Monday 28 November 2016

Critical review MMc502 (2500 word essay)

The possibilities of the distant and near future of VR in medicine and education and the effect it could have on society. 




In this research essay I will study the research into virtual reality (VR) and its future possibilities within medicine and education. “In a not-too-distant future, as VR technologies advance at a steady pace and become embedded in our lives, we may one day look back with a sense of amazement at students once bound to a physical classroom, campus setting, locale, or even place in time.” (Sinclair and Gunhouse, 2016). 


The future of virtual reality is clearly a highly exciting topic to ponder; in this essay I will look at new up-and-coming ways in which VR is utilised to benefit human beings, what the distant future could look like and where society will be with this promising technology. Could VR help cure our phobias? Could the use of VR help future scientists and doctors understand and cure cancer? Could the next generation be educated and trained with VR and perhaps grow up to one day change the course of humanity? 


The thought of these possibilities are truly exhilarating. While scientists and programmers have explored the possibilities of VR since the 1960s, 2015 marked the first time that VR hit the mainstream. Facebook CEO Mark Zuckerberg purchased Oculus Rift (the leading company in manufacturing VR) for $2 billion in March 2015, and by looking at how far Facebook has come since it was created by Zuckerberg, (GOOGLE, February 4, 2004) and its growth in the last year alone (‘$27 billion in revenue this year’ according to The Wall Street Journal), expectations for the future of Oculus are high. There are numerous other companies beginning to utilise this technology; you can watch movies in VR, live news events in VR and even hold face to face meetings. You can literally take people from opposite sides of the world and put them in the same room with virtual reality without using up any jet fuel. The market speaks for itself: "VR expected to grow to a $15.9 billion industry by 2019. The market for hardware, networks, software and content will reach $200 billion by 2020." (Reede and Bailiff, 2016). So will VR change the world as we know it? The reality has been a little less impressive so far, but with companies like Facebook and Microsoft pouring millions into these companies, could virtual reality break out of the misconception that it is just for gaming or watching movies and actually change how we live?


Recently, technology has been developed that could help paralysed people improve their physical conditions. A study by Donati et al. (2016) investigated the effects of brain-machine interface (BMI) training (which involved  VR training) on eight paraplegic patients with chronic spinal cord injury. After one year, all participants showed some improvement in sensation and 50% subsequently improved their classification from complete to incomplete paraplegia. Dr. Miguel Nicolelis, a neuroscientist involved with this study, has worked for up to 20 years to build and master these systems that record hundreds of simultaneous signals from the brain, and extract motor commands and translate them into movement. The encouraging results from the above study have led the authors to suggest that weekly training as part of rehabilitation could help patients re-engage and rekindle spinal cord nerves that survived the impact of car crashes, falls and other paralysing traumas. These studies are ground breaking and could revolutionise physiotherapy, making it possible for humans to recover from the most devastating of injuries. 


Elsewhere at the Medical Centre for Neurosurgery at the University of California, Los Angeles, the chair of neurosurgery Dr. Neil Martin is using VR on a different level. He is instead using it to help train and prepare his surgeons before they operate on patients. He uses the HTC Vive virtual reality headset to treat patients by stepping into the subversive world and looking at stacked 2D MRI scans that come together to make a 3 dimensional model of anatomy, i.e. a brain or lung. Using the head set he can submerge himself into the 3D model of his patients' brains and get a closer look at any abnormalities or tumours, allowing him to identify which tissues need to be removed and which structures need to be saved, as well as any issues which may arise during surgery (Santa Maria, 2016). He is able to pre-meditate surgery more effectively, and since the technology has been developed mortality rates have dropped in the last 12 months from 19% to 1%, a 99% success rate in brain tumour removal surgeries. “Virtual reality gives you that understanding of your entire 180 or even 360-degree anatomy that is impossible to get with any other technique”. “In 10 minutes, 15 minutes, I can see the critical issues that I’ve got in mind that have to be dealt with, and historically this took 10 or 20 years of experience” (Martin, 2016, cited by Santa Maria, 2016).


