Diminishing restrictive practices in psychiatric wards via virtual reality training:Old wine in a new bottle?

This editorial examines the application of virtual reality(VR)training to mitigate restrictive practices(RPs)within psychiatric facilities.RPs include physical restraints,seclusion,and chemical restraints,used to ensure patient safety but with varying usage rates across regions.In recent years,there has been a growing focus on the adverse effects of RPs on both healthcare workers and patients,leading to calls for its reduction.Previous research has shown the efficiency of VR training in RP reduction.This editorial will analyze the limitations of VR training in prior research aimed at reducing RP,emphasizing that the essence of RPs is a medical safety issue,calling for careful differentiation of the causes of RPs,and avoiding the use of AR technology as a"new bottle"for"old wine"to improve the quality and reproducibility of future research in this field.

Towards engineering a portable platform for laparoscopic pre-training in virtual reality with haptic feedback

Background Laparoscopic surgery is a surgical technique in which special instruments are inserted through small incision holes inside the body.For some time,efforts have been made to improve surgical pre training through practical exercises on abstracted and reduced models.Methods The authors strive for a portable,easy to use and cost-effective Virtual Reality-based(VR)laparoscopic pre-training platform and therefore address the question of how such a system has to be designed to achieve the quality of today's gold standard using real tissue specimens.Current VR controllers are limited regarding haptic feedback.Since haptic feedback is necessary or at least beneficial for laparoscopic surgery training,the platform to be developed consists of a newly designed prototype laparoscopic VR controller with haptic feedback,a commercially available head-mounted display,a VR environment for simulating a laparoscopic surgery,and a training concept.Results To take full advantage of benefits such as repeatability and cost-effectiveness of VR-based training,the system shall not require a tissue sample for haptic feedback.It is currently calculated and visually displayed to the user in the VR environment.On the prototype controller,a first axis was provided with perceptible feedback for test purposes.Two of the prototype VR controllers can be combined to simulate a typical both-handed use case,e.g.,laparoscopic suturing.A Unity based VR prototype allows the execution of simple standard pre-trainings.Conclusions The first prototype enables full operation of a virtual laparoscopic instrument in VR.In addition,the simulation can compute simple interaction forces.Major challenges lie in a realistic real-time tissue simulation and calculation of forces for the haptic feedback.Mechanical weaknesses were identified in the first hardware prototype,which will be improved in subsequent versions.All degrees of freedom of the controller are to be provided with haptic feedback.To make forces tangible in the simulation,characteristic values need to be determined using real tissue samples.The system has yet to be validated by cross-comparing real and VR haptics with surgeons.

Tree: Reducing the use of restrictive practices on psychiatric wards through virtual reality immersive technology training

BACKGROUND Restrictive practices(RPs)are defined by measures linked to physical and chemical restraints to reduce the movement or control behaviours during any emergency.Seclusion is an equal part of RPs intended to isolate and reduce the sensory stimulation to safeguard the patient and those within the vicinity.Using interventions by way of virtual reality(VR)could assist with reducing the need for RPs as it could help reduce anxiety or agitation by way of placing users into realistic and immersive environments.This could also aid staff to and change current RPs.AIM To assess the feasibility and effectiveness of using a VR platform to provide reduction in RP training.METHODS A randomised controlled feasibility study,accompanied by evaluations at 1 month and 6 months,was conducted within inpatient psychiatric wards at Southern Health National Health Service Foundation Trust,United Kingdom.Virti VR scenarios were used on VR headsets to provide training on reducing RPs in 3 inpatient psychiatric wards.Outcome measures included general self-efficacy scale,generalised anxiety disorder assessment 7(GAD-7),Burnout Assessment Tool 12,the Everyday Discrimination Scale,and the Compassionate Engagement and Action Scale.RESULTS Findings revealed statistically significant differences between the VR and treatment as usual groups,in the Everyday Discrimination Scale items Q8 and Q9:P=0.023 and P=0.040 respectively,indicating higher levels of perceived discrimination in the VR group.There were no significant differences between groups in terms of general self-efficacy,generalised anxiety disorder assessment 9,and Burnout Assessment Tool 12 scores.A significant difference was observed within the VR group for compassionate engagement from others(P=0.005)over time.Most respondents recorded System Usability Scale scores above 70,with an average score of 71.79.There was a significant reduction in rates of RPs in the VR group vs treatment as usual group with a fluctuating variability observed in the VR group likely due to external factors not captured in the study.CONCLUSION Ongoing advancement of VR technology enables the possibility of creating scenarios and simulations tailored to healthcare environments that empower staff by providing more comprehensive and effective training for handling situations.

