Low-Cost, Case-Based Ultrasound Training Utilizing Immersive Virtual Reality

Document Type

Conference Proceeding

Publication Date

4-20-2023

Publication Title

Acad Emerg Med

Abstract

Intro/Background: With the cost of entry into the immersive virtual reality (IVR) environment significantly decreasing the opportunity to use open-source solutions to create unique learning opportunities continues to improve. Most of the literature utilizes dedicated IVR applications, but these come with a price. By utilizing free drawing applications with collaborative capabilities, educators can create a virtual classroom where they can bring in their own digital material and overlay live drawings similar to traditional chalk talks. Purpose/Objective: Demonstrate a low cost to entry virtual learning environment that can be done completely remote with multiple users in a virtual collaborative classroom utilizing Gravity Sketch. Learners can see each other's headsets and hands, communicate, discuss cases, free draw and manipulate objects, and then take traditional 2D ultrasound images/clips and explain the 3D structures. In addition, advanced concepts and calculations such as cardiac output (CO) calculation with VTI/LVOTd/HR can be demonstrated with visual descriptions. Methods: One faculty and two residents utilized the Meta Quest 2 to connect into a multiuser classroom with the free application Gravity Sketch. Deidentified images of the case (vignette, vitals, labs, CXR, EKG, ultrasound) were uploaded into the environment prior to the session as well as object files. After a brief orientation the case was reviewed live in the virtual classroom. Users were able to draw to explain concepts, and point out abnormalities. Outcomes (if available): Successful implementation of a IVR learning session. Users were effectively able to interact with each other, communicate clearly, and draw/discuss the case including cardiac output calculation. The session was recorded from the HUD of the instructor, and this was later edited to a 2D instructional video that was shared with additional learners. The option also existed to live stream this encounter to a computer which could be shared via any video teleconferencing communication platform. Summary: Immersive virtual reality classrooms are feasible learning environments and allow for the ability to perform small group live sessions with an instructor completely remote. By using Gravity Sketch, which is a free application, the cost to entry is that of a Meta Quest headset at less than $500 USD per unit, and an internet connection. No additional computing power or tethering is needed in this workflow. We focused on an ultrasound case as the images generated are in 2 dimensions, while the structure being scanned exists in 3 dimensions. We could then take that ultrasound image and draw out of or into the screen to recreate that 3D structure from the image we are used to interpreting. We believe this potentially could improve learners visuospatial understanding of anatomy and pathology, and in turn improve quality of image acquisition and interpretation on real patients. Advanced cardiac output calculations can be explained in a new way that may make it more memorable and easier to understand. It also is an exciting and engaging way to run a small group and allow for individual creativity to flourish. All users were able to draw their own ultrasound probe and the plane that it creates and use that probe to demonstrate on an open skeleton/ cardiac model the correct location to obtain specific cardiac views on ultrasound. While the focus of this session was primarily on an ultrasound case, this concept can be applied to any topic of training in any specialty. By allowing for multiple users in remote environments to still be able to have a live interactive small group session, this brings an opportunity to break down barriers of access to expert instruction anywhere in the world.

Volume

30

First Page

423

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