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Find Your Place in the Emerging Immersive Education Universe
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Find Your Place in the Emerging Immersive Education Universe
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Upload Date:
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Language: EN.
Segment:0 .
I am Diane harnisch. I am a Sr. Consultant with Delta think and we're along with my partner, Bonnie Gruber. We're thrilled to be here today to talk with everyone about really interesting emerging topic, which is finding your place in the emerging immersive education universe. This is a health science case study, but the applications and needs can certainly transcend into any of our academic disciplines as we get started.
We'd just like to recognize our core values with SSP as well as the code of conduct. And today's conversation is really why immersive education? What is it? What are some of the current applications? We have a stellar rock star group of panelists today that will introduce themselves as in the first time that they actually speak, rather than taking some time to introduce them here at the beginning, we'll ask them to introduce themselves as we go, but we're going to talk about specific applications, advantages, benefits as well as challenges.
Get a few of our panelists to talk about where they see immersive education going in the next five years and then really sharing some perspectives on how you get started, where what are the roles and responsibilities across our ecosystem. And we have a very interesting case study on with one of our panelists that he will share as far as how his society has really addressed this new opportunity.
To get started, though. We're just to level set. Why we're here, to speak about and talk about immersive education, immersive technologies. If we give it some definition, it really starts at the very in the middle with extended realities, which is an umbrella term, which really is the merging of the physical and the virtual worlds. Mixed reality is that blend of physical and digital worlds.
Augmented reality is the overlaying of the existing of an existing physical environment with digital content. It's really an area that is very much moving to the forefront and gaining significant motivation or motivation and momentum. And then virtual reality is what a lot of people are thinking about insofar as immersive technologies putting the goggles on and actually becoming part of the visual space.
Specifically for immersive education. What is it? When we talk about immersive technologies, I think any of us that have kids see our kids with the goggles on or doing different things when it comes to the gaming industry. But immersive education is really the process of learning with the usage of simulated or an artificial environment.
Take that definition. It's existed forever. OK thinking about our health science case study, every medical student goes through clerkships. Every medical student does some type of apprenticeship. Nurses do apprenticeship that is immersive learning. OK what we are seeing here is technology further enabling that learning process and what some of those advantages are shown here.
Visualization when a learner is able to further visualize content, especially difficult content, it transforms the difficult into something more understandable. It gives them the right to fail. You don't want your surgical resident to be failing when they are learning to do a surgical approach for the first time. So this environment allows learning to have some missteps and some repetition, and it reduces that risk.
It provides a productive environment, keeps learners engaged and motivated because it's more engaging and exciting and dynamic than sitting in a classroom and having that just lecture type of environment improves the quality of of, of training moves from passive learning to active learning creates interest. It enriches the learning process and certainly it creates that hands on application, which is really a critical part of did I understand it?
If I understand it, I should be able to apply it. And if I can apply it, then I truly have mastered it. So we wanted to give a little perspective here at the beginning about some of the prevalence of immersive education, even though our case study is really around the health sciences, immersive education is happening across all of our disciplines. We did a little bit of a look, recent study of study of research that's being done.
There's a good deal of research right now being done to understand the impact and the outcomes of immersive education across all the disciplines. And this graph really shows that it's happening across all of our sciences, engineering, certainly medicine and even the social sciences, some of the key influences for the adoption. It's actually financially more feasible for academic institutions to incorporate.
Taking away the VR aspect, which is really the investment in those goggles. R can be deployed and we'll show that today through some of our examples. It can be deployed into devices that every one of us carry around every day, which is our mobile phones and our laptops and our tablets. Heightened power. The fidelity of our personal devices is causing a broader, more ubiquitous deployment as well as this last point is, is one that I think is a very important thing.
The barriers of what a typical teaching environment looks like, learning environment is breaking down. And that isn't just through the last couple of years with what happened to education. Many faculty walked into a wall and had to start teaching virtually. It was it was breaking down before. I do a lot of work with faculty around flipped classrooms, team based learning, there is a tremendous amount of learning being done outside of a classroom, and those learners of today in these new modalities are your researchers of tomorrow.
They are your practitioners of tomorrow. They're learning in an environment that is much less traditional than what we would have thought of academic education in the past. So a really important one last point here is by the numbers left this to last for a reason to really talk about market need before we talk about how big this need us. And as you can see here, the first part is all segments and applications that they are.
The numbers that we pulled together around all immersive technologies are being used across retail, consumer, the housing market, engineering, whatnot, entertainment, big market 20 by 2028 is projected to be $84 billion with a 58% kegger to continue to grow very, very rapidly. Looking at the education segment, specifically, a very large component of that large market, $13.1 billion 43% kegger.
And the last point, the 97% indicates the percentage of academic institutions in the United States that are engaging in and with immersive technologies in some way, they're either testing it, engaging with it or fully deployed. So your market is already going in this direction as far as the education. So today we have a great panel and we're bonding and are so thankful to our panelists for joining us today.
We have actually, I think, some many new faces to the SSP community, and we're thrilled to have them here with us today. As I said, we'll let them introduce themselves as they do speak, but we have content providers, we have immersive tech developers, and we have that important group of users with us today. So to get us started, we are going to have a little show and tell with the technology.
We try not to go completely immersive in case, we had some issues with the technology here in the room. But we do have some different demos and examples that we want to share with you, starting first with a very exciting project that is being funded by project firstline, which is a CDC collaborative, and I will turn it over to Angie and Corey to talk through this demo.
Great Thank you, Diane. So good morning, everyone. Or good afternoon, rather. So I'm Angie Varsha. I am the director of isolation and quarantine programs for special pathogens at Nebraska medicine, which is in Omaha, Nebraska. And for purposes of this panel, I serve as one of the primary investigators for the CDC'S project first line collaborative, where we are funded as an innovation partner.
So one of the tasks that we were asked to accomplish through this collaborative was to improve equitable access to advanced technology and immersive education for frontline health care personnel, particularly focusing on advancing infection control programming in small, rural and critical access hospitals. The majority of Nebraska is actually classified as frontier or rural areas. And so this was a particular passion project for me and my team.
So what we wanted to be able to do was provide these resource constrained facilities with better access to immersive technology. So we completed an analysis of a gap analysis that was done by our infection control and response team in 2016 to 2020. And when we looked at those results, we found that frontline infection preventionists had particular concerns in the areas of sterile processing and device reprocessing.
When we think about the application of immersive technology for frontline health care personnel, this is a group that has did not have access to these tools when they were going through their professional training, through college courses. And we found that this area of focus was where they had an infection preventionist who had a partial FTE.
They were also the director of nursing. They were also the director of quality. And now they're in charge of infection control, particularly in the last two years where COVID is running rampant. And hospitals are completely overwhelmed. The focus on infection control has been even higher. So one of the things that we set about doing after we identified the area of focus was to evaluate and select a platform.
One of the things that we were most concerned about was scalability. But then we also had to look at feasibility of implementation, accessibility of the technology and affordability to kind of talk to Diane's point of, you know, these things are being implemented by 98% of academic learning institutions. That is not the case in frontline health care environments.
And we want to make sure that our front line providers are getting the same access to education as people coming fresh out of school. We spoke with one health care facility and they had told us that their annual educational budget is $500 for the infection control department. So when we asked them if they would be willing to invest in technology to implement immersive education, their answer was no, we don't have a budget for that.
So how can you help us? That's the problem that my group is trying to tackle in coordination with the CDC. So as we said about evaluating platforms that were available, looking at vendor solutions, looking at partners who would walk down this challenging path with us. Some of the things that we really were looking for were, you know, a platform that could be deployed in all types of environments with limited access to bandwidth, limited access to technological infrastructure, limited funding to be able to implement these things and to find somebody that would be willing to partner with us as our team had never developed immersive education before.
So how did we identify what should be in the immersive space? So I'm really excited to turn it over to Corey to talk a little bit about the unique aspects of his platform. So Corey and I have partnered together to build the module, and we're going to show you a quick 4 minute demonstration of different components of the module. But I'd like if Corey could talk a little bit about the unique aspects of XR education and how we partner together to make this module.
I will first say that was quite a flattering introduction, that our technology had all these really great and revolutionary features to satisfy the demands of a project supported by the CDC and unmc's. A really grounded and phenomenal ambition. I'll first say that to put it in context, this idea of disease prevention, just imagine going through a procedure, right? All the instruments that are used to cut somebody open, get access and to correct things, right.
When those instruments are done with, they go somewhere. Right and that is that's what infection prevention is. It goes through a sterilization process. So it's really important that that process is it's, you know, secure. It's good because we don't want anything being transferred. Right or transmitted from those experiences. That's a really important deal. And so I would imagine you would all agree that it's very important that that process be seen through.
Right because that's a really big deal. You don't want to you don't want to be the one cut open with a knife that was used on somebody else that didn't go through the sterilization process. That's a really big deal. OK so anyway, that was funded by the CDC and was really fantastic. And so, yes, our platform was selected because we support all devices.
It's a device agnostic solution for immersive training and education. And I'll leave it at that since I'll talk about it more here in a minute. But yeah, let's definitely show that video of this project. All right. Let's see if the. And again, while this is being pulled up, I'll just emphasize that this was delivered to rural hospitals.
So many of you, I'm more than certain, are not attending a rural hospital. Maybe, maybe I'm wrong. A set of objectives that need to be met in order to move throughout the training and the. While you're pulling that up, Diane I'll just say. So these are going to be snippets. So our instructional technologist and our lead developer went through and picked out the components of this module.
So right now we have two novice modules, so kind of introductory level information for frontline infection, preventionists working in a sterile processing or device reprocessing center, and they'll walk through kind of the way that we built it, why we built it this way. And how these will build upon each other. Just to kind of give you a sense of what the learners experience, this is actually a video casted from the headset, so it looks a little bit jerky.
It's not as smooth as if you were doing it yourself, but we wanted to kind of show you if you were wearing a headset and going through it, this is what the experience would look like. So novice modules, these are all laid out, but in more advanced modules they will have paths of right and wrong choices. At each step in the module, you'll be given a bit of a backstory and objectives to check off.
Some objectives will be harder to find than others. Green hover lights will appear. If you need help in the novice modules. Once you have completed the objectives, a pop up box will appear, letting that you have correctly identified the issues in this step, and this box could include more educational information or training videos.
In some of the modules. We have also included items that you can pick up and move using your hand controllers in the VR modality. In this module, we can pick up this item and move it so we can identify the hazard underneath.
Put this person with all the protective equipment for the PPE so it tells us what to do. And after a little bit of time, if you don't select it, then it comes up with these like little green hover icons. So you want to click on this. Dons the scrubs, then the shorts to do shoe covers. And then down. And then a cap.
And that's. And face shield. Once box popped up and it tells you that you've equipped the right. We took common processes and developed them into storyboards and then communicated with our designers to build these modules to better serve the sterile processing departments in small and rural facilities.
Note to self, we need to include some background music for some of this.
Maybe from idea to module. We couldn't have done this without the team of experts in infection prevention and control, sterile processing and extended reality and design.
I'm sure many of you guys have heard the term digital twin, this sort of stuff, right? Like recreating exact replicas of environments. Right this is essentially what this is, again, in the world of xr, there are so many terms being thrown around and so much enthusiasm. But that's essentially what this is, right? It's a recreation of an experience that someone can have.
We hope these modules will help facilities be able to educate and inform professionals about the correct sterile processing and infection prevention processes. We like to take a minute to recognize our development team. It was a collaborative approach between Nebraska medicine, Nebraska medicine, Bellevue or Nick's team and then the Heisenberg group. Cool and again to emphasize simulated experiences that they can, that they can have not only the single this one time, but they can do it many times, over and over and over again right.
To confirm that they've got the process down. Right it's objective training and education to help them, you know, prepare. Right accelerate accelerated learning is really what we say. And I would add, so I know it's a little bit difficult to tell what the experience would be like. And this is one of our novice modules. So we're in the process of piloting these modules with small and rural hospitals in partnership with our state health departments and the CDC.
We've had an overwhelming response from people that want to be able to take these modules. So right now we have 20 people enrolled, 10 of them have completed all the modules in the pre and post assessments. And I think just for some data points to kind of give some weight to this presentation, our preliminary feedback has been extremely positive with 90% of participants rating the content as relevant, useful, and they anticipate that it would improve their practice.
While it might not seem that sterile processing and device reprocessing is a labor intensive or intimidating environment, when you're fresh out of nursing school and you're stepping into this environment, running an autoclave, being the person that's responsible for ensuring that all of these quality processes are running appropriately can be really overwhelming. When we got the feedback from folks who have taken the module to Corey's point, they've taken it on a phone, they've taken it on a PC or a tablet, and then they took it in the headset.
So they've actually taken each module three different times. What we found is that 60% of the people preferred the headset. 40 people, 40% of them preferred the iPad or a PC. And when we asked if they would prefer to take future education on a particular modality, almost, I think 90% of people said that they preferred the headset. But of those 90%, 60% said that they don't have access to headsets.
And so when we think about trying to give people equitable access to this type of education, it's critically important that we want either find a way to make the technology more affordable and accessible or we develop platforms, continue to develop delivery methods that can be found on all different types of devices that they do have access to, so that the inability to purchase a headset doesn't prohibit them from using this type of technology.
Thanks, Angie. Glory Paul, I think we were going to go to you next to speak about your. Perspectives, please. Sure Thank you. My name is Paul zemaitis. I'm the director within the education division at the American Academy of orthopedic surgeons.