Other ideas have been developed recently. McGhee et al. (2016), from the 3D Visualisation Aesthetics Lab, UNSW Australia, explored the visualisation of nanotechnology in order to further understand the behaviour of cancer cells. Their idea is that chemists and cell biologists can use virtual reality to get a better understanding of the microscopic environments they are researching and engineering in. For instance, they can watch virtual simulations of the different ways in which nanoparticle drugs are absorbed by cancer cells, potentially helping chemists in the drug-design process. They can immerse themselves into a human body and explore anatomy using a virtual reality head set. With this technology, doctors and scientists can test cancer cells virtually to see how they react under certain circumstances; this has the potential to bring about some groundbreaking discoveries resulting in a wide range of cancer treatments. The software is yet to be released but the potential of this idea speaks for itself and its effects could reach out further than cancer. It could cover a wide variety of illnesses and diseases, including exploration of the effects of HIV on cells in the body and how the virus shuts down the immune system and causes the body to lose the ability to fight infections. This technology could lead to a new understanding of diseases and could change the way doctors and surgeons are trained. 


VR is also being used to treat PTSD in ex army veterans. "I have no question that Oculus will revolutionise virtual reality for clinical purposes", according to Dr. Albert Rizzo, a research scientist at the University of California's Institute for Creative Technologies (ICT) (Maguire, 2014). Dr Rizzo is using the technology to recreate battle field scenarios from Iraq and Afghanistan. Rizzo can recreate the same events where soldiers were actually injured. The technology also helps patients with other trauma too and is not just limited to related traumas; he says the programme is like "an emotional obstacle course". Dr Rizzo has also created a virtual therapist that ask patients personal questions. The virtual therapist can converse with a patient just like a human but because it is not a real person, patients are more likely to open up about deeper issues and therefore are more likely to get a positive outcome from the counselling. “This is like the birth of a new way of doing things with technology” (Rizzo, 2014, cited Maguire, 2014). This method is a type of exposure therapy, which has been researched for over a decade since 1993. The first known comprehensive control study on the effectiveness of VRT (Virtual Reality Therapy) in the treatment of psychological disorders was conducted by North and North (1994). In this study, the researchers assessed the effectiveness of virtual reality in the treatment of agoraphobia (anxiety)”. (Luiselli and Fischer, 2016).


Educational software is being developed for VR. ‘The Body VR’ are developing simulations that will aid in the process of medical education for surgeons and physicians. “Seeing the human body in VR will allow radiologists to quickly understand the subtleties of an anatomical system, compare them to traditional CT & MRI scans, and remember the details of each part of the anatomy.” (The Body VR, 2016).  The Body will take the user inside the human body, travel through the bloodstream and understand how blood cells spread oxygen through the body. You can enter a living cell and learn how the body fights deadly viruses. Surgeons will be able to attend/perform ‘virtual operations’ without being in the operating theatre. Physicians will be able to visualise the actions of specific drugs in virtual reality. This software is soon to be realised and could change the way medicine is taught and practiced, redefining healthcare and education.  The future of education is going to involve virtual space so what impact will virtual reality make on the learning process? ‘Mission V’ is a company that are beginning to create immersive leaning experiences for children. The company is providing a ‘highly creative, totally immersive, game based learning environment for schools’. Mission V encourages students to connect and collaborate in a 3D world of their making. “We are getting ready to take the next step by supporting schools that will invest in head-mounted displays like the Oculus Rift,”  “We are in no doubt now that virtual reality will become an ever more important part of education”. (Corbett, 2014, cited Abrosimova, 2014). The ability to gain practical knowledge to the classroom without leaving it really makes immersive education an invaluable experience. Rather than being stuck in class listening to lectures, students can get real life experiences. “Students need inspiration and encouragement to keep exploring the potential of education for their own capabilities. Engagement that virtual reality can produce will eventually veer students’ desire for exploration more toward intellect and away from play” (Wild, 2016).  “The pedagogies of constructivism and game-based learning show that children learn best by doing or by being,” said Corbett (Abrosimova, 2014). “So they shouldn’t just read about history — they should ‘be’ historians. They shouldn’t just study archaeology — they should ‘be’ archaeologists.” 


Across the world, classrooms have been educating the next generation , with students using tablets in class and learning programming from a young age . VR is the next step in this direction. ENGAGE is a VR Immersive education company that recreate everyday and historical experiences through VR. The company's hope is that children can learn about historical events such as the Apollo 11 moon landings though immersive VR and by actually experiencing it, rather than just reading about it in a text book. ENGAGE is also a presentation platform and multi-user social learning platform, where educators will be given the tools to create their own immersive learning experiences, potentially transforming how educational content is delivered to their students and allowing people to connect in a more natural way over long distances by placing people together in a virtual classroom. ENGAGE also integrates with Dropbox, Google Drive and Youtube, allowing the easy sharing of documents and media.  


