Many patients experience severe to excruciating acute pain during a wide range of medical procedures.  Excessive pain is an important medical problem that can have long term negative consequences for patients.  For example, children often find it scary to visit the dentist (cavities) or the doctor (needles and blood draws), and this early learning (aversive conditioning) can make the patients avoid healthcare.  For children severely burned in a fire, pain during physical therapy exercises, and pain during cleaning of severe burn wounds is often severe to excruciating, even when powerful pain medications such as ketamine are used.  Psychological factors such as fear, anxiety, expectations of pain can amplify/increase how much pain patients consciously experience.  Fortunately, a new psychological pain control technique, VR distraction, can greatly reduce pain.  There is growing evidence that immersive virtual reality can dramatically reduce how much pain patients experience during painful medical procedures.  Patient look into a pair of virtual reality goggles, and have the illusion of going into a 3D computer generated world called SnowWorld.  In SnowWorld, patients throw snowballs at snowmen, penguins, and other objects.  Virtual Reality gives patients the illusion of “being there” in SnowWorld instead of being in the hospital.  The patient’s attention is so distracted by “going into” virtual reality that their brains have less attention available to process incoming nociceptive signals from the pain receptors.  In clinical research studies, patients with severe burn injuries report large and significant reductions in pain during Virtual Reality, and report having significantly “more fun” during wound care during VR.  In addition to feeling less pain during VR, fMRI brain scan studies with healthy volunteers show large reductions in pain-related brain activity during virtual reality.  Developing new non-pharmacologic analgesics such as VR is an international priority for the future of medicine.

Traditionally, training in real environment is considered important for independence and successful community integration but often is given near the final stage of rehabilitation programmes. This talk will show case a few VR-based systems developed in Hong Kong, which target at assessment and training of patients with cognitive decline due to different pathologies. In a safe and near real-life environment, cognitive training can start even at the early stage and have demonstrated proven efficacy and effectiveness. With high generalization power of VR, together with activation of similar neural structure provided by the virtual environment and interaction activities, it is conductive for patients to apply learning to real environment and may reduce convalesce time. For instances, a VR-based prospective memory assessment has been developed with high validity and reliability for clinical use. VRehab is a computer-assisted rehabilitation system for patients to receive stimulation training, such as using public transport, mobile phones and ATMs as well as grocery shopping. A virtual boutique is a computer application on cognitive training, using a retailing boutique shop as the training scenario. Patients will assume the role of a sales person to carry out real-life tasks for training their attention, memory, executive function and problem solving abilities. Research findings indicated that they can better apply the skills they acquire in this training to their daily lives e.g. sales and problem solving. Another VR-based convenient shop has been developed to train more demanding cognitive skills such as prospective memory, execution and problem solving, as well as vocational skills for better employability of persons who have been limited from productive work due to cognitive deficits.

At the beginning of the presentation, we will discuss the current virtual reality (VR) technology in cinical and biomedical applications. We will demonstrate an example of using VR in medical simulation for type and screen training, which determines both the ABO-Rh of the patient and screens for the presence of the most commonly found unexpected antibodies. It involves a simple draw and laboratory test of a blood sample. There are a series of steps involving type and screen procedures. However, some medical staff members may overlook certain steps or conduct some steps unsuccessfully as many of these staff are overloaded and work under high pressure. Therefore, we have developed an integrative solution to provide blood taking training for medical staff members in a Hospital by using the latest VR technology. In the VR training program, medical staff members can navigate and interact without distractions in a safe and calm environment, which is difficult to find in the real environment. The VR training program not only provides opportunites for additional medical staff members practice repeatedly, but also eliminates training time and costs compared with traditional training method. The project outcome is expected to provide an interesting and effective training to thousands of medical staff members who require training in type and screen in Hong Kong. After the demonstration, we will also introduce the latest development of mixed reality (MR) and the future development of extended reality (xR). We will explore how the development of artificial intelligence (AI) technology can be integrated with VR in order to extend its application in the biomedical and clinical areas.

Patient safety is the cornerstone of high quality health-care service nowadays. Up to half of the adverse events in hospitals are preventable and many of the patient’s disability or death can be avoided with safe clinical practice. 
In order to optimize patient care, health-care professionals have to learn and develop both technical and non-technical skills. The tradition concept of “See One, Do One & Teach One” is no longer ideal in today’s health-care environment. Simulation training has been proven to shorten the learning curve and reduce human errors, and become a valuable tool in health-care training in recent years. 
With advancement of technology, we are inspired to develop a virtual reality program on a simple yet important clinical procedure. It offers novices a realistic environment for learning and an unlimited number of practices. Future development of virtual reality in medical training is going to offer huge opportunities in the fast-paced and high-pressure medical field.