Gaming has captured a generation of youth, and with them many adults, who for years have been donning headsets in front of their computers, immersing themselves in and interacting with virtual worlds such as Minecraft or the newer Half-Life: Alyx. Advances in technology have augmented this immersive experience by placing users in a real-world setting overlaid by a virtual experience, allowing them to, for example, go on a Pokémon hunt (Pokémon GO) or enter the world of dinosaurs (Jurassic World Live). The immersive experience becomes even more fully blended when virtual and augmented realities are mixed to create a fully interactive environment, as users experience in the updated Demeo.
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May 2024Virtual (VR), augmented (AR), and mixed realities (MR) all fall under the umbrella of extended reality (XR) and are characterized by extending a user’s experience into different worlds via technology that simulates those realms. Although examples of technologies employing XR go back many decades, it was only in 1987 that the term “virtual reality” and in 1990 that “augmented reality” were coined; it wouldn’t be for another couple of decades that advances in XR technologies made “realities” more widely available and attractive across industries beyond their gaming. As described in a 2021 Forbes article, by 2020, XR had been adopted by industries as diverse as education, healthcare, and manufacturing and construction (Marr B. The fascinating history and evolution of extended reality (XR). Forbes. May 17, 2021. Available at forbes.com.)
In healthcare, currently, one of the main uses of XR occurs during surgery. A recent scoping review of hundreds of studies of the use of XR in surgery found the most evidence on VR for surgical training and preoperative preparation and on AR as a supplement to intraoperative guidance and imaging (Int Orthop. 2023;47:611-621). The authors note that technological advances in hardware and software are fueling the growth of XR-assisted surgery, making this technology more affordable, usable, well validated, and acceptable.
A 2023 systematic review of immersive technologies in medical education found that most studies reported on the use of VR and AR for surgical training and anatomical education, and that these immersive technologies were as effective as traditional teaching methods at generating positive learning outcomes and could be a more cost-effective way of teaching students (Med Sci Educ. 2023;33:275-286). Similar findings were reported in another systematic review showing that these immersive technologies for surgical training resulted in a substantial increase in surgical procedure ability scores and a decrease in surgery duration (Educ Res Rev. 2022;35:100429). The review highlighted the challenges to implementing immersive technologies in medical education, including the cost and technological assistance required, as well as the need for design improvements to minimize any detrimental effects these technologies might have on users, which can include dizziness.
Otolaryngology
Maya G. Sardesai, MD, MEd, associate professor and associate residency program director in the department of otolaryngology–head and neck surgery at the University of Washington School of Medicine in Seattle, said the use of XR in surgical training helps otolaryngologists learn difficult surgical tasks in a safe way without placing patients at risk and without the need for cadavers or animals. At her institution, she and colleagues incorporate VR into an annual boot camp for new residents to help them learn skull base anatomy. “The skull base can be complicated, with small spaces, and traditional approaches with computed tomography scans and scopes are limited because they offer only a two-dimensional view,” she said. With VR, “you get a better understanding and appreciation of this anatomy through a three-dimensional view that allows you to look inside the different spaces and see the nerves, blood vessels, and other tissues that lie within them,” she added.
With VR, “you get a better understanding and appreciation of this anatomy through a three-dimensional view that allows you to look inside the different spaces and see the nerves, blood vessels, and other tissues that lie within them.” —Maya G. Sardesai, MD, MEd