And I'll give a little bit of our case study at the end here on how we got here. But I'm going to kind of give a perspective on how this technology is being used in orthopedics right now. And I think there's two things to kind of differentiate here, and that's virtual reality and augmented reality. And the use cases are quite different between the two in virtual reality, much like how we saw in the demo here, it is being used kind of at the training level primarily.
I mean, it starts at the medical school. There are gross anatomy courses being taught in several medical schools around the country that actually are not using cadavers any longer. And they're being taught through virtual reality. And then all the way into residency, there are programs who have adopted this as a part of their I want to say curriculum, but I think that's a little bit strong because that's actually one of the barriers right now to its adoption is that there is no curriculum at this point, but some individual programs are using that.
And then all the way into the fellowship kind of phase of orthopedic training, some early preliminary studies right now are demonstrating that the technology has construct validity, meaning, you know, you actually can learn, acquire skills through this. It's largely kind of procedural based. You learn the steps of a particular procedure, you know, it being total hip arthroplasty, you know how to start and kind of go through the finish.
But it's not gone through to patient outcomes. You know, I don't think anybody in here would trust a resident halfway through their training just because they've gone through a virtual reality kind of training. But they're more confident going into the or when they are then working with the attendings. So to the point earlier made about accelerating that learning curve, really that's kind of the major opportunity here.
There's all kinds of different restrictions, work hour restrictions on residents. So this is kind of looked at as an augment and not a substitute for the other kind of training. And then the other one that I wanted to mention is augmented reality, which is being used much more as a tool in surgery right now. And there are a few companies that have FDA clearance for very narrow use cases of it.
There's one company that's doing a spine case where you can actually upload patients diagnostic studies into the xr, into the augmented reality system, and you can overlay their images over the patient. So as you're going in there, you can actually see the images in the particular uses for placement of screws in the spine. And so you can be much more precise and accurate in that placement, in the placement of that screw, which in that case is really important.
So, you know, those are a couple of the two use cases right now in orthopedics. There are a number of challenges, I think, to the adoption of it. The technology is good, but it's not there yet. You know, and I think that specifically in surgical training, you'll hear something around haptics and that's the actual tactile feedback of doing a procedure that technology is getting better, but we're still a ways off from that.
And then the curriculum piece, there were some other studies done around other surgical simulators done. And when orthopedic programs have them in place, if they're not built into a curriculum, the adoption varies quite a bit where you have some residents using the simulator, a lot others are not. So it really needs to be tied into a curriculum and then further down the road as the technology gets better, you know, I think that the use case could get into credentialing for orthopedic surgeons.
Are you maintaining licensure that way? And it might be a way to. Get the practicing surgeons using it. And then finally, I think building on the accessibility, I think the potential for this also is to get it in the hands of medical students who don't necessarily have access to a lot of orthopedic training in their medical schools. Not every medical school has the exact same kind of training and exposure.
And so it kind of creates a pipeline into orthopedics if you can get them more exposure through virtual reality at that early phase. So that's kind of at a very high level of where Ar VR is in orthopedics right now. Thanks Thank you. Paul Frank I think your next. Yeah come on up. All right.
Minimize this. All right. Hi, everyone. My name is Frank Sculley. I'm the CEO of a New York based company called biodigital. We are a medical visualization company. Been in the 3D for medical education space for about 18 years now.
The first decade we provided consulting services and over the last 8 or 9, we license a virtual probody platform that we call the biodigital human to a series of segments across health care. Last night I was told by at least 10 people don't try to do a live demo, so I'm going to try and do a live demo. Fingers crossed.
But before I jump in and show you some of these modules, I think some of the themes that you're hearing right. I think Diane started by mentioning ubiquitin then Angie followed on around affordability and accessibility. So that concept around immersive, I think is especially important to emphasize and something we think a lot about. So if you're going to build something, make sure it's available to your end users and try and meet your end users where they live.
Don't force them into another workflow, right? People are already inundated with all types of different software solutions. So that was fundamental to the design of this platform. And for the record, doing something that others tell you not to do is like a premier quality of a CEO. So that's how we know this. He's telling the truth right now.
Validated that's right. Taking risk. So again, going back to that accessibility point, the first thing to note here is this is not my laptop. I don't know how powerful it is. I just needed to go to a URL to pull up the technology. equally.
I can pull up the same URL on my iPhone. Going back now to all the way to the iPhone seven, we fully support this. We also I'm focusing on web and mobile just to complement what some of the other speakers are doing today. All of what you're seeing is also accessible in a headset and as Paul mentioned, augmented virtual reality. Each of them, we think, has their own place in the immersive ecosystem.
But you can see here something that we really the reason we were able to do this was somewhere around 2012, these specifications developed. So again, this is built with only HTML standards. If you're technical, it doesn't require a plugin, nothing to install. And even these massive data sets are virtual human bodies comprised of over 10,000 independently selectable objects.
Will run on any device. And that was quite an engineering feat that I give a ton of credit to my team for accomplishing. the head and neck. Being one of the more complex regions of the human body. If I'm the peel off some of the layers. You get a sense of what was involved and to get this right. You know, we partnered with New York University Medical Center.
Johns Hopkins had compared it with imaging data sets. It was heavily peer reviewed. And now we're working even more closely with our partner in Wolters kluwer in the distribution of the product. But you can see all these parts. Independently selectable described. And easily manipulatable in interactive 3D.
So something that was somewhat unprecedented to be able to understand the spatial relationships in anatomy like this. And then in addition to that, to truly emulate the human body. And that's our goal, is not only to map anatomy, but to make this a comprehensive virtual map of the human body. Think of it as like Google Maps for the human body. We also had emulate physiology, disease, states and treatments more time than I have to go into today.
But just want to show you technologically what's now possible. On any device. You know, we can emulate things like the physiologic function of the heart. Similar to the head and neck. If I dissect off some of the layers.
You can dive in and see how a heart valve functions. So this is now heavily also used in clinical workflows. Again, we have medical device customers, pharmaceuticals, hospitals, education companies, schools, and to be able to quickly contrast and compare in a visual format from normal function to abnormal function, we found to have just incredible learning benefits.
Can you give me the hook at any time, by the way? OK um, just touch on another couple quick concepts. Simulated procedures. So the cognitive tasks in a procedure. You know, from being able to. Go into the simulation lab or a very expensive cadaver dissection versus having access to something like this on the subway.
And I'm not I don't go nearly as far. I think we position our technology as complementary. Those other learning modalities are still needed. But can you get your customer from A to B and then they can go to B to C more affordably when they have access to those facilities, which we know are quite expensive. So this technology.
It's been now validated in a number of peer reviewed studies, studies that we don't bias. We're not involved in done by academic medical centers. A few years ago. A European medical school did one where they had a control group using virtual models of anatomy, and then they had their other I mean, sorry, the control group was using the cadaver.
Another group was using the biodigital cadaver models. And again, we positioned our technology as complementary. And we do believe there's still a ton of value in those cadaver dissections. But what they found was that group actually performed 16% better on their exams and having access to the technology fully remote. Uh, more recently, the Smile Train society did a similar study and found that compared to traditional methods, that resident education was enhanced compared to using illustration, text and so on within these virtual environments.
So when you think about adoption, I think and we'll I guess we'll talk more about the future, but the efficacy of the technology is really beginning to surface. Years ago, we were servicing mostly the visionaries, the early adopters, those people that were willing to take risk. Now, in many of the segments we serve, it's become more mainstream and. Dios the reason being is because it's now much easier to adopt.
It's more turnkey, it's more affordable, and it's been proven the benefits of improvement. So again, lowering risk to adoption, which is incredibly important. So I'll stop there. I could. You know, I could. Leslie is next.
Thank you, Frank. No problem, sir. Put your slides back up. Now, Leslie's going to go to some other things. And everyone, we hope that this is spurring some different thoughts and questions. And we certainly are happy to take as many questions as you have later. We're just going to continue to do a little show and tell.
And Leslie is next. Thank you. My name let me take off my mask right now that I'm at the podium. My name is Leslie Hammersmith. I'm the assistant dean for technology enhanced instruction with the University of Illinois College of Medicine at Peoria. My role there is really is working with the whole enterprise of medical education from the phase one, you know, very the first year medical students all the way through residency, education and physician education.
So half my time is spent with the graduate medical education and on the applications within the clinic and surgical planning and some of the things that we've talked about there and educating residents as they're going through their programs just on in every program that we have. So it's very broad. And in the undergraduate medical education, the basic sciences and core knowledge, preparing students to enter into clerkships and then using technologies within their clerkships as to advance their skills and training.
So it's a pretty broad. So I work with faculty one on one, and in small groups I work on the curriculum development side of what we're trying to do. Hold on. There we go with developing classrooms. Let's see if I can make this a little bit bigger. I know that let's go back to the beginning. It's going to be small for you here.
This is just the background for you to have something visual to look at. I'll make this link available to you at the end if you want to go through and read this. So I'm going to frame this because I work with faculty and on faculty development and in the technologies that are in our classroom and how we're incorporating it into our instruction. And when the pandemic hit, how do we actually go to online teaching in 24 hours, which was really fun.
But actually it was really fun because I worked 20 years to get to that point. And finally I had that moment. So I might have different perspective. But after the pandemic hit the College of medicine, let me step prior to the pandemic, the College of medicine has we have a virtual reality lab, a six workstation with headsets. It's HTC Vive lab that's set up in our anatomy technology area.
So we call it the anatomy technology lab. It has an anatomage table. If you're not familiar with anatomage, it's so if you think about digital, but like 10 years ago where you have this humongous table that it's touch screen, you can see the images and you can use your fingers and manipulate it, but you can't really take it anywhere. It feels really clunky now. So it was really cool at the time, like 2015.
It was kind of cool. So we have that in our anatomy tech lab and then we have the virtual work, the headsets prior to the pandemic, we had faculty, a faculty member who has left, who left our institution, which is a key thing to consider as in an academic environment for initiatives like this and how it's being integrated into curriculum. We had a faculty member who was focusing his research on developing virtual reality, so we had lots of virtual reality modules that were created in a platform called nouveau in vogue.com. I'm not here to represent nouveau.
It was the platform that we had available to us. Let me just get out of here real quick. I'll show you very quickly. What this platform is. It's a sort of workspace based. It's a public you can go to google.com, you can create your own account. And they have lots of courses that are available to you publicly.
It is app based so you can access on your browser. You can go in and you can see what courses are there for you to enroll in. You can enroll in one of them and go through that course. If you can download the app, get it installed on your computer and your computer must be able to run this, the technology, right? So that is I'm not going I'm not going to go into an nouveau course live because this does this.
Like I said, you need to have the app, right? That's one of the barriers, actually. You have to have an app and the app only runs on Windows. And 76% of our students in the medical school are Apple users, IOS, Mac OS. And so right there you have this access barrier before you even get started. But still we manage. We manage to create content.
We manage to have our students go through the content we get. We got data back. They really liked going through the virtual reality content. And so we know that there is good reason to continue having this initiative going forward. So let me jump then to the pandemic and what happened at the pandemic. Our lab closed. Nobody was on campus.
We couldn't go into the lab. We had social distancing. You know, we had another access problem. Our faculty member left. And so we didn't have a champion to kind of lead the further development of what was happening in the lab. So after a year of coming back onto campus, I decided we need to do something. We need to organize around what's happening in our virtual Reality Lab or what's going to die.
And so I created a faculty fellow program to get interested faculty to be committed for 6 to eight months to immerse themselves in immersive learning and go through development from very beginning of learning what is VR and what our applications of virtual reality in education to having a course ready to be put into our curriculum that following year. So four members and this I'll just go through this really quick for members.
You can look at this and read about the program and how we had it set up. So four faculty members were selected to be part of this program. Two of them focused on the phase one. So the first and second year core knowledge, medical education, and two of them were resident physicians working on resident education that would go back into the clinic.
They again in duveau the platform. I hope you can get an idea here. You see some floating glasses? Can you see my cursor right here? You see some floating glasses sitting there? You see the background? Looks like Mars. So the idea you have an open book, it's blank page when you go into and when you create a course on this platform.
Meaning that you have to if you want to see a clinical environment, you pretty much have to create it yourself. If you want to see a heart model, you have to find your Half model and upload it and have it there for yourself. This was attractive for many of our faculty because they are the curriculum developers. They own their content, it is their intellectual property.
And so they were excited to be able to take the things that they have made and that fit our learning objectives perfectly for our curriculum and put it into this environment that excited them. And duvaux then allows you to record lectures so you can have and it limits the time. So you can have five minutes of instructor led presentation. That's the glasses. So when your viewer, when your student in the environment and you start the recording, you all of a sudden see these glasses floating next to you and they have a pointer and they can use that to point at things.
So there's a presence there sort of guiding you that's not really there. You kind of have to get used to that and you can walk into them, you know. So sometimes you walk into them and you're like in their glasses and you're like, wait, oh, sorry. So it gets really confusing sometimes. But but that's the idea. The other aspect that they liked about that is that there are space for assessment questions.
They go through the pre-recorded lecture of five minutes, a lesson of five minutes, and then some questions are assessment questions are listed and they can go through and answer those assessment questions. Now it's kind of limited because it's sort of have four arrows, these little arrows down here. Are marking different places in your question might be which what is the pathway that involves whatever and then you have to click on the colored arrow and hit Submit and then it will either give you a check, green check.
Yes, that's correct. Or red x, so there are some limitations, but they like the idea of assessment at that and we don't really have a way to export that assessment. So it's sort of stuck in its sort of self review and not something that a faculty member can go through and see that process of students learning faculty loved going through the program. So that was the anatomy faculty little screenshot this one is on mapping the nephron this one actually we just used this in the curriculum.
