When Dr. Ziv Haskal saw a virtual reality video of a buffalo walking through a field, he immediately knew the value of the technology.
“You show that to anyone, from the housekeeper to the full professor, and they just fall back in shock,” he said. “I still have that Google Cardboard [viewframe]. I went and wrote a pitch, got a grant and filmed a video.”
Haskal, a professor of interventional radiology at the University of Virginia, recently unveiled his virtual reality teaching tool, which places viewers at his shoulder as he performs a complicated procedure, and enables a 360-degree view of his procedure suite.
The technology has the potential to transform how radiology is taught, Haskal believes, and to vastly expand the number of radiologists who can help patients with chronic liver problems.
“I’ve spent my 25-year career trying to perfect something, while knowing that you can’t ever achieve perfection,” Haskal said. “But this could be the transformative, step-through-the-door technology that really helps apprenticeship training on medical procedures.”
The video, viewed through virtual reality goggles, shows Haskal inserting a transjugular intrahepatic portosystemic shunt. Through a small nick in a patient’s neck, Haskal threads a small tube through the liver to connect one vein to another and relieve pressure on the liver.
“Everybody, as soon as they see it, gets what’s happening immediately,” Haskal said. “The question is how to harness it. It may well be that these kinds of things become a standard part of medical education for students.”
Normally, Haskal would teach the procedure the way he himself was taught: by asking someone to walk into the room and go over the procedure beforehand, or by looking at a 2-D video animation.
He’s taught hundreds of radiologists that way. But that strategy has drawbacks: it’s expensive to fly doctors out to witness a procedure, or bring in a specialist to demonstrate. It also doesn’t guarantee that a trained professional is on hand when a crisis occurs.
“If I can teach six or seven doctors in India, then they can help 25,000 people with liver disease,” he said. “But still, the skill transfer is really inefficient.”
But if a doctor can train with virtual reality and then have VR goggles for a refresher before a complex procedure, the chances increase that the procedure can be done quickly and efficiently, Haskal said. He’d like to begin showing it to students and medical fellows soon.
A 2007 study by the University of New Mexico’s School of Medicine found that first-year medical students who were fully immersed in a virtual reality environment learned much faster than students who simply watched a video.
Haskal’s virtual reality video also can be adjusted for patients, he believes. Before each procedure, Haskal explains the process to a patient and tries to put them at ease.
But hospitals can be scary and complex places for some, and it might be more effective to let a patient virtually walk through the halls, enter the room and get a walk-through of the procedure and post-operation recovery, on their own time and in the comfort of their home.
“You want to break down the barrier between patient and physician,” Haskal said. “But you also want to make sure that the doctor is an expert and has the ability to refresh.”
Some doctors have used virtual reality to help patients in therapy or to prepare for a complex surgery — surgeons at the Masonic Children’s Hospital in Minneapolis recently made a model of conjoined twins’ bodies and organs to plan how to avoid pitfalls before separation.
Stanford University and Ohio University have used virtual and augmented reality to model a child’s heart and simulate an emergency room setup. But few demonstrate single, routine procedures on live patients.
Haskal wants the VR video to be free for any doctors or members of the public to view.
At the recent official unveiling, Haskal received a warm response, and said UVa’s Medical Center and School of Medicine also have been receptive. He’d like it to become a standard part of medical education and would like to add VR videos that cover other procedures.
“You can really help a lot of people,” he said. “It’s a force multiplier.”