In conclusion, throughout history there have been major fundamental changes in society which have dramatically affected the way people live globally. A number of agricultural revolutions triggered shifts in food production. Before these we lived as hunter gathers and were much less efficient, with small amounts of people feeding other small amounts of people. Following the first agricultural revolution, we started farming, planting large amounts of seeds to produce crops to feed the masses and society gained a great efficiency, arguably for the first time. It took fewer people to feed a greater number of people and signalled a huge shift in society. The industrial revolution, which began in the late 18th century, again led to a significant change in society. We went from one or two people working to produce a chair or clothing, to producing goods at a much faster rate. Although we became more efficient, we ran into a problem. If someone owned a factory or a mill, they would require employees to share knowledge with and to train. But how? We developed a need for universal education, meaning people gained greater skills and knowledge which leads us to where we are today and the next revolution - the ‘information revolution’. With companies and corporations like Google and Facebook, it has never been easier to gather and share information. What takes us maybe minutes to research now using the internet could have taken us decades without it. So think of the next generation; if we give them tools such as Google or VR to learn with then we could potentially make another fundamental change in society, where maybe everyone is educated in a way that meets their individual needs and learning styles. This could push everyone to reach their absolute potential, and if that generation came together as a community then the human race would have again gained even more efficiency and could perhaps have the ability and tools to solve the issues that are a currently a threat to humanity, such as climate change and disease. 









Table of Contents 

Abrosimova, K. (2014) 5 ways virtual reality will change education. Available at: http://www.hypergridbusiness.com/2014/09/5-ways-virtual-reality-will-change-education/ [Accessed: 24 November 2016].


Donati, A. R. C., Shokur, S., Morya, E., Campos, D. S. F., Moioli, R. C., Gitti, C. M., Augusto, P. B., Tripodi, S., Pires, C. G., Pereira, G. A., Brasil, F. L., Gallo, S., Lin, A. A., Takigami, A. K., Aratanha, M. A., Joshi, S., Bleuler, H., Cheng, G., Rudolph, A. and Nicolelis, M. A. L. (2016). Long-Term Training with a Brain-Machine Interface-Based Gait Protocol Induces Partial Neurological Recovery in Paraplegic Patients. Scientific Reports. 6: 30383.


Luiselli. J and Fischer. A,. (2016). "Computer-Assisted And Web-based innovations in psychology, special education and health" [online] available at: https://books.google.co.uk/books?hl=en&lr=&id=NwLSBgAAQBAJ&oi=fnd&pg=PA141&dq=virtual+reality+therapy&ots=aQ1xQghjaK&sig=aGXOWfpUJkXIelmPwgjsnLHfmHc#v=onepage&q=virtual%20reality%20therapy&f=false, [Accessed November 2016].


Maguire. P. (2014). "Inside the research institute battling PTSD with Virtual Reality". MOTHERBOARD [online], Available at: http://motherboard.vice.com/read/inside-the-clinic-battling-ptsd-with-virtual-reality/, [Accessed November 2016].


McGhee, J., Bailey, B., Parton, R. G., Ariotti, N. and Johnston, A. (2016). Journey to the Centre of the Cell (JTCC): a 3D VR experience derived from migratory breast cancer cell image data. In SIGGRAPH ASIA 2016 VR Showcase (p. 11). ACM.


Reede, D. and Bailiff, L. (2016). "When Virtual Reality meets Education". Tech Crunch Network [online], Available at: https://techcrunch.com/2016/01/23/when-virtual-reality-meets-education/, [Accessed November 2016].

Santa Maria, C. (2016). "The future of VR isn't games or movies - it's medicine". Real future, Fusion [online], Available at: http://fusion.net/story/281679/real-future-episode-10-doctor-vr/, [Accessed November 2016].


Sinclair, B. and Gunhouse, G. (2016). "The Promise of Virtual Reality in higher Education". Educause Review [online], Available at: http://er.educause.edu/articles/2016/3/the-promise-of-virtual-reality-in-higher-education, [Accessed November 2016].


The Body VR. (2016). "Medical" [online], Available at: http://thebodyvr.com/medical-training/#av-layout-grid-1, [Accessed November 20160].
Wild, J. (2016). "five ways VR can change education" Hypergrid business. [online]. available at: http://www.hypergridbusiness.com/2014/09/5-ways-virtual-reality-will-change-education/. [Accessed November 2016].

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