Virtual reality tools for training in gastrointestinal endoscopy:A systematic review

BACKGROUND Virtual reality(VR)has emerged as an innovative technology in endoscopy training,providing a simulated environment that closely resembles real-life scenarios and offering trainees a valuable platform to acquire and enhance their endoscopic skills.This systematic review will critically evaluate the effectiveness and feasibility of VR-based training compared to traditional methods.AIM To evaluate the effectiveness and feasibility of VR-based training compared to traditional methods.By examining the current state of the field,this review seeks to identify gaps,challenges,and opportunities for further research and implementation of VR in endoscopic training.METHODS The study is a systematic review,following the guidelines for reporting systematic reviews set out by the PRISMA statement.A comprehensive search command was designed and implemented and run in September 2023 to identify relevant studies available,from electronic databases such as PubMed,Scopus,Cochrane,and Google Scholar.The results were systematically reviewed.RESULTS Sixteen articles were included in the final analysis.The total number of participants was 523.Five studies focused on both upper endoscopy and colonoscopy training,two on upper endoscopy training only,eight on colonoscopy training only,and one on sigmoidoscopy training only.Gastrointestinal Mentor virtual endoscopy simulator was commonly used.Fifteen reported positive results,indicating that VR-based training was feasible and acceptable for endoscopy learners.VR technology helped the trainees enhance their skills in manipulating the endoscope,reducing the procedure time or increasing the technical accuracy,in VR scenarios and real patients.Some studies show that the patient discomfort level decreased significantly.However,some studies show there were no significant differences in patient discomfort and pain scores between VR group and other groups.CONCLUSION VR training is effective for endoscopy training.There are several well-designed randomized controlled trials with large sample sizes,proving the potential of this innovative tool.Thus,VR should be more widely adopted in endoscopy training.Furthermore,combining VR training with conventional methods could be a promising approach that should be implemented in training.

Research on the Dual-Creation Talent Training Model of New Energy Automobile Based on Virtual Simulation

At present,as China vigorously develops new energy automobiles,the social demand for related talents has increased significantly,so the relevant institutions need to optimize and adjust the talent training mode to help the development of new energy automobiles.This paper summarizes the existing problems of China’s new energy automobile talent training mode,and analyzes the significance of the virtual simulation-based dual-creation talent training mode of new energy automobile and its specific implementation strategies,in order to provide references for the relevant personnel.

Research on the Design and Application of Virtual and Real Integrated Training Platform Based on Intelligent Manufacturing

In this paper,we built a robot training platform using virtual simulation software,and the robot assembly,handling,and palletizing were realized.The workstation includes an industrial robot,gas control unit,track function module,assembly function module,palletizing function module,vision module,etc.,and robot movement is achieved through language programming.The platform provides conditions for the practical ability training of application-oriented talents.

Understanding the effects of structured self-assessment in directed,self-regulated simulation-based training of mastoidectomy:A mixed methods study

Objective:Self-directed training represents a challenge in simulation-based training as low cognitive effort can occur when learners overrate their own level of performance.This study aims to explore the mechanisms underlying the positive effects of a structured self-assessment intervention during simulation-based training of mastoidectomy.Methods:A prospective,educational cohort study of a novice training program consisting of directed,self-regulated learning with distributed practice(5x3 procedures)in a virtual reality temporal bone simulator.The intervention consisted of structured self-assessment after each procedure using a rating form supported by small videos.Semi-structured telephone interviews upon completion of training were conducted with 13 out of 15 participants.Interviews were analysed using directed content analysis and triangulated with quantitative data on secondary task reaction time for cognitive load estimation and participants’self-assessment scores.Results:Six major themes were identified in the interviews:goal-directed behaviour,use of learning supports for scaffolding of the training,cognitive engagement,motivation from self-assessment,selfassessment bias,and feedback on self-assessment(validation).Participants seemed to self-regulate their learning by forming individual sub-goals and strategies within the overall goal of the procedure.They scaffolded their learning through the available learning supports.Finally,structured self-assessment was reported to increase the participants’cognitive engagement,which was further supported by a quantitative increase in cognitive load.Conclusions:Structured self-assessment in simulation-based surgical training of mastoidectomy seems to promote cognitive engagement and motivation in the learning task and to facilitate self-regulated learning.