Last week was the first time we had students coming in and going through this for this, the block that was happening that was related to this, this project. And so you can see here there's a model. There's they have 3D model. And then there are slides here that are similar to PowerPoint slides. Right? probably was a derivative of something that had been in a PowerPoint slide that you can import the image and put that in there.
And so you're seeing a mixed a variety of the kinds of elements that you can put into the platform, which also was attractive to us because we have a lot of content that is not necessarily built for immersive learning environments, but we would like to reuse and put it into an immersive learning environment, hopefully bringing the making it more active and immersive into this, this, this space.
So that's another example. The students liked going through that. And then this, this faculty member is one of our clinician, our resident physicians, and his module is more on cardiac physical exam and giving the other residents the, you know, the steps for doing an exam. And I wish this would be really great to have the video of it, but I was not as fearless as a CEO.
I'm in academic technology and that kind of like pounded into you that technology will probably fail. So you can see this one is interesting because right here, this is a little this is a video screen. This is an actual video of somebody swallowing. You can see the swallowing action happening and it's on top of and in this screenshot, it's a little bit transparent, but it shows the throat and the esophagus like going down and the connection.
So they're overlaying what is actually happening in the video over our 3D model. And then you can expand, you can change the transparency, you can highlight where things are going. And so the visualization and the constructor that knowledge is something unique to what you can do here. And then there are the ekgs and other videos that are happening. So you can see the vitals and the student then can control that.
They can mess with that on their own. And when they hit play, then the faculty instructor will come in and provide the overview. And then at the end you have the questions. So also a very good model. And then this is another physician, a resident physician on heart failure. And she also did the same sort of thing. Now you can see her environment doesn't look like Mars because she has these are just images of a clinic and a bed that she has.
And if you back out of that, Mars is on the outside of it still. You're not out of Mars. You're just you can just immerse yourself here. And that's a video of a patient who is actually having symptoms of heart failure. And part of her module is to have the learner identify with the arrows. They can move the arrows and point to, OK, where are you seeing what are the symptoms that you're seeing?
Can you mark them? And then when you hit play, then she goes over like these are the things you should have had marked and you can set yourself up that way. So that was also something we liked. Do you want me to go on to challenges? Yeah and we had to do a lot of Partnerships. So our this, this project, this program didn't have a funds attached to it.
So the faculty did not receive, you know, Tens of thousands of to buy equipment they were or to buy assets. Because what we learned is that we really have zero 3D assets just sitting around, you know, and so we were our faculty were scrounging, felt like it. We felt like we were scrounging. But we have there's lots of pockets of innovation happening across the OSF hospitals, academic faculty, academic panhandling, panhandling because we had to go and say, did you or do you already have something developed here?
Or our partners that jump simulation center where they have a medical visualization group, they were key because we could go to them for no cost or low cost due to our partnership and have them create custom models for us, which we like because we want the intellectual property of it, we want the copyright of it, we want to own that because we want to use it. And derivatives, from what we're creating here, this can't be the only way that we're doing this.
And so that is really key for us. That's what we wanted. What we learned is that our faculty, if they're in charge of finding their own assets and creating them, they have to learn a lot more about 3D assets than they ever wanted to know. They don't want to know about, you know, the polygon count that you need in order for it to fit inside of or to work very well in the Nuvo platform or whatever platform you're using.
They don't want to do that, and I don't want them to waste their time trying to find that either. I don't want them to have to go to sketchfab, you know, where you can go and you can purchase sometimes pretty cheaply, but you can purchase and own models. But then sometimes it's not perfect for what we're trying to show. And so we have to go to blender, which is another app, a whole other skill set.
I don't want my faculty to become blender experts, to have to be able to use their assets. You know, they need to be able to have a repository of the content that will suit their needs as best as possible with the least amount of editing or modifications because we end up paying for those somehow that that is necessary. So it's kind of a balance.
So we're I don't know, I think I might be getting into the going five years from now. So you guys tell me what you want me to go right now? You start because I don't want to talk too long here. Why don't you speak a little bit regarding you've learned all these things. Where do you expect this to go? What does your program look like in the next five years? And then we're going to share ask that question to a couple of the other panelists, please.
Yeah, so right now, so we're this puts us. We ended up with four courses that can be put into our curriculum. Going back to what Angie had said before about access, that is so key to me because I have courses now available, but how do I get people in them and using them not only finding the place where it fits into the curriculum that we talked about to that curriculum module.
Where does it go into the curriculum? But how then if you have it in the curriculum, how are how do people actually get to it and use it? And what is the support consequence of that from a university's perspective especially? And so that's kind of where we are right now, the sustainability of these courses. An access. And I'm starting to think actually about headsets and like the quest two headset I would love to have in my right now, just have them and give them out to people.
But our University does not. Or maybe it's just my it group is concerned about the privacy concerns, especially around with meta, right? And so they're like, well, we don't want you to get that. We don't want to have it connected to the Facebook thing. There are no other headsets out there that will just put on your head and you could do things. There are no other headsets really right out there.
And we've been looking at them all and evaluating how does it fit into our enterprise, how does it fit into the it management of this from that perspective? But most importantly for the user, how easy is it for them to use it? So, you know, think back to 2009, 2010. If you were alive back then, we were all alive, right? They had a lot of iPad initiatives at universities.
So students would matriculate, boom, boom. Everybody got an iPad. There was content for it. That would be great for me. Give me some like a quest. And I'm saying quest. And I'm not here to I'm not trying to we don't have them at the University at all. So I'm not trying to promote that.
But just as an example, if all my students that are matriculating, we gave them a quest. Two, you decide what account you're using. You decide how you're doing it. We're just providing content that was selected, perhaps created, you know, and aggregated by our faculty. That you can access through that device wherever it is, whatever platform it is, because you've seen some really great platforms here and there are really great platforms out there.
So that's kind of what I'm thinking. Is there going to be a virtual reality as part of sort of the initiative to get that access handed? Now it has to be cheap enough. The licensing has to be flexible enough. It's not just my campus of 65 students per class, but we have three campuses. So if something happens in Peoria, it has to go to Chicago and Rockford because those are our other campuses.
And it has to expand and it can't cost the University or the college millions of dollars to do that. But that's the access point, like so the faculty Fellows program, that's what we had to do with our faculty. They didn't come with equipment and we didn't give them laptops. They had to come to our lab to do these things, to our lab and then to their workstations at work.
And they were bouncing back and forth. And while Nuvo has a first person view, so you can you don't have to have a headset. We we are trying to make this immersive. We felt like that was not so immersive, right? So in five years now we're excited about the idea that Apple is coming out with their version of augmented reality and virtual reality. And if you start reading about that, that I think has potential.
And 76% of our students are already in that ecosystem. So if we could get something that is in that ecosystem that is not cost prohibitive to adopt but just sort of plugs right into something that we've already accommodated within the University environment, that would be fantastic. But it's happening in 2023 and 2024, and I think the next two years are really it's really going to show us the directions that we can go into.
Great Thank you. Thank you. Um, we heard call to action around Content Accessibility. But I think a great case study with Leslie at University of Illinois is they're doing it. They're making that content themselves. So and why is that? Frank talked about outcomes. Data is coming to the forefront with immersive content, that the learning process is enhanced with these type of tools.
So yes, we're early, but yes, it's the momentum is continuing to pick up. So I'd like to just ask Angie, if you could speak just a bit about where you think and your training environment this is going to look like in the next five years as well. Sure thanks, Diane. So, you know, talking with our team and trying to put together some thoughts about where we want to see this go in 5 years and then where we think it actually will be was a really interesting discussion.
And so as we were talking with our instructional technologists, really the Association is predicting by 2025 that nine out of 10 people in the industry of immersive technology believe that it will be as ubiquitous as mobile devices. So everyone, 90% of people are going to be accessing this on a regular basis. That's not five years from now. Right? that's three years from now.
So what we really think is that as health care workers continue to be stretched prior to covid, we already knew there was going to be a nursing shortage. Not a surprise, but this just accelerated the issue, the ability for people to be able to take time off or get paid time to attend trainings that are 8 to 10 hours for hands on workshops, those days are gone. We're not even getting time for people to get paid, time off for that type of training now.
So we really do feel like the solution is immersive technologies being used as a tool set to solve the issue. I think to Paul's point, they're never going to be the full solution. This is really an augment to be able to provide better education, more efficiently and more effectively in a more engaging manner. We do think it makes an enormous difference on scalability, quality, cost of training content.
When you think about the price of a simulation mannequin and the upkeep for that year over year compared to the cost of creating a module and then being able to change out an asset, the return on investment is significantly different. The upfront costs are significantly different and the costs over time trend down with immersive technology where simulation mannequins are trending up, replacement parts, consumables, all of those things are different.
So I really do see that for the future, that virtual reality and immersive technologies are going to be more embedded into not just academic institutions and higher education, but for frontline health care workers to maintain proficiency and competency. I think one other piece that I just want to touch on is the implementation of augmented reality and virtual reality and how those are being combined together in some cases.
There's a gentleman in England who has developed a way to utilize augmented reality to see both a virtual version of the end of a helicopter while utilizing mannequins so that it feels like a real simulation. So blending together technologies to give people a more realistic experience to really help them advance practice. There is a white paper on it.
It's professor Bob stone. He is in the UK and it's how do you fix a camera onto an HTC Vive headset to be able to experience these things? So that's really the next step, is pushing the envelope so that learners are getting the most realistic simulated experience they can to make them be better health care professionals, better providers, more prepared for those intense situations where failure is not an option.
Paul, did you have anything to add with the five year perspective, please? Sure So I think moving forward the next five years, I think the resource constraints of different organizations, that's a huge barrier at this point. I mean, it's a barrier for our own organization as well. And so I think, you know, partnerships was something that was mentioned, you know, a little bit earlier.
And I would challenge, you know, to kind of think about the IP a little bit differently. We're we're not very interested in actually owning that IP in that space. And so, you know, the big device makers, you know, in orthopedics specifically, you know, obviously have much deeper pockets than an organization like ours or, you know, individual health care systems and institutions like that.
And so there are a few key players in the VR space specifically that would do also work with the large device manufacturers to develop a lot of this content. And so the way that you can then do that, transfer that into education is then kind of strip it away of any sort of, you know, recognition that it is a, you know, a Johnson Johnson product or a Stryker product or something like that.
And so that way you can have it kind of be agnostic to, you know, any sort of corporate entity and then you can start delivering CME through that. And, you know, I think from a hardware perspective, you know, the next five years, I think the price is likely going to drop significantly over that. We've already seen VR headsets drop considerably over the last few years. That'll probably continue.
Same thing with Ar. You know, I mean the hardware, I mean, as with a lot of things in technology, the hardware piece is going to be the part that's going to get real cheap and almost disposable and it's going to be, you know, a software as a service kind of model going forward. But the key will be, you know, who is going to fund that initial development of the content.
And I think looking at partnership models really is going to be the way going forward. So I think that'll be key going forward. Because I really love what you said about. But looking at intellectual property differently because I mentioned that one of the attractive parts for our faculty is like, oh, we can control this can be exactly what I wanted.
And the amount of time and effort and extraneous knowledge to them that they had changed that. So right now we're actually moving away from using a platform like nuvo, where it expects you to have everything there to more products like digital or education or medical Holodeck is one that we're actively looking at as well because we want to have high quality, because what we're producing, we don't have the money or the time to make it as high fidelity as what we want.
So the faculty expectation they found during the project, their expectations had to be lowered and lowered and lowered and they weren't. That was very disappointing for them. So it has changed the way that we look at the space. And so I think that's really key that they're going to be a lot of changes in how we approach that. And for on the academic side, the University may not be such in stride with us as quickly they're going to say no to things because they're going to ask, well, what about the intellectual property and copyright and privacy, all those pieces?
So that's an interesting struggles. OK, cool. All right. Well, my name is Corey heisner. Just so you guys all know, and not just from my sarcastic comments, but, like, I'm actually part of the panel for real. So I was just going to make a point here. Introduce our technology.
So we represent technology, right? We're we created a device agnostic, immersive training and education platform. Right? so you'll hear the term platform many times when you hear the technology. But our platform addresses creation, deployment and distribution of content to all devices. So if, for example, I asked you guys, everyone pull out your headsets, everyone pull out your VR headsets really quick and I'll invite you into this course.
How many people right here have your VR headset ready to go? Nobody right. So if I asked you to pull out your phone and explain that your phone could also or does also serve as an immersive technology device, right. You might be surprised because we only hear about the VR headsets and it's valid. Like they deliver the immersive experience 100% Our technology focus, the tech that we're responsible for, supports delivery of immersive technology, training, education to all phones, tablets, desktops and VR headsets.
Here, what you see in front of you are projected on the screen is, as I have opened the desktop version of the application education XR. And again, we're agnostic to content. We have no horse in that game. We're agnostic to the hardware. We have no horse in that game. OK, we know what, what and what's valuable.
But we created an agnostic platform, agnostic of, you know, it doesn't matter what device you have or what content, right? It's available on all devices. So here I've invited and Alex and Ben, just if you guys can scooch down just a little bit and get right in front of the right in front of just because I can't. Yeah, there you go. So I've got a couple of participants in from different parts of the country.
Ben is in here from Salt Lake city, Utah. Alex is in here from Madison, Wisconsin. And we're here, obviously. Right? we're in Chicago. So basically what we can do is we can together we can go through a training experience. We're on multiple devices. I'm grabbing the wire. Alex has the soldering iron.
