Virtual Patients in an Immersive Environment

Virtual Patients in an Immersive Environment

One of the underlying themes that keeps resurfacing on my thinking about designing learning in a virtual environment is that, in many ways reality is mundane, but with simulation, anything can, potentially at least, be interesting. Condensing, highlighting, and improving those 2-3 moments or key events of an experience can make for a compelling simulation on almost any topic.

In 2006 one of my favorite sport’s documentaries was released. Zidane, un portrait du 21e siècle (Zidane, A 21st Century Portrait) Zinedine Zidane was one of the most naturally talented football (soccer) players of his generation. In this documentary 17 separate cameras are focused solely on him, and follow him around a single 90 minute game of football – there are touches of genius in there but for the most part, there is a lot of not a lot of action. The key events though are incredible moments of genius or imbecility (he gets sent off during the last few minutes of the match) It is a fascinating insight into the world of a professional football player.

Imagine now if rather than a film this was a virtual experience – I would suggest that this would improve the experience – we could all, in glorious 3D enjoy the experience more – this would be such a strong memory inducing moment. Imagine the learning from experiencing such dramatic events first hand! Linking this to something more resembling my day job of medical education, imagine a virtual triage situation with not just 2D patients but a completely immersive experience or a fully tactile “body” that responds to your touch. That would really be something memorable and immersive.

The US Army is already exploring this as a training option and it seems that this is going to have more research done and more

Growing up, the future of Virtual Reality and truly immersive 3d with all its jetsonesque benefits was always just around the corner.

The future is here, and it has come faster than anyone thought. In an age marked by the rapid integration of computers in schools, the ultimate technology looms on the horizon – the age of virtual reality in schools. Using virtual reality as an educational tool conjures up visions of a Jetsons-like futuristic scenario, students exploring their schoolwork immersed in virtual reality, gaining a deeper understanding of their subjects.

The above isn’t a press release for a new educational game or new approach, it was actually written 15 years ago

Read more here.

Over the next few years it will be interesting to see where Virtual reality goes with the Oculus acquistion by facebook. They certainly seem to be creating immersive, memorable, unique experiences that are “virtually” impossible to replicate due to cost, safety, or ethical issues

However, the key affordances of virtual environments are in some ways already available with today’s technology and are being harnessed in the creation of Virtual Patient Simulations to give the user the sense of immersion, investment and immediacy.

Spatial Immersion

Spatial immersion occurs when a user feels the simulated world is perceptually convincing. The player feels that he or she is really “there” and that a simulated environment looks and feels “real”. The prospect of utilizing this idea of presence can be exemplified by Salmon (2009), who states that “[Such environments] enable learners not only to see how a place looks, but also feel what it is like being part of it”, (2009: 523). Following this with a focus on the potential for virtual patients, it can be seen that representations of real, recreated, abstract, or imagined environments may otherwise be of impractical size, distance, or cost, or may present too significant a hazard to experience in person, (Baylis, 2000; Bartle, 2003).

The leap to close the gap can easily be realized. imagine a virtual triage situation with not just 2D patients but a completely immersive experience or a fully tactile “body” that responds to your touch. That would really be something memorable and immersive.

Psychological/perceptual immersion

Psychological immersion occurs when a player confuses a simulation with real life.

The sensation of total immersion in a simulation can be so described: as the user losing any sense of critical distance to the experience and becoming emotionally involved. It doesn’t feel like a simulation – you are a part of, it feels too real.

A more appropriate and robustly academic definition could be simply to call it a sense of immersion.

The feeling of presence as experienced by the user has figured substantially in the research literature (cf. Witmer & Singer, 1998; Salmon, 2000). Inducing a sense of immersion in the environment, and consequently creating a sense of investment in the learning, is an important goal of the design, and a potential outcome of any simulation. This would then ultimately (hopefully!) lead onto a sense of investment within the simulation.

I want X to happen because Y.

I want to successfully treat this patient because they clearly need my help and I can relieve their suffering.

Immersion within a simulation is positively correlated with heightened emotions (Riva et al., 2007) and can be seen as a prerequisite for learning goals that require the user to experience being an active participant within the environment (cf. Herrington et al., 2003). This sense of immersion and investment is something that is particularly relevant and desirable for this area of research within Medical Education.

Long Term future of VR

We will need to wait and see what and how and if VR makes its way into mainstream Medical Education. I feel though, that it is somewhat inevitable; and like any tool for teaching, instructional designers will need to ensure that VR fits. The good news is that there is grounded theory for it to take advantage of.


  • What do you think? Do you agree?
  • In Medical Education will truly 3D Virtual Environments ever be a part of mainstream education?
  • Is there a need for such hi-fidelity?
  • What challenges do you think instructional designers in the next 10 years will face with the implementation of 3D worlds?
  • How do virtual patients fit into a contemporary medical education curriculum?
  • How important is immersion in designing learning?