Virtual Reality in Medicine
As recently as September 2019, reporters, scientists and health professionals have been discussing the role of virtual reality in medicine.1 Virtual reality, known as VR, is a contemporary technological experience that includes three-dimensional images that appear to be life-sized from the user’s perspective, as well as tracking of a user’s head and eye movements that allow the images displayed to reflect the change in perspective.2 VR devices are often described as head mounted displays, but VR simulations can exist in desktop or other visual forms.3 Notably, VR has been on the rise in medicine, either through rehabilitation and treatment1 or in education.4 Given the importance of technology to twenty-first century medicine, it is crucial to understand the role VR can play in health care.
For one, research has shown that VR can be effective in the treatment and rehabilitation of patients with various medical pathologies. Specifically, as found in a review by Li et al., it can be used for pain management for both acute and chronic pain by inhibiting pain signaling in key regions.5 VR can actually be more beneficial than real-life therapy for certain psychological diseases requiring exposure therapy, such as social anxiety.5 Another review by Pourmand et al. found that VR could be effective in neurocognitive diagnosis and physical rehabilitation as well as pain management.6 Two other reviews show that VR can benefit patients suffering from eating disorders7 or rehabilitating after a stroke.8 A recent study protocol even aimed to use VR, alongside smartphone technology, to motivate behavior change in adults with comorbid depression and obesity.9 However, despite the promising nature and various applications of VR, a recent systematic review by Dascal et al. shows that there is a lack of large, well-controlled studies to show its clinical and cost-effectiveness.10 While VR may have the potential to effect change in medical treatment, it remains unclear how practical or efficacious the technology will be in the long term.
In addition to its use in the treatment and rehabilitation of patients, VR has also become well-known for its role in medical education. While McGrath et al. explain the use of VR to assess competence in emergency medicine trainees,11 Kim et al. outline its part in plastic surgery education (particularly in planning, navigation and training).12 Li et al. also explore VR in training for laparoscopic, orthopedic and skull surgery.5 In their review, Freina and Ott list VR’s many roles in nursing, dental and medical education.4 Finally, in a 12-month randomized trial, Moro et al. placed anatomy students into learning modes with VR (with head mounted displays), augmented reality (AR; camera and screens with digital models) or tablet displays.13 The authors found no significant differences between mean assessment scores in VR, AR or tablet displays. Thus, as with VR in treatment and rehabilitation, VR in education must be further investigated to assess efficacy and best practices.
Given these data, VR clearly serves as an innovative technological advancement in medicine, and can have functions in both treatment and education. Nonetheless, future research—meaning longer-lasting, larger, better-controlled and higher-powered studies, along with cost analyses—is needed to truly assess the benefits of VR for health professionals, patients and the health care system.
1. Hobson K. The Case for a Course of Virtual Reality. US News & World Report: US News & World Report LP; September 4, 2019.
2. Strickland J. How Virtual Reality Works. HowStuffWorks.com. Online: InfoSpace Holdings; June 29, 2007.
3. Mazuryk T, Gervautz M. Virtual Reality: History, Applications, Technology and Future. Austria: Vienna University of Technology; 1996.
4. Freina L, Ott M. A literature review on immersive virtual reality in education: State of the art and perspectives. Paper presented at: The International Scientific Conference eLearning and Software for Education 2015.
5. Li L, Yu F, Shi D, et al. Application of virtual reality technology in clinical medicine. American Journal of Translational Research. 2017;9(9):3867–3880.
6. Pourmand A, Davis S, Lee D, Barber S, Sikka N. Emerging Utility of Virtual Reality as a Multidisciplinary Tool in Clinical Medicine. Games for Health Journal. 2017;6(5):263–270.
7. Riva G. Letter to the Editor: Virtual reality in the treatment of eating and weight disorders. Psychological Medicine. 2017;47(14):2567–2568.
8. Laver K, George S, Thomas S, Deutsch JE, Crotty M. Virtual reality for stroke rehabilitation: an abridged version of a Cochrane review. European Journal of Physical and Rehabilitation Medicine. 2015;51(4):497–506.
9. Williams LM, Pines A, Goldstein-Piekarski AN, et al. The ENGAGE study: Integrating neuroimaging, virtual reality and smartphone sensing to understand self-regulation for managing depression and obesity in a precision medicine model. Behaviour Research and Therapy. 2018;101:58–70.
10. Dascal J, Reid M, IsHak WW, et al. Virtual Reality and Medical Inpatients: A Systematic Review of Randomized, Controlled Trials. Innovations in Clinical Neuroscience. 2017;14(1-2):14–21.
11. McGrath JL, Taekman JM, Dev P, et al. Using Virtual Reality Simulation Environments to Assess Competence for Emergency Medicine Learners. Academic Emergency Medicine. 2018;25(2):186–195.
12. Kim Y, Kim H, Kim YO. Virtual Reality and Augmented Reality in Plastic Surgery: A Review. Archives of Plastic Surgery. 2017;44(3):179–187.
13. Moro C, Štromberga Z, Raikos A, Stirling A. The effectiveness of virtual and augmented reality in health sciences and medical anatomy. Anatomical Sciences Education. 2017;10(6):549–559.