Ben, go ahead. I'll let you take the wire and then they can, you know, we can all do this training together from different parts of the world again, regardless of location, regardless of device. And so this is what our technology represents to date. We have this is our 11th. I've been my academic background is phasing out my minor academic background compared to, you know, PhD is obviously, but it's Physiology and developmental biology.
So in the past 11 plus years, working and creating immersive content, innovative content experiences for medical device manufacturers and medical institutions, we've learned that one offs, high production costs and scalability issues are preventing, if not delaying, what is predicted to be $1 trillion industry and extended reality. The numbers that were presented up here are actually quite a bit.
They're significantly smaller than what we have, right. The kegger for training and education is actually it's a $300 billion industry. Extended reality is expected to be responsible for $1 trillion of, you know, business development across not just medical specific, but everywhere. So currently to date, we work with obviously unmc, mass general, Mayo clinic, Cleveland clinic, Cleveland clinic, for example.
They wanted to create your one year to medical school, anatomy, education. And that's how we springboarded the development of this platform. They came and said, hey, look, we need medical school, education, all devices. We created education xr, but we also created education XR with the idea in mind that we could deliver training to anybody.
So now we're creating with schools in California for federally funded career technical education. We're creating content for diesel technology, for advanced transportation, for print design, so that students who are, you know, doing vocational skills training for interpretation of designs and manufacturing, they're getting trained with content on the platform so that they can get jobs literally by Nasa, right?
So they get this training and they go, now can qualify for a job with Nasa. I mentioned advanced transportation. Another big deal in California. You know, not only incentives, but mandatory. Right incentives to transition to manufacturing that supports alternative energy. Right so. Am I missing?
I miss him. EMT we're doing statistics, math again. Zero bias on what the content is, but the value is accelerated transfer of learning, right? Or knowledge transfer. So we say accelerating the transfer of knowledge. That's our goal because there are shortages not only for nursing shortages all over the place, especially right now.
Right? people don't want jobs because they'd rather hang out, but it's going to come back. But when it comes back, like vocational skills training is a big deal. All these different job placement is a really big deal. OK anyway, I'll let you guys go. Um, Alex and Ben, Thanks for joining, guys. Appreciate it. Thank you.
Literally just talking into these devices, we can hear each other and talk. This is a good example of remote distance learning, training and education. OK, that's really cool. Any other. Yeah, pretty cool. Pretty cool. Um, so.
Oh, I think after everything we've heard and it's interesting and advanced technologies, but it is very accessible. And I think the team has shown a number of different ways in which it's used. But I think for this audience, trying to understand how you get started. And if it looks daunting and what are the next steps and what are the first steps really?
And I think, Paul, we were going to start with you a little bit, even in market discovery and some of the work that has. Embarked on. For sure. So one thing actually, I just want to piggyback on Corey's presentation there. We did something similar to that with an or training where we had about 700 different surgeons across the country join in for a virtual reality webinar.
So you could see it if you didn't have a virtual reality headset. We live streamed it so you could watch it there. And then if you did have a headset, you could actually join with everybody in the virtual or and you could sit there and we had four different faculty go through a total knee arthroplasty, and each faculty were from one of the different corners of the country.
So, you know, I think the opportunity to bring people together is really pretty incredible with the technology going forward. But so my question is, is, is how did we get here? So the American Academy of orthopedic surgeons, you know, obviously we have a number of our members, you know, leading faculty who are in this space. We're working with these companies to develop content. And so we've got some, you know, very vocal proponents of this.
And, you know, how does the Academy get involved in that? And so it really, you know, this is going to be kind of not so much about the technology itself, but really about the process and how does an organization go about getting involved? Because there are significant risks, I think, in rushing into this too quickly. You know, this is an evolving space. These companies are at very different stages of their own life cycles.
There's a lot of capital being funded into the space right now. Some of the really leading VR kind of companies have a lot of venture funding behind them. So it can be, you know, enticing to just jump in and say, hey, that's the one we're going to go with without really kind of understanding what your role is. And so what we did is really, you know, start at a very high level macro, understand the industry outside of orthopedics, outside of health care, understand the different use cases and start to kind of funnel it down and to really understand our role.
And so we also went out and did a whole bunch of different interviews with different users, is different kind of market segments. Who's, who's a content producer, who's working in the hardware? Corey was a part of that process for us as well, and then progressively kind of narrow it down and understand who our audience is. And you start kind of going through what the learner, what the learner's journey is.
And from there you start distilling, OK, what problem are you ultimately trying to solve? And I think that is a real big risk right there is to look at this technology and think that it's a solution for an undefined problem and think can just kind of apply it and it's going to work for you. So getting very specific on what you're trying to solve for. And I think in several of these different instances, we've seen that the technology serves a kind of a different purpose.
It's, you know, it's one piece of the puzzle into the whole kind of learners journey. And so we progressively funneled that down, and we're really going to focus on kind of setting the standards and the parameters for training. We're not going to be in the content development kind of space. We've got, you know, the abos, the American Board of orthopedic surgery has a list of procedures that a resident should be proficient in coming out of residency.
And so if we can set the standards and then work with industry and the partnerships to start developing the modules that correspond with those particular procedures, then you can get kind of scalability. You know, when the company does make it and then a particular institution can get, it's easier for them to access it if that content is available.
But really, from the Academy standpoint, we kind of look at ourselves as kind of we're the ones that can kind of set the benchmarks, the guardrails around this because it really should be surgeon led. In our case, we've got the we've got the experts. And so that's kind of in a nutshell what our kind of process is. I'd be, you know, Diane or Bonnie or any I mean, any other questions you want to probe on that?
That was terrific. And our last few minutes, if we did want to open it up to the room, if anyone had any questions you want to ask the panelists want to give you that opportunity. Maybe specifically for the Nebraska education team, although if anybody has data on this, I'm interested specifically if there's any data either from your project or published elsewhere about a differential efficacy in educational outcomes if you.
So I'm thinking about your platform. As you can use it. You can use a truly immersive Oculus or whatever, or you can look at it on a laptop or phone. In terms of educational efficacy, meaning the skills acquisition of the learners and whatever kind of assessment was done at the completion. Is there a differential between those environments or are they more or less the same or do we not know?
I'll start with just our project. And I would say right now we just don't know. I think that is Ebbinghaus is one of the outcomes that we want to achieve by doing this pilot project, particularly focusing in infection control. And so to kind go off of what Paul had said, one of the things that we ran into is we didn't really understand from the beginning what are the right types of skills to build in a VR environment.
And so it took us a little bit of starting and stopping. But as we went through and we finished building out the novice modules, we're now building an intermediate and then an advanced module. There is an assessment at the end of each module and then we also have like a post pilot survey essentially trying to better understand did you get more, did you have better impact when you took this on your phone, on your computer, on your headset?
What we know right now is that people have been our net promoter score is 70% So of the people that take it, 70% of them said, yes, we would absolutely recommend this to a friend or a colleague. What we have not yet been able to evaluate is by taking this, do you actually have better skills to operate an autoclave? Can you actually do a better job of assessing the infection control environment in a sterile processing department? Right now our focus is on really understanding will the technology be adopted?
What type of platforms are most likely to be adopted in these types of facilities? And then really, once we have that, trying to understand how do we get it into their hands, the next phase of our work will really be focusing on, OK, great. We've established what the delivery method should be. We've come up with a distributive model to get it to them.
Now we start to think about, can we actually measure outcomes? And then ultimately, like the goal is to save more lives, right? So impact patient outcomes, improve patient safety, increase practitioner proficiency and have better health outcomes in small and rural hospitals. So your question is exactly the one we want to answer. Probably my colleagues have worked in this space longer than I have better examples about skills, outcomes and efficacy, but that's exactly the question that we want to answer.
Yeah, I'll add to it that there's overwhelmingly positive. There are overwhelmingly positive outcomes from doing virtual training. Right and it depends on the type of question you're asking. Again, not to deflect the question, but Andrew brings up a really good point. Um, it depends on what you want to achieve from the study, right?
And so is it our outcomes? I'll give an example. So there's a college in northern California College of the redwoods, right? They came to us and said, hey, we want to create training for CNC machining. We have three machines, we have 100 students every semester. We can't possibly we don't have enough time to get these students on these machines.
And so we created a virtual, you know, training for those machines. And what did that do? It closed the gap, right? It accelerated getting access to. They didn't need to spend the time wasting time learning to turn on the machine or look for the labels. All that qualification, time to get on the machine. They were able to do that remotely digitally and then get right to the machine when they got into class.
The other example I'll give and I'll actually defer to Paul because I bet Paul is really good examples, especially there's an overwhelming like data from orthopedics and that'd be really great. But in Merck's case, Merck came and said, hey, they have quality assurance engineers who are trying to get it takes them two months to qualify qualify a quality assurance engineer that two months of reading material, static material from a desktop.
And so that is just before they can get before they can walk the line, right. To actually inspect it and be qualified to do that and save millions of dollars. Now, with you know, we created a, you know, the digital twin of these lines and give them the ability to from any device go through and get that training. So now it cuts that two months down to two weeks and now they're qualified to get on the line and actually and do that because we've recreated the whole thing.
They can do it virtually hundreds times, as many times as they want. There's no limit. And that's a really powerful. That's a again, that's answering different questions. So when we create an interaction, this is not these are not viewing tools of a VR experience, an interaction. When we create it, it's interactive on every device, not just watch it and do it's do do, do on everything.
And anyway, but I'm curious, do you want to give him I think it was a really great data for orthopedics. Yeah so, you know, most of the data that's been published has really come from the last couple of years and the body of evidence is growing that, you know, that skills acquisition, you know, so that's where the construct validity is really coming into play there. But the but the outcomes of these studies are really focused on, you know, going through a VR and it's level 1 evidence right now.
They actually are doing controlled triage. Sample sizes are very small on that, but they are putting, you know, trainees through a virtual reality kind of program. And then you go to a cadaver versus one just going through a regular book training or watching a video and then going to a cadaver. And what then they're testing is did you procedurally go through, you know, say, a total hip arthroplasty?
Did you follow the steps correctly? You know, how long did it take you to complete the procedure? And the preliminary data are showing that the virtual reality trained surgeons, trainees are actually they are completing it properly. The procedure is going more quickly. But this is now on a cadaver, right? This isn't in a real world situation. And so the data just aren't there yet to say that this is going to transfer to improve patient outcomes.
And that's really where we need more research done. And then also over time, how much time. Do you really have to have to be in virtual reality? Is there a ceiling effect also? You know, at some point, you know, is this just, you know, you're not going to get any better by going through it, too. And those are kind of questions that are still out there. I'll refer to.
Law of diminishing returns. Right it takes so much money. It takes only so much money to get close to reality. But you never really like in vr, I'm using Padlet. I'll use a pen as representation. I'm using a paddle to represent, you know, instruments and a drill. Everything, right? Just a single paddle.
So I'm never really it's never really real. But if I give a if I give a resident the ability to go through and train and do a procedure where they couldn't do it before, that's an easy like overwhelming, then the statistics are always in the 200 300% It's they seem kind of ridiculous but it's either you can do something or couldn't do something, but now you can. So that's powerful, right? Because we're still closing the gap.
So now when they get into the actual hands on training, then, oh, I know where to go. I know where this is supposed to be. I know. And boom, I go faster. So I have a question. I think, touched on scalability. I'm curious about the scalability and standardization.
Do you think these technologies and the complexity of building these modules will lead to more scalable standardized solutions, or will we still see education created by individual institutions or by even faculty? I'll give you my $0.02. I think that we are seeing somewhat of both, that the solutions are becoming much more scalable in that you have the underlying platform.
Those platforms can have a wealth of assets on them. But then like what I showed you, those assets can also be tailored and that is a huge trend that almost every academic center we work with, every education company, the device companies all want to put their own flavor on things, so they want to make know Leslie's point. Massive changes. They don't have the time or the bandwidth or the money, but they want to make incremental changes.
So if you can put the right baseline of assets in place and then allow them to adapt them. That's what I think is the future and that's what's going to allow it to truly scale. So that's know, it's something that we're heavily focused on. That plus, again, the fragmentation of solutions. So put the technology where people already live, take it and embed it in the wealth of information that an organization already has versus creating an entirely new workflow.
Yes, I really wanted to say that too, because in order for it to be scalable, it has to fit into the infrastructure that's being built. And when universities, for example, and even in the hospitals, when they're building their infrastructure, their systems, you know, we that's what the people like us on the panel, you know, we have to inform them like this is coming. You know, we have to build this into the system in order for it to be flexible.
And then the money has to be there. That continued investment from leadership, which is what I'm advocating for right now, is like we have what now? It's like three generations old headsets. So where's the money to get these heads? Because that was grant funded. It was soft money before. We need to fund it into the enterprise to make it scalable and we want the standards with the modification.
So I really should have said anything more because you said it perfectly. So Thanks. um, I've got a question. To what extent have you talked to the games industry? Because as I was listening to everything you were all saying, I had two words going through my head, I suppose. Three words.
One was unity and the other one was Unreal engine. And I was sitting there about the market thinking about the marketplaces they've got. And I was thinking particularly with Unreal engine, about the fact that they have built something to make life easier for architects to use a game engine to do renders and take clients through and stuff like that. And I was just wondering.
Have they paid any attention to the education world, to the teaching world? Is that coming next? What's going on there? Because that seems to be a very interesting place. Um, sure. Happy to. Happy to chime in. I mean, a lot of what you saw was enabled by all the money thrown into video games, right?