Mechanism of Kinect-based virtual reality training for motor functional recovery of upper limbs after subacute stroke

The Kinect-based virtual reality system for the Xbox 360 enables users to control and interact with the game console without the need to touch a game controller, and provides rehabilitation training for stroke patients with lower limb dysfunctions. However, the underlying mechanism remains un- clear. In this study, 18 healthy subjects and five patients after subacute stroke were included. The five patients were scanned using functional MRI prior to training, 3 weeks after training and at a 12-week follow-up, and then compared with healthy subjects. The FugI-Meyer Assessment and Wolf Motor Function Test scores of the hemiplegic upper limbs of stroke patients were significantly increased 3 weeks after training and at the 12-week follow-up. Functional MRI results showed that contralateral primary sensorimotor cortex was activated after Kinect-based virtual reality training in the stroke patients compared with the healthy subjects. Contralateral primary sensorimotor cortex, the bilateral supplementary motor area and the ipsilateral cerebellum were also activated during hand-clenching in all 18 healthy subjects. Our findings indicate that Kinect-based virtual reality training could promote the recovery of upper limb motor function in subacute stroke patients, and brain reorganization by Kinect-based virtual reality training may be linked to the contralateral sen- sorimotor cortex.

Head-mounted display-based intuitive virtual reality training system for the mining industry

Virtual reality(VR) training technology in the mining industry is a new field of research and utilization.The successful application of VR training system is critical to mine safety and production. Through the statistics of the current research and applications of VR training systems in mining industry, all the input/output devices are classified. Based on the classifications of the input/output devices that are used in the VR system, the current VR training systems for the mining industry could be divided into three types: screen-based general type, projector-based customized type, and head-mounted display(HMD)-based intuitive type. By employing a VR headset, a smartphone and a leap motion device, an HMDbased intuitive type VR training system prototype for drilling in underground mines has been developed.Ten trainees tried both the HMD-based intuitive system and the screen-based general control system to compare the experiences and training effects. The results show that the HMD-based system can give a much better user experience and is easy to use. Three of the five components of a VR training system,namely, the user, the tasks, and software and database should be given more attention in future research.With more available technologies of input and output devices, VR engines, and system software, the VR training system will eventually yield much better training results, and will play a more important role in as a training tool for mine safety.

Virtual reality simulators for gastrointestinal endoscopy training

The use of simulators as educational tools for medical procedures is spreading rapidly and many efforts have been made for their implementation in gastrointestinal endoscopy training. Endoscopy simulation training has been suggested for ascertaining patient safety while positively influencing the trainees' learning curve. Virtual simulators are the most promising tool among all available types of simulators. These integrated modalities offer a human-like endoscopy experience by combining virtual images of the gastrointestinal tract and haptic realism with using a customized endoscope. From their first steps in the 1980s until today, research involving virtual endoscopic simulators can be divided in two categories: investigation of the impact of virtual simulator training in acquiring endoscopy skills and measuring competence. Emphasis should also be given to the financial impact of their implementation in endoscopy, including the cost of these state-of-theart simulators and the potential economic benefits from their usage. Advances in technology will contribute to the upgrade of existing models and the development of new ones; while further research should be carried out to discover new fields of application.

The Effects of Simulation-Based Learning Using Virtual Reality in Nursing Student:A Meta-Analysis

Purpose:This study is a meta-analysis to assess the effect of simulation-based learning using virtual reality(VR)on knowledge,affective,and performance domain outcomes of learning in nursing students.Methods:A literature search was conducted using Cochrane library,PubMed,EMBASE,Web of Science,ProQuest,ScienceDirect,Springer and Ovid eight electronic English databases,independently by 2 of the authors from January 2008 to December 2018.The RevMan 5.3 program of the Cochrane library was used to analyze the data with mean and standardized differences.Results:A total of 10 studies(5 randomized control trials(RCTs)and 5 non-RCTs)involved 630 nursing students.As a whole,simulation-based learning using VR appeared to have beneficial effects on the knowledge(I2=50%,95%CI 0.35[0.09,0.62],P=0.009),have no significant difference on the performance(I2=97%,95%CI 1.05[-0.54,2.63],P=0.19)and have a negative impact on the affective field(I2=0%,95%CI-0.43[-0.71,-0.15],P=0.003).Conclusion:The existing evidences imply that simulation-based learning using VR might have a positive trend that is beneficial to knowledge and clinical skill acquisition.However,the best way of integration still needs further research to be identified.

