“Don't you see how you can better provide the opportunity for our medical students to be immersively involved in procedures like managing childbirth through virtual reality?
“It is becoming increasingly difficult to get patients to consent to being handled by students through such procedures.”
This remark from our eventual lead researcher got me to rethink our method of teaching such clinical skills, hence beginning our dream of bringing virtual reality (VR) technology into our local academic healthcare scene.
We went on to form a team of academicians bent on realising this dream, and together, we made several attempts to secure a research grant in order to move the initiative forward.
“VR? You must be kidding. It is financially beyond our means. Useful technology, but inaccessible.”
Our hearts sank; it was a no-go.
That was five years ago – a disheartening remark from an authority figure.
But wait, never say die.
When the Mestecc R&D grant application opened in 2019, we started working on a proposal with an industry collaborator.
Many months later – nine months of hard toil to be exact – we submitted our application.
And the rest is history.
As the first university to win the Mestecc R&D grant in its new format, in collaboration with industry, the Universiti Kebangsaan Malaysia (UKM) team is grateful for the opportunity to have been able to acquire a professional VR interactive screen, subsequently fulfilling our dream of generating healthcare VR modules.
The journey has been long and arduous, with much sweat and tears, but it has been worthwhile, as we tread along the road less travelled.
Available modules
Currently, we have developed VR training modules in disaster response, orthopaedics and ophthalmology.
A number of therapeutic modules in psychiatry and psychology, as well as in childbirth management, are either in the final stages of development or are being tested for utility and rigour, including a childbirth pain relief module.
A dental module is in the initial phase of development.
One of the therapeutic VR ventures undertaken by the team is the design of a VR-based social-skills training module for youths with high-functioning autism spectrum disorder (HFASD).
Possible scenarios that can be rehearsed to improve social function include icebreaking, making acquaintances, expressing emotions appropriately, improving eye contact and showing correct facial expressions.
Thus, this VR module could potentially serve as an adjunctive treatment option to disperse fear and anxiety prior to actual physical exposure to real human interaction and real-life situations for such youths.
The research team, led by consultant adolescent and paediatric psychiatrist Associate Prof Dr Wan Salwina Wan Ismail, is currently in the midst of recruiting youths with HFASD to test the module.
A synergistic collaboration
Our project highlights the importance of collaboration between university and industry.
In our case, the joint venture between UKM and Integrasi Erat Sdn Bhd (IESB) began from the initial mooting of the idea and the subsequent commencement of proposal-writing in order to apply for the grant.
The emphasis was not only on research elements, but also to pragmatically explore potential commercialisation, so that the end product is not merely a shelf exhibit.
Functionality and building a library of VR-based healthcare modules were major goals from the start.
In this respect, mutual trust between the parties was a great necessity and asset.
According to Vantage Market Research, the global augmented and virtual reality (AR/VR) healthcare market is projected to attain a value of USD10.57 billion (RM49.37 billion) by 2030 from USD1.3bil (RM6.1bil) at a compound annual growth rate (CAGR) of 29.9% during the forecast period of 2022–2028.
The use of AR and VR in healthcare has been on the rise due to the potential benefits that they offer.
VR and AR can be used across various medical specialities for the purpose of teaching and learning, clinical rehearsal, medical research, therapeutics, and diagnostics, as the platform allows a non-invasive method to study complex procedures in a less risky environment.
The UKM-IESB team was led by IESB as the project leader, guided by senior consultant emergency physician Professor Dr Ismail Mohd Saiboon, who is certified as a Healthcare Simulation Educator from the Society for Simulation in Healthcare (SSH), as the lead researcher from UKM.
Other members of the UKM team were drawn from two large research groups within the Faculty of Medicine: the Medical Education and Simulation Research (MESRe) group and the Health Technology Innovation Laboratory (HTIL@UKM).
Local perception
In the local context, the in-depth views of a group of 15 healthcare professionals on the feasibility and utility of VR in healthcare were explored in a qualitative study published last December (2022) in UKM's Medicine and Health journal.
It was evident that Malaysian healthcare professionals are aware of this technological advancement and are eager to put it to good use, given its perceived great potential in clinical training and practice.
Of particular importance is the benefit of VR in maintaining patient and trainer-trainee safety, and its anticipated long-term cost effectiveness.
Apart from the expected decline in the cost of new technological modalities over time, VR provides a software platform that can be customised or personalised according to user requirements.
Nonetheless, the lack of awareness of the local availability of VR technology and expertise was obvious among the study participants.
This poses a challenge in the expansion of VR usage among local healthcare professionals.
Raising awareness regarding the availability of VR locally is indeed crucial.
It is hoped that the placement of our VR endeavour among the eight finalists (out of a record number of nearly 700 entries) in the Times Higher Education (THE) Awards Asia 2023’s Technological or Digital Innovation of the Year category, will help in this goal.
Our entry was the only Malaysian one to be shortlisted for the final round in this category in the Awards widely known as the “Oscars of higher education”.
Hope for the future
It is our view that the use of simulation in healthcare through VR technology should be explored not just for academic purposes, but also for translation into a new norm in clinical practice to help tackle contemporary healthcare challenges.
Part of this team’s roadmap is to build a VR marketplace for the commercialisation of VR-based healthcare products.
Developing healthcare-based VR modules is quite different from developing VR modules for other purposes such as gaming, architecture and engineering.
It requires the VR expert to do much reading and understanding, as well as have experience in dealing with subject matter experts from various fields of healthcare.
Without a doubt, VR has great potential in healthcare advancement waiting to be tapped.
This has to be recognised by major stakeholders such as the Health and Higher Education ministries, so that they too can capitalise on the amazing potential of VR.
The core UKM VR team hopes that, with our VR equipment in place, we will be in a strategic position to generate a myriad of VR-based healthcare modules through the establishment of a collaborative network.
And as we continue to populate our library of healthcare VR modules, we hope that the medical fraternity nationwide will be able to benefit from the commercialisation of these locally- produced digital tools.
Prof Dr Zaleha Abdullah Mahdy is a senior consultant obstetrician and gynaecologist, and HTIL@UKM head. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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