Like that was the driving force for a lot of the back end technologies that enabled interactive 3D. So we've absolutely piggybacked on that momentum from a platform and an accessibility standpoint. In terms of the marketplaces you're mentioning. Yeah, like because. Which is odd, right? I mean, health care, as people mentioned, is very risk adverse because at the end of the day, the customers are dealing with patient lives.
So lags innovation wise behind other industries by like 10 to 15 years. So the marketplaces that are out there, including oculus, is still cater almost solely to games. But I do expect that to change over the next few years as all these training and enterprise applications become more mainstream. Time for one more question.
And if not, I want to thank our panel for coming this morning. You guys were terrific. I hope everybody learned something new. Uh, from them. They showed some great demos and it was really interesting to be a part of this process of even bringing this panel together for you guys today at SSP. So please talk to us if you have any questions afterwards. And Thank you for coming.
Segment:0 .
I am Diane harnisch. I am a Sr. Consultant with Delta think and we're along with my partner, Bonnie Gruber. We're thrilled to be here today to talk with everyone about really interesting emerging topic, which is finding your place in the emerging immersive education universe. This is a health science case study, but the applications and needs can certainly transcend into any of our academic disciplines as we get started.
We'd just like to recognize our core values with SSP as well as the code of conduct. And today's conversation is really why immersive education? What is it? What are some of the current applications? We have a stellar rock star group of panelists today that will introduce themselves as in the first time that they actually speak, rather than taking some time to introduce them here at the beginning, we'll ask them to introduce themselves as we go, but we're going to talk about specific applications, advantages, benefits as well as challenges.
Get a few of our panelists to talk about where they see immersive education going in the next five years and then really sharing some perspectives on how you get started, where what are the roles and responsibilities across our ecosystem. And we have a very interesting case study on with one of our panelists that he will share as far as how his society has really addressed this new opportunity.
To get started, though. We're just to level set. Why we're here, to speak about and talk about immersive education, immersive technologies. If we give it some definition, it really starts at the very in the middle with extended realities, which is an umbrella term, which really is the merging of the physical and the virtual worlds. Mixed reality is that blend of physical and digital worlds.
Augmented reality is the overlaying of the existing of an existing physical environment with digital content. It's really an area that is very much moving to the forefront and gaining significant motivation or motivation and momentum. And then virtual reality is what a lot of people are thinking about insofar as immersive technologies putting the goggles on and actually becoming part of the visual space.
Specifically for immersive education. What is it? When we talk about immersive technologies, I think any of us that have kids see our kids with the goggles on or doing different things when it comes to the gaming industry. But immersive education is really the process of learning with the usage of simulated or an artificial environment.
Take that definition. It's existed forever. OK thinking about our health science case study, every medical student goes through clerkships. Every medical student does some type of apprenticeship. Nurses do apprenticeship that is immersive learning. OK what we are seeing here is technology further enabling that learning process and what some of those advantages are shown here.
Visualization when a learner is able to further visualize content, especially difficult content, it transforms the difficult into something more understandable. It gives them the right to fail. You don't want your surgical resident to be failing when they are learning to do a surgical approach for the first time. So this environment allows learning to have some missteps and some repetition, and it reduces that risk.
It provides a productive environment, keeps learners engaged and motivated because it's more engaging and exciting and dynamic than sitting in a classroom and having that just lecture type of environment improves the quality of of, of training moves from passive learning to active learning creates interest. It enriches the learning process and certainly it creates that hands on application, which is really a critical part of did I understand it?
If I understand it, I should be able to apply it. And if I can apply it, then I truly have mastered it. So we wanted to give a little perspective here at the beginning about some of the prevalence of immersive education, even though our case study is really around the health sciences, immersive education is happening across all of our disciplines. We did a little bit of a look, recent study of study of research that's being done.
There's a good deal of research right now being done to understand the impact and the outcomes of immersive education across all the disciplines. And this graph really shows that it's happening across all of our sciences, engineering, certainly medicine and even the social sciences, some of the key influences for the adoption. It's actually financially more feasible for academic institutions to incorporate.
Taking away the VR aspect, which is really the investment in those goggles. R can be deployed and we'll show that today through some of our examples. It can be deployed into devices that every one of us carry around every day, which is our mobile phones and our laptops and our tablets. Heightened power. The fidelity of our personal devices is causing a broader, more ubiquitous deployment as well as this last point is, is one that I think is a very important thing.
The barriers of what a typical teaching environment looks like, learning environment is breaking down. And that isn't just through the last couple of years with what happened to education. Many faculty walked into a wall and had to start teaching virtually. It was it was breaking down before. I do a lot of work with faculty around flipped classrooms, team based learning, there is a tremendous amount of learning being done outside of a classroom, and those learners of today in these new modalities are your researchers of tomorrow.
They are your practitioners of tomorrow. They're learning in an environment that is much less traditional than what we would have thought of academic education in the past. So a really important one last point here is by the numbers left this to last for a reason to really talk about market need before we talk about how big this need us. And as you can see here, the first part is all segments and applications that they are.
The numbers that we pulled together around all immersive technologies are being used across retail, consumer, the housing market, engineering, whatnot, entertainment, big market 20 by 2028 is projected to be $84 billion with a 58% kegger to continue to grow very, very rapidly. Looking at the education segment, specifically, a very large component of that large market, $13.1 billion 43% kegger.
And the last point, the 97% indicates the percentage of academic institutions in the United States that are engaging in and with immersive technologies in some way, they're either testing it, engaging with it or fully deployed. So your market is already going in this direction as far as the education. So today we have a great panel and we're bonding and are so thankful to our panelists for joining us today.
We have actually, I think, some many new faces to the SSP community, and we're thrilled to have them here with us today. As I said, we'll let them introduce themselves as they do speak, but we have content providers, we have immersive tech developers, and we have that important group of users with us today. So to get us started, we are going to have a little show and tell with the technology.
We try not to go completely immersive in case, we had some issues with the technology here in the room. But we do have some different demos and examples that we want to share with you, starting first with a very exciting project that is being funded by project firstline, which is a CDC collaborative, and I will turn it over to Angie and Corey to talk through this demo.
Great Thank you, Diane. So good morning, everyone. Or good afternoon, rather. So I'm Angie Varsha. I am the director of isolation and quarantine programs for special pathogens at Nebraska medicine, which is in Omaha, Nebraska. And for purposes of this panel, I serve as one of the primary investigators for the CDC'S project first line collaborative, where we are funded as an innovation partner.
So one of the tasks that we were asked to accomplish through this collaborative was to improve equitable access to advanced technology and immersive education for frontline health care personnel, particularly focusing on advancing infection control programming in small, rural and critical access hospitals. The majority of Nebraska is actually classified as frontier or rural areas. And so this was a particular passion project for me and my team.
So what we wanted to be able to do was provide these resource constrained facilities with better access to immersive technology. So we completed an analysis of a gap analysis that was done by our infection control and response team in 2016 to 2020. And when we looked at those results, we found that frontline infection preventionists had particular concerns in the areas of sterile processing and device reprocessing.
When we think about the application of immersive technology for frontline health care personnel, this is a group that has did not have access to these tools when they were going through their professional training, through college courses. And we found that this area of focus was where they had an infection preventionist who had a partial FTE.
They were also the director of nursing. They were also the director of quality. And now they're in charge of infection control, particularly in the last two years where COVID is running rampant. And hospitals are completely overwhelmed. The focus on infection control has been even higher. So one of the things that we set about doing after we identified the area of focus was to evaluate and select a platform.
One of the things that we were most concerned about was scalability. But then we also had to look at feasibility of implementation, accessibility of the technology and affordability to kind of talk to Diane's point of, you know, these things are being implemented by 98% of academic learning institutions. That is not the case in frontline health care environments.
And we want to make sure that our front line providers are getting the same access to education as people coming fresh out of school. We spoke with one health care facility and they had told us that their annual educational budget is $500 for the infection control department. So when we asked them if they would be willing to invest in technology to implement immersive education, their answer was no, we don't have a budget for that.
So how can you help us? That's the problem that my group is trying to tackle in coordination with the CDC. So as we said about evaluating platforms that were available, looking at vendor solutions, looking at partners who would walk down this challenging path with us. Some of the things that we really were looking for were, you know, a platform that could be deployed in all types of environments with limited access to bandwidth, limited access to technological infrastructure, limited funding to be able to implement these things and to find somebody that would be willing to partner with us as our team had never developed immersive education before.
So how did we identify what should be in the immersive space? So I'm really excited to turn it over to Corey to talk a little bit about the unique aspects of his platform. So Corey and I have partnered together to build the module, and we're going to show you a quick 4 minute demonstration of different components of the module. But I'd like if Corey could talk a little bit about the unique aspects of XR education and how we partner together to make this module.
I will first say that was quite a flattering introduction, that our technology had all these really great and revolutionary features to satisfy the demands of a project supported by the CDC and unmc's. A really grounded and phenomenal ambition. I'll first say that to put it in context, this idea of disease prevention, just imagine going through a procedure, right? All the instruments that are used to cut somebody open, get access and to correct things, right.
When those instruments are done with, they go somewhere. Right and that is that's what infection prevention is. It goes through a sterilization process. So it's really important that that process is it's, you know, secure. It's good because we don't want anything being transferred. Right or transmitted from those experiences. That's a really important deal. And so I would imagine you would all agree that it's very important that that process be seen through.
Right because that's a really big deal. You don't want to you don't want to be the one cut open with a knife that was used on somebody else that didn't go through the sterilization process. That's a really big deal. OK so anyway, that was funded by the CDC and was really fantastic. And so, yes, our platform was selected because we support all devices.
It's a device agnostic solution for immersive training and education. And I'll leave it at that since I'll talk about it more here in a minute. But yeah, let's definitely show that video of this project. All right. Let's see if the. And again, while this is being pulled up, I'll just emphasize that this was delivered to rural hospitals.
So many of you, I'm more than certain, are not attending a rural hospital. Maybe, maybe I'm wrong. A set of objectives that need to be met in order to move throughout the training and the. While you're pulling that up, Diane I'll just say. So these are going to be snippets. So our instructional technologist and our lead developer went through and picked out the components of this module.
So right now we have two novice modules, so kind of introductory level information for frontline infection, preventionists working in a sterile processing or device reprocessing center, and they'll walk through kind of the way that we built it, why we built it this way. And how these will build upon each other. Just to kind of give you a sense of what the learners experience, this is actually a video casted from the headset, so it looks a little bit jerky.
It's not as smooth as if you were doing it yourself, but we wanted to kind of show you if you were wearing a headset and going through it, this is what the experience would look like. So novice modules, these are all laid out, but in more advanced modules they will have paths of right and wrong choices. At each step in the module, you'll be given a bit of a backstory and objectives to check off.
Some objectives will be harder to find than others. Green hover lights will appear. If you need help in the novice modules. Once you have completed the objectives, a pop up box will appear, letting that you have correctly identified the issues in this step, and this box could include more educational information or training videos.
In some of the modules. We have also included items that you can pick up and move using your hand controllers in the VR modality. In this module, we can pick up this item and move it so we can identify the hazard underneath.
Put this person with all the protective equipment for the PPE so it tells us what to do. And after a little bit of time, if you don't select it, then it comes up with these like little green hover icons. So you want to click on this. Dons the scrubs, then the shorts to do shoe covers. And then down. And then a cap.
And that's. And face shield. Once box popped up and it tells you that you've equipped the right. We took common processes and developed them into storyboards and then communicated with our designers to build these modules to better serve the sterile processing departments in small and rural facilities.
Note to self, we need to include some background music for some of this.
Maybe from idea to module. We couldn't have done this without the team of experts in infection prevention and control, sterile processing and extended reality and design.
I'm sure many of you guys have heard the term digital twin, this sort of stuff, right? Like recreating exact replicas of environments. Right this is essentially what this is, again, in the world of xr, there are so many terms being thrown around and so much enthusiasm. But that's essentially what this is, right? It's a recreation of an experience that someone can have.
We hope these modules will help facilities be able to educate and inform professionals about the correct sterile processing and infection prevention processes. We like to take a minute to recognize our development team. It was a collaborative approach between Nebraska medicine, Nebraska medicine, Bellevue or Nick's team and then the Heisenberg group. Cool and again to emphasize simulated experiences that they can, that they can have not only the single this one time, but they can do it many times, over and over and over again right.
To confirm that they've got the process down. Right it's objective training and education to help them, you know, prepare. Right accelerate accelerated learning is really what we say. And I would add, so I know it's a little bit difficult to tell what the experience would be like. And this is one of our novice modules. So we're in the process of piloting these modules with small and rural hospitals in partnership with our state health departments and the CDC.
We've had an overwhelming response from people that want to be able to take these modules. So right now we have 20 people enrolled, 10 of them have completed all the modules in the pre and post assessments. And I think just for some data points to kind of give some weight to this presentation, our preliminary feedback has been extremely positive with 90% of participants rating the content as relevant, useful, and they anticipate that it would improve their practice.
While it might not seem that sterile processing and device reprocessing is a labor intensive or intimidating environment, when you're fresh out of nursing school and you're stepping into this environment, running an autoclave, being the person that's responsible for ensuring that all of these quality processes are running appropriately can be really overwhelming. When we got the feedback from folks who have taken the module to Corey's point, they've taken it on a phone, they've taken it on a PC or a tablet, and then they took it in the headset.
So they've actually taken each module three different times. What we found is that 60% of the people preferred the headset. 40 people, 40% of them preferred the iPad or a PC. And when we asked if they would prefer to take future education on a particular modality, almost, I think 90% of people said that they preferred the headset. But of those 90%, 60% said that they don't have access to headsets.
