virtual content, which is called a virtual environment (VE). The MARquette Visualization Lab (MARVL) is an example of a VE. Robust processes and workflows that allow for the creation of content for use within MARVL further increases the userbase for this valuable resource. A workflow was created to display biomedical computational fluid dynamics (CFD) and complementary data in a wide range of VE’s. This allows a researcher to study the simulation in its natural three-dimensional (3D) morphology. In addition, it is an exciting way to extract more information from CFD results by taking advantage of improved depth cues, a larger display canvas, custom interactivity, and an immersive approach that surrounds the researcher. The CFD to VR workflow was designed to be basic enough for a novice user. It is also used as a tool to foster collaboration between engineers and clinicians. The workflow aimed to support results from common CFD software packages and across clinical research areas. ParaView, Blender and Unity were used in the workflow to take standard CFD files and process them for viewing in VR. Designated scripts were written to automate the steps implemented in each software package. The workflow was successfully completed across multiple biomedical vessels, scales and applications including: the aorta with application to congenital cardiovascular disease, the Circle of Willis with respect to cerebral aneurysms, and the airway for surgical treatment planning. The workflow was completed by novice users in approximately an hour. Bringing VR further into didactic teaching within academia allows students to be fully immersed in their respective subject matter, thereby increasing the students’ sense of presence, understanding and enthusiasm. MARVL is a space for collaborative learning that also offers an immersive, virtual experience. A workflow was created to view PowerPoint presentations in 3D using MARVL. A resulting Immersive PowerPoint workflow used PowerPoint, Unity and other open-source software packages to display the PowerPoint presentations in 3D. The Immersive PowerPoint workflow can be completed in under thirty minutes

A Mixed Methods Case Study Exploring Simulation and Caring in Nursing Education

Current research in nursing education suggests a shift from traditional didactic transmission methods to student-centered pedagogies to prepare nursing students with substantive knowledge necessary for competent practice in a complex healthcare environment. Simulation has emerged as a pedagogy that offers students the opportunity to critically think, solve problems, and care for diverse patients in a nonthreatening, safe environment. As the use of simulation increases, a concern is whether or not it can hinder the development of caring behaviors necessary for competent and compassionate nursing practice. This research was a study of nursing students’ descriptions of the simulation experience, and perceptions of caring in nursing along with the display of caring behaviors in the simulated environment. Key findings include: 1) simulation was viewed as a positive and negative learning experience by students; 2) students displayed nonverbal and verbal caring behaviors during simulation; 3) students believed displaying caring in a simulated environment was challenging because the simulator could not respond as an actual person

Effectiveness analysis of traditional and mixed reality simulations in medical training: a methodological approach for the assessment of stress, cognitive load and performance