The application of virtual reality training for anastomosis during robot-assisted radical prostatectomy

Objective:To investigate the application of virtual reality training in vesicourethral anastomosis during robot-assisted radical prostatectomy(RARP).Methods:Three certified robotic urologists who underwent virtual reality training were enrolled in the study group.The other three without training were enrolled in the control group.Parameters were recorded before and after the training.Then a total of 18 patients undergoing RARP were enrolled and randomized assigned to receive anastomosis procedures with certified urologists who either obtained or did not obtain training.The quality of the anastomosis was evaluated.Results:For the virtual training evaluation,the overall score was significantly improved from 65.0±10.8 to 92.7±3.5(p=0.014);the time of anastomosis was shortened;the economy of motion improved;instrument collisions decreased after training(p<0.05).Besides,the effectiveness of the virtual training was evaluated in the 18 real anastomosis procedures which were completed either by three urologists with training or three urologists without training.Most intriguingly,the average time of anastomosis was shortened from 40.0±12.4 min to 25.1±7.1 min(p=0.015).The parameters including time of operation,creatinine level of drainage,postoperative hospital stay and duration of catheter drainage were comparable before and after training.Two leakages,which were observed in procedures by doctors without training,needed salvage sutures by a senior doctor.Conclusions:Virtual reality training enabled surgeons to become quickly familiar with robotic system manipulation,improved their skills for vesicourethral anastomosis and shortened the learning curve,thus helping them operate with high efficacy and quality.

Virtual reality for immersive multi-user firefighter-training scenarios

Background Virtual reality(VR)applications can be used to provide comprehensive training scenarios that are difficult or impossible to represent in physical configurations.This includes team training for emergency services such as firefighting.Creating a high level of immersion is essential for achieving effective virtual training.In this respect,motion-capture systems offer the possibility of creating highly immersive multi-user training experiences,including full-body avatars.Methods This study presents a preliminary prototype that helps extin-guish a virtual fire on a container ship as a VR training scenario.The prototype provides a full-body and multi-user VR experience based on the synthesis of position data provided by the motion-capture system and orientation data from the VR headsets.Moreover,the prototype facilitates an initial evaluation of the results.Results The results confirm the value of using VR for training procedures that are difficult to implement in the real world.Furthermore,the results show that motion-capture-based VR technologies are particularly useful for firefighting training,in which participants can collaborate in difficult-to-access environments.However,this study also indicates that increasing the immersion in such training remains a challenge.Conclusions This study presents a prototypical VR application that enables the multi-user training of maritime firefighters.Future research should evaluate the initial results,provide more extensive training scenarios,and measure the training progress.

Virtual reality simulation in training endoscopic skills: A systematic review

Objective:Training young physicians in gastrointestinal endoscopy through virtual reality(VR)simulators has become popular.It is important to evaluate the benefits and usefulness of this technology for teaching endoscopic skills.The objective of this literature review is to understand the benefits of VR technology through quantitative and qualitative examination of learning outcomes.Methods:A literature search of 7 databases was conducted.Studies which compared the effects of learning through VR simulation and another method of learning were included.In addition,studies were included if they evaluated learning outcomes on clinical patients.Participants could be medical residents,fellows,physicians,or nurses.Common outcomes measured across studies included subjective overall performance scores,total procedure times,rate of successful procedure completion,error rates,patient pain or discomfort,and measures of independence.Results:A total of 22 studies were included.Overall,VR simulation training was seen to be comparable or significantly better than clinical training,no training,other types of simulation,and another form of VR training.Many authors reported increasing patient safety,reducing stress and time constraints,and shortening the learning curve as advantages of VR simulation training.However,this form of training is also expensive and may result in the learning of bad habits.Conclusion:VR simulation technology can be a valuable form of educating endoscopy novices if properly supervised during training,and if there is also integration of clinical training.

Application and Design of Virtual Reality Technology in Railway Maintenance Training

Virtual reality technology is a brand new comprehensive information technology emerging during the end of 21 st century. In recent years in particular, it gains rapid development, involving industries like education, industry, military, entertainment and medicine. Combined with the characteristics of railway maintenance training, this thesis proposes the application of virtual reality in courseware, distance education, locomotive simulation driving, locomotive overhauling oil and breakdown processing, and illustrates key technology and solution of the exploitation of virtual reality technology.