And so when we think about trying to give people equitable access to this type of education, it's critically important that we want either find a way to make the technology more affordable and accessible or we develop platforms, continue to develop delivery methods that can be found on all different types of devices that they do have access to, so that the inability to purchase a headset doesn't prohibit them from using this type of technology.
Thanks, Angie. Glory Paul, I think we were going to go to you next to speak about your. Perspectives, please. Sure Thank you. My name is Paul zemaitis. I'm the director within the education division at the American Academy of orthopedic surgeons.
And I'll give a little bit of our case study at the end here on how we got here. But I'm going to kind of give a perspective on how this technology is being used in orthopedics right now. And I think there's two things to kind of differentiate here, and that's virtual reality and augmented reality. And the use cases are quite different between the two in virtual reality, much like how we saw in the demo here, it is being used kind of at the training level primarily.
I mean, it starts at the medical school. There are gross anatomy courses being taught in several medical schools around the country that actually are not using cadavers any longer. And they're being taught through virtual reality. And then all the way into residency, there are programs who have adopted this as a part of their I want to say curriculum, but I think that's a little bit strong because that's actually one of the barriers right now to its adoption is that there is no curriculum at this point, but some individual programs are using that.
And then all the way into the fellowship kind of phase of orthopedic training, some early preliminary studies right now are demonstrating that the technology has construct validity, meaning, you know, you actually can learn, acquire skills through this. It's largely kind of procedural based. You learn the steps of a particular procedure, you know, it being total hip arthroplasty, you know how to start and kind of go through the finish.
But it's not gone through to patient outcomes. You know, I don't think anybody in here would trust a resident halfway through their training just because they've gone through a virtual reality kind of training. But they're more confident going into the or when they are then working with the attendings. So to the point earlier made about accelerating that learning curve, really that's kind of the major opportunity here.
There's all kinds of different restrictions, work hour restrictions on residents. So this is kind of looked at as an augment and not a substitute for the other kind of training. And then the other one that I wanted to mention is augmented reality, which is being used much more as a tool in surgery right now. And there are a few companies that have FDA clearance for very narrow use cases of it.
There's one company that's doing a spine case where you can actually upload patients diagnostic studies into the xr, into the augmented reality system, and you can overlay their images over the patient. So as you're going in there, you can actually see the images in the particular uses for placement of screws in the spine. And so you can be much more precise and accurate in that placement, in the placement of that screw, which in that case is really important.
So, you know, those are a couple of the two use cases right now in orthopedics. There are a number of challenges, I think, to the adoption of it. The technology is good, but it's not there yet. You know, and I think that specifically in surgical training, you'll hear something around haptics and that's the actual tactile feedback of doing a procedure that technology is getting better, but we're still a ways off from that.
And then the curriculum piece, there were some other studies done around other surgical simulators done. And when orthopedic programs have them in place, if they're not built into a curriculum, the adoption varies quite a bit where you have some residents using the simulator, a lot others are not. So it really needs to be tied into a curriculum and then further down the road as the technology gets better, you know, I think that the use case could get into credentialing for orthopedic surgeons.
Are you maintaining licensure that way? And it might be a way to. Get the practicing surgeons using it. And then finally, I think building on the accessibility, I think the potential for this also is to get it in the hands of medical students who don't necessarily have access to a lot of orthopedic training in their medical schools. Not every medical school has the exact same kind of training and exposure.
And so it kind of creates a pipeline into orthopedics if you can get them more exposure through virtual reality at that early phase. So that's kind of at a very high level of where Ar VR is in orthopedics right now. Thanks Thank you. Paul Frank I think your next. Yeah come on up. All right.
Minimize this. All right. Hi, everyone. My name is Frank Sculley. I'm the CEO of a New York based company called biodigital. We are a medical visualization company. Been in the 3D for medical education space for about 18 years now.
The first decade we provided consulting services and over the last 8 or 9, we license a virtual probody platform that we call the biodigital human to a series of segments across health care. Last night I was told by at least 10 people don't try to do a live demo, so I'm going to try and do a live demo. Fingers crossed.
But before I jump in and show you some of these modules, I think some of the themes that you're hearing right. I think Diane started by mentioning ubiquitin then Angie followed on around affordability and accessibility. So that concept around immersive, I think is especially important to emphasize and something we think a lot about. So if you're going to build something, make sure it's available to your end users and try and meet your end users where they live.
Don't force them into another workflow, right? People are already inundated with all types of different software solutions. So that was fundamental to the design of this platform. And for the record, doing something that others tell you not to do is like a premier quality of a CEO. So that's how we know this. He's telling the truth right now.
Validated that's right. Taking risk. So again, going back to that accessibility point, the first thing to note here is this is not my laptop. I don't know how powerful it is. I just needed to go to a URL to pull up the technology. equally.
I can pull up the same URL on my iPhone. Going back now to all the way to the iPhone seven, we fully support this. We also I'm focusing on web and mobile just to complement what some of the other speakers are doing today. All of what you're seeing is also accessible in a headset and as Paul mentioned, augmented virtual reality. Each of them, we think, has their own place in the immersive ecosystem.
But you can see here something that we really the reason we were able to do this was somewhere around 2012, these specifications developed. So again, this is built with only HTML standards. If you're technical, it doesn't require a plugin, nothing to install. And even these massive data sets are virtual human bodies comprised of over 10,000 independently selectable objects.
Will run on any device. And that was quite an engineering feat that I give a ton of credit to my team for accomplishing. the head and neck. Being one of the more complex regions of the human body. If I'm the peel off some of the layers. You get a sense of what was involved and to get this right. You know, we partnered with New York University Medical Center.
Johns Hopkins had compared it with imaging data sets. It was heavily peer reviewed. And now we're working even more closely with our partner in Wolters kluwer in the distribution of the product. But you can see all these parts. Independently selectable described. And easily manipulatable in interactive 3D.
So something that was somewhat unprecedented to be able to understand the spatial relationships in anatomy like this. And then in addition to that, to truly emulate the human body. And that's our goal, is not only to map anatomy, but to make this a comprehensive virtual map of the human body. Think of it as like Google Maps for the human body. We also had emulate physiology, disease, states and treatments more time than I have to go into today.
But just want to show you technologically what's now possible. On any device. You know, we can emulate things like the physiologic function of the heart. Similar to the head and neck. If I dissect off some of the layers.
You can dive in and see how a heart valve functions. So this is now heavily also used in clinical workflows. Again, we have medical device customers, pharmaceuticals, hospitals, education companies, schools, and to be able to quickly contrast and compare in a visual format from normal function to abnormal function, we found to have just incredible learning benefits.
Can you give me the hook at any time, by the way? OK um, just touch on another couple quick concepts. Simulated procedures. So the cognitive tasks in a procedure. You know, from being able to. Go into the simulation lab or a very expensive cadaver dissection versus having access to something like this on the subway.
And I'm not I don't go nearly as far. I think we position our technology as complementary. Those other learning modalities are still needed. But can you get your customer from A to B and then they can go to B to C more affordably when they have access to those facilities, which we know are quite expensive. So this technology.
It's been now validated in a number of peer reviewed studies, studies that we don't bias. We're not involved in done by academic medical centers. A few years ago. A European medical school did one where they had a control group using virtual models of anatomy, and then they had their other I mean, sorry, the control group was using the cadaver.
Another group was using the biodigital cadaver models. And again, we positioned our technology as complementary. And we do believe there's still a ton of value in those cadaver dissections. But what they found was that group actually performed 16% better on their exams and having access to the technology fully remote. Uh, more recently, the Smile Train society did a similar study and found that compared to traditional methods, that resident education was enhanced compared to using illustration, text and so on within these virtual environments.
So when you think about adoption, I think and we'll I guess we'll talk more about the future, but the efficacy of the technology is really beginning to surface. Years ago, we were servicing mostly the visionaries, the early adopters, those people that were willing to take risk. Now, in many of the segments we serve, it's become more mainstream and. Dios the reason being is because it's now much easier to adopt.
It's more turnkey, it's more affordable, and it's been proven the benefits of improvement. So again, lowering risk to adoption, which is incredibly important. So I'll stop there. I could. You know, I could. Leslie is next.
Thank you, Frank. No problem, sir. Put your slides back up. Now, Leslie's going to go to some other things. And everyone, we hope that this is spurring some different thoughts and questions. And we certainly are happy to take as many questions as you have later. We're just going to continue to do a little show and tell.
And Leslie is next. Thank you. My name let me take off my mask right now that I'm at the podium. My name is Leslie Hammersmith. I'm the assistant dean for technology enhanced instruction with the University of Illinois College of Medicine at Peoria. My role there is really is working with the whole enterprise of medical education from the phase one, you know, very the first year medical students all the way through residency, education and physician education.
So half my time is spent with the graduate medical education and on the applications within the clinic and surgical planning and some of the things that we've talked about there and educating residents as they're going through their programs just on in every program that we have. So it's very broad. And in the undergraduate medical education, the basic sciences and core knowledge, preparing students to enter into clerkships and then using technologies within their clerkships as to advance their skills and training.
So it's a pretty broad. So I work with faculty one on one, and in small groups I work on the curriculum development side of what we're trying to do. Hold on. There we go with developing classrooms. Let's see if I can make this a little bit bigger. I know that let's go back to the beginning. It's going to be small for you here.
This is just the background for you to have something visual to look at. I'll make this link available to you at the end if you want to go through and read this. So I'm going to frame this because I work with faculty and on faculty development and in the technologies that are in our classroom and how we're incorporating it into our instruction. And when the pandemic hit, how do we actually go to online teaching in 24 hours, which was really fun.
But actually it was really fun because I worked 20 years to get to that point. And finally I had that moment. So I might have different perspective. But after the pandemic hit the College of medicine, let me step prior to the pandemic, the College of medicine has we have a virtual reality lab, a six workstation with headsets. It's HTC Vive lab that's set up in our anatomy technology area.
So we call it the anatomy technology lab. It has an anatomage table. If you're not familiar with anatomage, it's so if you think about digital, but like 10 years ago where you have this humongous table that it's touch screen, you can see the images and you can use your fingers and manipulate it, but you can't really take it anywhere. It feels really clunky now. So it was really cool at the time, like 2015.
It was kind of cool. So we have that in our anatomy tech lab and then we have the virtual work, the headsets prior to the pandemic, we had faculty, a faculty member who has left, who left our institution, which is a key thing to consider as in an academic environment for initiatives like this and how it's being integrated into curriculum. We had a faculty member who was focusing his research on developing virtual reality, so we had lots of virtual reality modules that were created in a platform called nouveau in vogue.com. I'm not here to represent nouveau.
It was the platform that we had available to us. Let me just get out of here real quick. I'll show you very quickly. What this platform is. It's a sort of workspace based. It's a public you can go to google.com, you can create your own account. And they have lots of courses that are available to you publicly.
It is app based so you can access on your browser. You can go in and you can see what courses are there for you to enroll in. You can enroll in one of them and go through that course. If you can download the app, get it installed on your computer and your computer must be able to run this, the technology, right? So that is I'm not going I'm not going to go into an nouveau course live because this does this.
Like I said, you need to have the app, right? That's one of the barriers, actually. You have to have an app and the app only runs on Windows. And 76% of our students in the medical school are Apple users, IOS, Mac OS. And so right there you have this access barrier before you even get started. But still we manage. We manage to create content.
We manage to have our students go through the content we get. We got data back. They really liked going through the virtual reality content. And so we know that there is good reason to continue having this initiative going forward. So let me jump then to the pandemic and what happened at the pandemic. Our lab closed. Nobody was on campus.
We couldn't go into the lab. We had social distancing. You know, we had another access problem. Our faculty member left. And so we didn't have a champion to kind of lead the further development of what was happening in the lab. So after a year of coming back onto campus, I decided we need to do something. We need to organize around what's happening in our virtual Reality Lab or what's going to die.
And so I created a faculty fellow program to get interested faculty to be committed for 6 to eight months to immerse themselves in immersive learning and go through development from very beginning of learning what is VR and what our applications of virtual reality in education to having a course ready to be put into our curriculum that following year. So four members and this I'll just go through this really quick for members.
You can look at this and read about the program and how we had it set up. So four faculty members were selected to be part of this program. Two of them focused on the phase one. So the first and second year core knowledge, medical education, and two of them were resident physicians working on resident education that would go back into the clinic.
They again in duveau the platform. I hope you can get an idea here. You see some floating glasses? Can you see my cursor right here? You see some floating glasses sitting there? You see the background? Looks like Mars. So the idea you have an open book, it's blank page when you go into and when you create a course on this platform.
Meaning that you have to if you want to see a clinical environment, you pretty much have to create it yourself. If you want to see a heart model, you have to find your Half model and upload it and have it there for yourself. This was attractive for many of our faculty because they are the curriculum developers. They own their content, it is their intellectual property.
And so they were excited to be able to take the things that they have made and that fit our learning objectives perfectly for our curriculum and put it into this environment that excited them. And duvaux then allows you to record lectures so you can have and it limits the time. So you can have five minutes of instructor led presentation. That's the glasses. So when your viewer, when your student in the environment and you start the recording, you all of a sudden see these glasses floating next to you and they have a pointer and they can use that to point at things.
So there's a presence there sort of guiding you that's not really there. You kind of have to get used to that and you can walk into them, you know. So sometimes you walk into them and you're like in their glasses and you're like, wait, oh, sorry. So it gets really confusing sometimes. But but that's the idea. The other aspect that they liked about that is that there are space for assessment questions.