La simulazione nell'educazione in medicina è considerata un metodo di formazione in grado di migliorare le competenze cliniche e il comportamento degli operatori sanitari e, di conseguenza, la qualità dell'assistenza per il paziente. Inoltre, l'utilizzo di nuove tecnologie come la Realtà Aumentata, offre ai discenti l'opportunità di esercitarsi in un ambiente immersivo. L'opportunità di sperimentare questo innovativo metodo didattico è efficace non solo nel ridurre il rischio di errori e approcci sbagliati ma anche nel provare ansia e stress simili a quelli avvertiti nella pratica reale. La sfida sta nel trovare il giusto equilibrio. I discenti devono infatti provare lo stesso stress che avvertirebbero lavorando ad un vero caso clinico ma, allo stesso tempo, devono essere controllati ed evitati possibili disturbi da stress post-traumatico, verificabili soprattutto nel campo della gestione delle emergenze (pronto soccorso). Inoltre, è fondamentale anche ottenere alte prestazioni e un apprendimento adeguato, evitando sovraccarichi cognitivi che influenzerebbero negativamente l’apprendimento. Tuttavia, ad oggi mancano ancora studi approfonditi sull'impatto che le simulazioni mediche hanno su stress, frustrazione, carico cognitivo e apprendimento dei discenti. Per questo motivo, l'obiettivo principale di questo studio è valutare l'efficacia del training tramite simulazione, analizzando prestazioni, ansia, stress e carico cognitivo durante simulazioni cliniche tradizionali (con manichino) ed avanzate (in realtà mista). A questo scopo, è stato sviluppato un approccio metodologico strutturato e completo per valutare le prestazioni, le condizioni emotive e cognitive degli studenti. Questo comprende l'acquisizione e l'analisi di parametri psicologici (valutazione soggettiva), segnali biometrici (valutazione oggettiva) e prestazioni. Questa indagine consente di evidenziare i punti deboli delle simulazioni e offre l'opportunità di definire utili linee guida per la riprogettazione e l'ottimizzazione delle stesse. La metodologia è stata applicata su tre casi studio: il primo si riferisce a simulazioni ad alta fedeltà per la gestione del paziente in pronto soccorso, il secondo si riferisce a simulazioni a bassa fedeltà per la pratica della rachicentesi. Per il terzo caso studio, è stato progettato e sviluppato un prototipo di simulatore in realtà mista per la rachicentesi, con l'obiettivo di migliorare il senso di realismo e immersione della simulazione a bassa fedeltà. 148 studenti sono stati coinvolti nei primi due casi studio osservazionali, mentre soltanto 36 studenti hanno preso parte allo studio pilota sulla simulazione in realtà mista. In tutti i casi di studio sono state effettuate analisi descrittive delle prestazioni, degli stati cognitivi ed emotivi. Per le simulazioni ad alta e bassa fedeltà, le analisi di regressione statistica hanno evidenziato quali variabili influenzano le prestazioni, lo stress e il carico cognitivo degli studenti. Per lo studio pilota sulla realtà mista, l'analisi della user experience ha sottolineato i limiti tecnici della nuova tecnologia.Simulation in medical education is considered a training method capable of improving clinical competence and practitioners’ behaviour, and, consequently quality of care and patient’s outcome. Moreover, the use of new technologies, such as augmented reality, offers to the learners the opportunity to engage themselves in an immersive environment. The opportunity to experiment with this innovative instructional method is effective not only in reducing the risk of errors and wrong approaches but also in experiencing anxiety and stress as in real practice. The challenge is to find the right stress balance: learners have to feel as if they were practicing in the real stressful clinical case, and, at the same time, post-traumatic stress disorders, verifiable especially in the emergency field, must be controlled and avoided. Moreover, it is fundamental also to obtain high performance and learning, thus avoiding cognitive overloads. However, extensive researches about the impact of medical simulations on students’ stress, frustration, cognitive load, and learning are still lacking. For this reason, the main objective of this study is to assess simulation training effectiveness by analysing performance, anxiety, stress, and cognitive load during traditional (with manikin) and advanced (with augmented reality) clinical simulations. A structured and comprehensive methodological approach to assess performance, emotional and cognitive conditions of students has been developed. It includes the acquisition and analysis of psychological parameters (subjective assessment), biometric signals (objective assessment), and task performance. This investigation allows to point out simulations’ weaknesses and offers the opportunity to define useful optimisation guidelines. The methodology has been applied to three case studies: the first one refers to high-fidelity simulations, for the patient management in the emergency room, the second one refers to low-fidelity simulation for rachicentesis. For the third case study, a prototype of a mixed reality simulator for the rachicentesis practice has been designed and developed aiming at improving the sense of realism and immersion of the low-fidelity simulation. While 148 students have been enrolled in the first two case studies, only 36 students have taken part in the pilot study about mixed reality simulation. Descriptive analysis about performance, cognitive and emotional states have been done in all the case studies. For the high-fidelity and low-fidelity simulations, the statistical regression analysis has pointed out which variables affect students’ performance, stress, and cognitive load. For the pilot study about mixed reality, the user experience analysis highlighted the technical limitations of the new technology