Virtually coupled train set control subject to space-time separation:A distributed economic MPC approach with emergency braking configuration

The emerging virtual coupling technology aims to operate multiple train units in a Virtually Coupled Train Set(VCTS)at a minimal but safe distance.To guarantee collision avoidance,the safety distance should be calculated using the state-of-the-art space-time separation principle that separates the Emergency Braking(EB)trajectories of two successive units during the whole EB process.In this case,the minimal safety distance is usually numerically calculated without an analytic formulation.Thus,the constrained VCTS control problem is hard to address with space-time separation,which is still a gap in the existing literature.To solve this problem,we propose a Distributed Economic Model Predictive Control(DEMPC)approach with computation efficiency and theoretical guarantee.Specifically,to alleviate the computation burden,we transform implicit safety constraints into explicitly linear ones,such that the optimal control problem in DEMPC is a quadratic programming problem that can be solved efficiently.For theoretical analysis,sufficient conditions are derived to guarantee the recursive feasibility and stability of DEMPC,employing compatibility constraints,tube techniques and terminal ingredient tuning.Moreover,we extend our approach with globally optimal and distributed online EB configuration methods to shorten the minimal distance among VCTS.Finally,experimental results demonstrate the performance and advantages of the proposed approaches.

Multimodal teaching,learning and training in virtual reality:a review and case study

It is becoming increasingly prevalent in digital learning research to encompass an array of different meanings,spaces,processes,and teaching strategies for discerning a global perspective on constructing the student learning experience.Multimodality is an emergent phenomenon that may influence how digital learning is designed,especially when employed in highly interactive and immersive learning environments such as Virtual Reality(VR).VR environments may aid students'efforts to be active learners through consciously attending to,and reflecting on,critique leveraging reflexivity and novel meaning-making most likely to lead to a conceptual change.This paper employs eleven industrial case-studies to highlight the application of multimodal VR-based teaching and training as a pedagogically rich strategy that may be designed,mapped and visualized through distinct VR-design elements and features.The outcomes of the use cases contribute to discern in-VR multimodal teaching as an emerging discourse that couples system design-based paradigms with embodied,situated and reflective praxis in spatial,emotional and temporal VR learning environments.

A virtual reality based surgical skills training simulator for catheter ablation with real-time and robust interaction

Background Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia that can cause severe heart problems.Catheter ablation is one of the most ideal procedures for the treatment of AF.Physicians qualified to perform this procedure need to be highly skilled in manipulating the relevant surgical devices.This study proposes an interactive surgical simulator with high fidelity to facilitate efficient training and low-cost medical education.Methods We used a shared centerline model to simulate the interaction between multiple surgical devices.An improved adaptive deviation-feedback approach is proposed to accelerate the convergence of each iteration.The periodical beating of the human heart was also simulated in real time using the position-based dynamics(PBD)framework to achieve higher fidelity.We then present a novel method for handling the interaction between the devices and the beating heart mesh model.Experiments were conducted in a homemade simulator prototype to evaluate the robustness,performance,and flexibility of the proposed method.Preliminary evaluation of the simulator was performed by medical students,residents,and surgeons.Results The interaction between surgical devices,static vascular meshes,and beating heart mesh was stably simulated in a frame rate suitable for interaction.Conclusion Our simulator is capable of simulating the procedure of catheter ablation with high fidelity and provides immersive visual experiences and haptic feedback.

Development of a plastic injection molding training system using Petri nets and virtual reality

In this study, Virtual Reality (VR)-based plastic injection molding training system (VPIMTS), which can be modeled as an integrated system with a task planning module, an intelligent instruction module, a simulation module, and virtual envi-ronment (VE) module, was developed. Presented in this paper are an architecture of VPIMTS, a practical knowledge modelling approach for modelling the training scenarios of the system by using Petri nets formalism and key techniques (FEM, injection molding procedure modelling) which have been developed independently. The utilization of the Petri net model realized the environment where the trainee can behave freely, and also made it possible to equip the system with the function of showing the next action of the trainee whenever he wants. The overall system is a powerful approach for highly improving the trainee’s comprehension and injection molding study-efficiency by building digital, intelligent, knowledgeable, and visual aids.

The Relationship between Presence and Performance in Virtual Simulation Training

The use of virtual simulation-based training continues to expand, as organizations explore alternative methods to reduce the cost of training. While virtual simulation has been empirically validated to be effective in the transfer of skills to the live environment, what is still unknown is what effect, if any, that an individual’s sense of presence in the simulation has on their performance. In this paper, we examine the relationship between presence and performance while performing a psychomotor task in a virtual environment. The independent variables were visual display and expertise level. The dependent variables were presence and performance. We found evidence of a moderate relationship between the degree of presence experienced in the simulation and an individual’s performance over three training trials. Results of this study may inspire future research to investigate whether higher presence in virtual simulation results in higher performance.