They go through the pre-recorded lecture of five minutes, a lesson of five minutes, and then some questions are assessment questions are listed and they can go through and answer those assessment questions. Now it's kind of limited because it's sort of have four arrows, these little arrows down here. Are marking different places in your question might be which what is the pathway that involves whatever and then you have to click on the colored arrow and hit Submit and then it will either give you a check, green check.
Yes, that's correct. Or red x, so there are some limitations, but they like the idea of assessment at that and we don't really have a way to export that assessment. So it's sort of stuck in its sort of self review and not something that a faculty member can go through and see that process of students learning faculty loved going through the program. So that was the anatomy faculty little screenshot this one is on mapping the nephron this one actually we just used this in the curriculum.
Last week was the first time we had students coming in and going through this for this, the block that was happening that was related to this, this project. And so you can see here there's a model. There's they have 3D model. And then there are slides here that are similar to PowerPoint slides. Right? probably was a derivative of something that had been in a PowerPoint slide that you can import the image and put that in there.
And so you're seeing a mixed a variety of the kinds of elements that you can put into the platform, which also was attractive to us because we have a lot of content that is not necessarily built for immersive learning environments, but we would like to reuse and put it into an immersive learning environment, hopefully bringing the making it more active and immersive into this, this, this space.
So that's another example. The students liked going through that. And then this, this faculty member is one of our clinician, our resident physicians, and his module is more on cardiac physical exam and giving the other residents the, you know, the steps for doing an exam. And I wish this would be really great to have the video of it, but I was not as fearless as a CEO.
I'm in academic technology and that kind of like pounded into you that technology will probably fail. So you can see this one is interesting because right here, this is a little this is a video screen. This is an actual video of somebody swallowing. You can see the swallowing action happening and it's on top of and in this screenshot, it's a little bit transparent, but it shows the throat and the esophagus like going down and the connection.
So they're overlaying what is actually happening in the video over our 3D model. And then you can expand, you can change the transparency, you can highlight where things are going. And so the visualization and the constructor that knowledge is something unique to what you can do here. And then there are the ekgs and other videos that are happening. So you can see the vitals and the student then can control that.
They can mess with that on their own. And when they hit play, then the faculty instructor will come in and provide the overview. And then at the end you have the questions. So also a very good model. And then this is another physician, a resident physician on heart failure. And she also did the same sort of thing. Now you can see her environment doesn't look like Mars because she has these are just images of a clinic and a bed that she has.
And if you back out of that, Mars is on the outside of it still. You're not out of Mars. You're just you can just immerse yourself here. And that's a video of a patient who is actually having symptoms of heart failure. And part of her module is to have the learner identify with the arrows. They can move the arrows and point to, OK, where are you seeing what are the symptoms that you're seeing?
Can you mark them? And then when you hit play, then she goes over like these are the things you should have had marked and you can set yourself up that way. So that was also something we liked. Do you want me to go on to challenges? Yeah and we had to do a lot of Partnerships. So our this, this project, this program didn't have a funds attached to it.
So the faculty did not receive, you know, Tens of thousands of to buy equipment they were or to buy assets. Because what we learned is that we really have zero 3D assets just sitting around, you know, and so we were our faculty were scrounging, felt like it. We felt like we were scrounging. But we have there's lots of pockets of innovation happening across the OSF hospitals, academic faculty, academic panhandling, panhandling because we had to go and say, did you or do you already have something developed here?
Or our partners that jump simulation center where they have a medical visualization group, they were key because we could go to them for no cost or low cost due to our partnership and have them create custom models for us, which we like because we want the intellectual property of it, we want the copyright of it, we want to own that because we want to use it. And derivatives, from what we're creating here, this can't be the only way that we're doing this.
And so that is really key for us. That's what we wanted. What we learned is that our faculty, if they're in charge of finding their own assets and creating them, they have to learn a lot more about 3D assets than they ever wanted to know. They don't want to know about, you know, the polygon count that you need in order for it to fit inside of or to work very well in the Nuvo platform or whatever platform you're using.
They don't want to do that, and I don't want them to waste their time trying to find that either. I don't want them to have to go to sketchfab, you know, where you can go and you can purchase sometimes pretty cheaply, but you can purchase and own models. But then sometimes it's not perfect for what we're trying to show. And so we have to go to blender, which is another app, a whole other skill set.
I don't want my faculty to become blender experts, to have to be able to use their assets. You know, they need to be able to have a repository of the content that will suit their needs as best as possible with the least amount of editing or modifications because we end up paying for those somehow that that is necessary. So it's kind of a balance.
So we're I don't know, I think I might be getting into the going five years from now. So you guys tell me what you want me to go right now? You start because I don't want to talk too long here. Why don't you speak a little bit regarding you've learned all these things. Where do you expect this to go? What does your program look like in the next five years? And then we're going to share ask that question to a couple of the other panelists, please.
Yeah, so right now, so we're this puts us. We ended up with four courses that can be put into our curriculum. Going back to what Angie had said before about access, that is so key to me because I have courses now available, but how do I get people in them and using them not only finding the place where it fits into the curriculum that we talked about to that curriculum module.
Where does it go into the curriculum? But how then if you have it in the curriculum, how are how do people actually get to it and use it? And what is the support consequence of that from a university's perspective especially? And so that's kind of where we are right now, the sustainability of these courses. An access. And I'm starting to think actually about headsets and like the quest two headset I would love to have in my right now, just have them and give them out to people.
But our University does not. Or maybe it's just my it group is concerned about the privacy concerns, especially around with meta, right? And so they're like, well, we don't want you to get that. We don't want to have it connected to the Facebook thing. There are no other headsets out there that will just put on your head and you could do things. There are no other headsets really right out there.
And we've been looking at them all and evaluating how does it fit into our enterprise, how does it fit into the it management of this from that perspective? But most importantly for the user, how easy is it for them to use it? So, you know, think back to 2009, 2010. If you were alive back then, we were all alive, right? They had a lot of iPad initiatives at universities.
So students would matriculate, boom, boom. Everybody got an iPad. There was content for it. That would be great for me. Give me some like a quest. And I'm saying quest. And I'm not here to I'm not trying to we don't have them at the University at all. So I'm not trying to promote that.
But just as an example, if all my students that are matriculating, we gave them a quest. Two, you decide what account you're using. You decide how you're doing it. We're just providing content that was selected, perhaps created, you know, and aggregated by our faculty. That you can access through that device wherever it is, whatever platform it is, because you've seen some really great platforms here and there are really great platforms out there.
So that's kind of what I'm thinking. Is there going to be a virtual reality as part of sort of the initiative to get that access handed? Now it has to be cheap enough. The licensing has to be flexible enough. It's not just my campus of 65 students per class, but we have three campuses. So if something happens in Peoria, it has to go to Chicago and Rockford because those are our other campuses.
And it has to expand and it can't cost the University or the college millions of dollars to do that. But that's the access point, like so the faculty Fellows program, that's what we had to do with our faculty. They didn't come with equipment and we didn't give them laptops. They had to come to our lab to do these things, to our lab and then to their workstations at work.
And they were bouncing back and forth. And while Nuvo has a first person view, so you can you don't have to have a headset. We we are trying to make this immersive. We felt like that was not so immersive, right? So in five years now we're excited about the idea that Apple is coming out with their version of augmented reality and virtual reality. And if you start reading about that, that I think has potential.
And 76% of our students are already in that ecosystem. So if we could get something that is in that ecosystem that is not cost prohibitive to adopt but just sort of plugs right into something that we've already accommodated within the University environment, that would be fantastic. But it's happening in 2023 and 2024, and I think the next two years are really it's really going to show us the directions that we can go into.
Great Thank you. Thank you. Um, we heard call to action around Content Accessibility. But I think a great case study with Leslie at University of Illinois is they're doing it. They're making that content themselves. So and why is that? Frank talked about outcomes. Data is coming to the forefront with immersive content, that the learning process is enhanced with these type of tools.
So yes, we're early, but yes, it's the momentum is continuing to pick up. So I'd like to just ask Angie, if you could speak just a bit about where you think and your training environment this is going to look like in the next five years as well. Sure thanks, Diane. So, you know, talking with our team and trying to put together some thoughts about where we want to see this go in 5 years and then where we think it actually will be was a really interesting discussion.
And so as we were talking with our instructional technologists, really the Association is predicting by 2025 that nine out of 10 people in the industry of immersive technology believe that it will be as ubiquitous as mobile devices. So everyone, 90% of people are going to be accessing this on a regular basis. That's not five years from now. Right? that's three years from now.
So what we really think is that as health care workers continue to be stretched prior to covid, we already knew there was going to be a nursing shortage. Not a surprise, but this just accelerated the issue, the ability for people to be able to take time off or get paid time to attend trainings that are 8 to 10 hours for hands on workshops, those days are gone. We're not even getting time for people to get paid, time off for that type of training now.
So we really do feel like the solution is immersive technologies being used as a tool set to solve the issue. I think to Paul's point, they're never going to be the full solution. This is really an augment to be able to provide better education, more efficiently and more effectively in a more engaging manner. We do think it makes an enormous difference on scalability, quality, cost of training content.
When you think about the price of a simulation mannequin and the upkeep for that year over year compared to the cost of creating a module and then being able to change out an asset, the return on investment is significantly different. The upfront costs are significantly different and the costs over time trend down with immersive technology where simulation mannequins are trending up, replacement parts, consumables, all of those things are different.
So I really do see that for the future, that virtual reality and immersive technologies are going to be more embedded into not just academic institutions and higher education, but for frontline health care workers to maintain proficiency and competency. I think one other piece that I just want to touch on is the implementation of augmented reality and virtual reality and how those are being combined together in some cases.
There's a gentleman in England who has developed a way to utilize augmented reality to see both a virtual version of the end of a helicopter while utilizing mannequins so that it feels like a real simulation. So blending together technologies to give people a more realistic experience to really help them advance practice. There is a white paper on it.
It's professor Bob stone. He is in the UK and it's how do you fix a camera onto an HTC Vive headset to be able to experience these things? So that's really the next step, is pushing the envelope so that learners are getting the most realistic simulated experience they can to make them be better health care professionals, better providers, more prepared for those intense situations where failure is not an option.
Paul, did you have anything to add with the five year perspective, please? Sure So I think moving forward the next five years, I think the resource constraints of different organizations, that's a huge barrier at this point. I mean, it's a barrier for our own organization as well. And so I think, you know, partnerships was something that was mentioned, you know, a little bit earlier.
And I would challenge, you know, to kind of think about the IP a little bit differently. We're we're not very interested in actually owning that IP in that space. And so, you know, the big device makers, you know, in orthopedics specifically, you know, obviously have much deeper pockets than an organization like ours or, you know, individual health care systems and institutions like that.
And so there are a few key players in the VR space specifically that would do also work with the large device manufacturers to develop a lot of this content. And so the way that you can then do that, transfer that into education is then kind of strip it away of any sort of, you know, recognition that it is a, you know, a Johnson Johnson product or a Stryker product or something like that.
And so that way you can have it kind of be agnostic to, you know, any sort of corporate entity and then you can start delivering CME through that. And, you know, I think from a hardware perspective, you know, the next five years, I think the price is likely going to drop significantly over that. We've already seen VR headsets drop considerably over the last few years. That'll probably continue.
Same thing with Ar. You know, I mean the hardware, I mean, as with a lot of things in technology, the hardware piece is going to be the part that's going to get real cheap and almost disposable and it's going to be, you know, a software as a service kind of model going forward. But the key will be, you know, who is going to fund that initial development of the content.
And I think looking at partnership models really is going to be the way going forward. So I think that'll be key going forward. Because I really love what you said about. But looking at intellectual property differently because I mentioned that one of the attractive parts for our faculty is like, oh, we can control this can be exactly what I wanted.
And the amount of time and effort and extraneous knowledge to them that they had changed that. So right now we're actually moving away from using a platform like nuvo, where it expects you to have everything there to more products like digital or education or medical Holodeck is one that we're actively looking at as well because we want to have high quality, because what we're producing, we don't have the money or the time to make it as high fidelity as what we want.
So the faculty expectation they found during the project, their expectations had to be lowered and lowered and lowered and they weren't. That was very disappointing for them. So it has changed the way that we look at the space. And so I think that's really key that they're going to be a lot of changes in how we approach that. And for on the academic side, the University may not be such in stride with us as quickly they're going to say no to things because they're going to ask, well, what about the intellectual property and copyright and privacy, all those pieces?
So that's an interesting struggles. OK, cool. All right. Well, my name is Corey heisner. Just so you guys all know, and not just from my sarcastic comments, but, like, I'm actually part of the panel for real. So I was just going to make a point here. Introduce our technology.
So we represent technology, right? We're we created a device agnostic, immersive training and education platform. Right? so you'll hear the term platform many times when you hear the technology. But our platform addresses creation, deployment and distribution of content to all devices. So if, for example, I asked you guys, everyone pull out your headsets, everyone pull out your VR headsets really quick and I'll invite you into this course.
How many people right here have your VR headset ready to go? Nobody right. So if I asked you to pull out your phone and explain that your phone could also or does also serve as an immersive technology device, right. You might be surprised because we only hear about the VR headsets and it's valid. Like they deliver the immersive experience 100% Our technology focus, the tech that we're responsible for, supports delivery of immersive technology, training, education to all phones, tablets, desktops and VR headsets.
Here, what you see in front of you are projected on the screen is, as I have opened the desktop version of the application education XR. And again, we're agnostic to content. We have no horse in that game. We're agnostic to the hardware. We have no horse in that game. OK, we know what, what and what's valuable.
But we created an agnostic platform, agnostic of, you know, it doesn't matter what device you have or what content, right? It's available on all devices. So here I've invited and Alex and Ben, just if you guys can scooch down just a little bit and get right in front of the right in front of just because I can't. Yeah, there you go. So I've got a couple of participants in from different parts of the country.
Ben is in here from Salt Lake city, Utah. Alex is in here from Madison, Wisconsin. And we're here, obviously. Right? we're in Chicago. So basically what we can do is we can together we can go through a training experience. We're on multiple devices. I'm grabbing the wire. Alex has the soldering iron.
Ben, go ahead. I'll let you take the wire and then they can, you know, we can all do this training together from different parts of the world again, regardless of location, regardless of device. And so this is what our technology represents to date. We have this is our 11th. I've been my academic background is phasing out my minor academic background compared to, you know, PhD is obviously, but it's Physiology and developmental biology.
So in the past 11 plus years, working and creating immersive content, innovative content experiences for medical device manufacturers and medical institutions, we've learned that one offs, high production costs and scalability issues are preventing, if not delaying, what is predicted to be $1 trillion industry and extended reality. The numbers that were presented up here are actually quite a bit.
They're significantly smaller than what we have, right. The kegger for training and education is actually it's a $300 billion industry. Extended reality is expected to be responsible for $1 trillion of, you know, business development across not just medical specific, but everywhere. So currently to date, we work with obviously unmc, mass general, Mayo clinic, Cleveland clinic, Cleveland clinic, for example.
They wanted to create your one year to medical school, anatomy, education. And that's how we springboarded the development of this platform. They came and said, hey, look, we need medical school, education, all devices. We created education xr, but we also created education XR with the idea in mind that we could deliver training to anybody.
So now we're creating with schools in California for federally funded career technical education. We're creating content for diesel technology, for advanced transportation, for print design, so that students who are, you know, doing vocational skills training for interpretation of designs and manufacturing, they're getting trained with content on the platform so that they can get jobs literally by Nasa, right?
So they get this training and they go, now can qualify for a job with Nasa. I mentioned advanced transportation. Another big deal in California. You know, not only incentives, but mandatory. Right incentives to transition to manufacturing that supports alternative energy. Right so. Am I missing?
I miss him. EMT we're doing statistics, math again. Zero bias on what the content is, but the value is accelerated transfer of learning, right? Or knowledge transfer. So we say accelerating the transfer of knowledge. That's our goal because there are shortages not only for nursing shortages all over the place, especially right now.
Right? people don't want jobs because they'd rather hang out, but it's going to come back. But when it comes back, like vocational skills training is a big deal. All these different job placement is a really big deal. OK anyway, I'll let you guys go. Um, Alex and Ben, Thanks for joining, guys. Appreciate it. Thank you.
Literally just talking into these devices, we can hear each other and talk. This is a good example of remote distance learning, training and education. OK, that's really cool. Any other. Yeah, pretty cool. Pretty cool. Um, so.
Oh, I think after everything we've heard and it's interesting and advanced technologies, but it is very accessible. And I think the team has shown a number of different ways in which it's used. But I think for this audience, trying to understand how you get started. And if it looks daunting and what are the next steps and what are the first steps really?
And I think, Paul, we were going to start with you a little bit, even in market discovery and some of the work that has. Embarked on. For sure. So one thing actually, I just want to piggyback on Corey's presentation there. We did something similar to that with an or training where we had about 700 different surgeons across the country join in for a virtual reality webinar.
So you could see it if you didn't have a virtual reality headset. We live streamed it so you could watch it there. And then if you did have a headset, you could actually join with everybody in the virtual or and you could sit there and we had four different faculty go through a total knee arthroplasty, and each faculty were from one of the different corners of the country.
So, you know, I think the opportunity to bring people together is really pretty incredible with the technology going forward. But so my question is, is, is how did we get here? So the American Academy of orthopedic surgeons, you know, obviously we have a number of our members, you know, leading faculty who are in this space. We're working with these companies to develop content. And so we've got some, you know, very vocal proponents of this.
And, you know, how does the Academy get involved in that? And so it really, you know, this is going to be kind of not so much about the technology itself, but really about the process and how does an organization go about getting involved? Because there are significant risks, I think, in rushing into this too quickly. You know, this is an evolving space. These companies are at very different stages of their own life cycles.
There's a lot of capital being funded into the space right now. Some of the really leading VR kind of companies have a lot of venture funding behind them. So it can be, you know, enticing to just jump in and say, hey, that's the one we're going to go with without really kind of understanding what your role is. And so what we did is really, you know, start at a very high level macro, understand the industry outside of orthopedics, outside of health care, understand the different use cases and start to kind of funnel it down and to really understand our role.
And so we also went out and did a whole bunch of different interviews with different users, is different kind of market segments. Who's, who's a content producer, who's working in the hardware? Corey was a part of that process for us as well, and then progressively kind of narrow it down and understand who our audience is. And you start kind of going through what the learner, what the learner's journey is.
And from there you start distilling, OK, what problem are you ultimately trying to solve? And I think that is a real big risk right there is to look at this technology and think that it's a solution for an undefined problem and think can just kind of apply it and it's going to work for you. So getting very specific on what you're trying to solve for. And I think in several of these different instances, we've seen that the technology serves a kind of a different purpose.
It's, you know, it's one piece of the puzzle into the whole kind of learners journey. And so we progressively funneled that down, and we're really going to focus on kind of setting the standards and the parameters for training. We're not going to be in the content development kind of space. We've got, you know, the abos, the American Board of orthopedic surgery has a list of procedures that a resident should be proficient in coming out of residency.
And so if we can set the standards and then work with industry and the partnerships to start developing the modules that correspond with those particular procedures, then you can get kind of scalability. You know, when the company does make it and then a particular institution can get, it's easier for them to access it if that content is available.
But really, from the Academy standpoint, we kind of look at ourselves as kind of we're the ones that can kind of set the benchmarks, the guardrails around this because it really should be surgeon led. In our case, we've got the we've got the experts. And so that's kind of in a nutshell what our kind of process is. I'd be, you know, Diane or Bonnie or any I mean, any other questions you want to probe on that?
That was terrific. And our last few minutes, if we did want to open it up to the room, if anyone had any questions you want to ask the panelists want to give you that opportunity. Maybe specifically for the Nebraska education team, although if anybody has data on this, I'm interested specifically if there's any data either from your project or published elsewhere about a differential efficacy in educational outcomes if you.
So I'm thinking about your platform. As you can use it. You can use a truly immersive Oculus or whatever, or you can look at it on a laptop or phone. In terms of educational efficacy, meaning the skills acquisition of the learners and whatever kind of assessment was done at the completion. Is there a differential between those environments or are they more or less the same or do we not know?
I'll start with just our project. And I would say right now we just don't know. I think that is Ebbinghaus is one of the outcomes that we want to achieve by doing this pilot project, particularly focusing in infection control. And so to kind go off of what Paul had said, one of the things that we ran into is we didn't really understand from the beginning what are the right types of skills to build in a VR environment.
And so it took us a little bit of starting and stopping. But as we went through and we finished building out the novice modules, we're now building an intermediate and then an advanced module. There is an assessment at the end of each module and then we also have like a post pilot survey essentially trying to better understand did you get more, did you have better impact when you took this on your phone, on your computer, on your headset?
What we know right now is that people have been our net promoter score is 70% So of the people that take it, 70% of them said, yes, we would absolutely recommend this to a friend or a colleague. What we have not yet been able to evaluate is by taking this, do you actually have better skills to operate an autoclave? Can you actually do a better job of assessing the infection control environment in a sterile processing department? Right now our focus is on really understanding will the technology be adopted?
What type of platforms are most likely to be adopted in these types of facilities? And then really, once we have that, trying to understand how do we get it into their hands, the next phase of our work will really be focusing on, OK, great. We've established what the delivery method should be. We've come up with a distributive model to get it to them.
Now we start to think about, can we actually measure outcomes? And then ultimately, like the goal is to save more lives, right? So impact patient outcomes, improve patient safety, increase practitioner proficiency and have better health outcomes in small and rural hospitals. So your question is exactly the one we want to answer. Probably my colleagues have worked in this space longer than I have better examples about skills, outcomes and efficacy, but that's exactly the question that we want to answer.
Yeah, I'll add to it that there's overwhelmingly positive. There are overwhelmingly positive outcomes from doing virtual training. Right and it depends on the type of question you're asking. Again, not to deflect the question, but Andrew brings up a really good point. Um, it depends on what you want to achieve from the study, right?
And so is it our outcomes? I'll give an example. So there's a college in northern California College of the redwoods, right? They came to us and said, hey, we want to create training for CNC machining. We have three machines, we have 100 students every semester. We can't possibly we don't have enough time to get these students on these machines.
And so we created a virtual, you know, training for those machines. And what did that do? It closed the gap, right? It accelerated getting access to. They didn't need to spend the time wasting time learning to turn on the machine or look for the labels. All that qualification, time to get on the machine. They were able to do that remotely digitally and then get right to the machine when they got into class.
The other example I'll give and I'll actually defer to Paul because I bet Paul is really good examples, especially there's an overwhelming like data from orthopedics and that'd be really great. But in Merck's case, Merck came and said, hey, they have quality assurance engineers who are trying to get it takes them two months to qualify qualify a quality assurance engineer that two months of reading material, static material from a desktop.
And so that is just before they can get before they can walk the line, right. To actually inspect it and be qualified to do that and save millions of dollars. Now, with you know, we created a, you know, the digital twin of these lines and give them the ability to from any device go through and get that training. So now it cuts that two months down to two weeks and now they're qualified to get on the line and actually and do that because we've recreated the whole thing.
They can do it virtually hundreds times, as many times as they want. There's no limit. And that's a really powerful. That's a again, that's answering different questions. So when we create an interaction, this is not these are not viewing tools of a VR experience, an interaction. When we create it, it's interactive on every device, not just watch it and do it's do do, do on everything.
And anyway, but I'm curious, do you want to give him I think it was a really great data for orthopedics. Yeah so, you know, most of the data that's been published has really come from the last couple of years and the body of evidence is growing that, you know, that skills acquisition, you know, so that's where the construct validity is really coming into play there. But the but the outcomes of these studies are really focused on, you know, going through a VR and it's level 1 evidence right now.
They actually are doing controlled triage. Sample sizes are very small on that, but they are putting, you know, trainees through a virtual reality kind of program. And then you go to a cadaver versus one just going through a regular book training or watching a video and then going to a cadaver. And what then they're testing is did you procedurally go through, you know, say, a total hip arthroplasty?
Did you follow the steps correctly? You know, how long did it take you to complete the procedure? And the preliminary data are showing that the virtual reality trained surgeons, trainees are actually they are completing it properly. The procedure is going more quickly. But this is now on a cadaver, right? This isn't in a real world situation. And so the data just aren't there yet to say that this is going to transfer to improve patient outcomes.
And that's really where we need more research done. And then also over time, how much time. Do you really have to have to be in virtual reality? Is there a ceiling effect also? You know, at some point, you know, is this just, you know, you're not going to get any better by going through it, too. And those are kind of questions that are still out there. I'll refer to.
Law of diminishing returns. Right it takes so much money. It takes only so much money to get close to reality. But you never really like in vr, I'm using Padlet. I'll use a pen as representation. I'm using a paddle to represent, you know, instruments and a drill. Everything, right? Just a single paddle.
So I'm never really it's never really real. But if I give a if I give a resident the ability to go through and train and do a procedure where they couldn't do it before, that's an easy like overwhelming, then the statistics are always in the 200 300% It's they seem kind of ridiculous but it's either you can do something or couldn't do something, but now you can. So that's powerful, right? Because we're still closing the gap.
So now when they get into the actual hands on training, then, oh, I know where to go. I know where this is supposed to be. I know. And boom, I go faster. So I have a question. I think, touched on scalability. I'm curious about the scalability and standardization.
Do you think these technologies and the complexity of building these modules will lead to more scalable standardized solutions, or will we still see education created by individual institutions or by even faculty? I'll give you my $0.02. I think that we are seeing somewhat of both, that the solutions are becoming much more scalable in that you have the underlying platform.
Those platforms can have a wealth of assets on them. But then like what I showed you, those assets can also be tailored and that is a huge trend that almost every academic center we work with, every education company, the device companies all want to put their own flavor on things, so they want to make know Leslie's point. Massive changes. They don't have the time or the bandwidth or the money, but they want to make incremental changes.
So if you can put the right baseline of assets in place and then allow them to adapt them. That's what I think is the future and that's what's going to allow it to truly scale. So that's know, it's something that we're heavily focused on. That plus, again, the fragmentation of solutions. So put the technology where people already live, take it and embed it in the wealth of information that an organization already has versus creating an entirely new workflow.
Yes, I really wanted to say that too, because in order for it to be scalable, it has to fit into the infrastructure that's being built. And when universities, for example, and even in the hospitals, when they're building their infrastructure, their systems, you know, we that's what the people like us on the panel, you know, we have to inform them like this is coming. You know, we have to build this into the system in order for it to be flexible.
And then the money has to be there. That continued investment from leadership, which is what I'm advocating for right now, is like we have what now? It's like three generations old headsets. So where's the money to get these heads? Because that was grant funded. It was soft money before. We need to fund it into the enterprise to make it scalable and we want the standards with the modification.
So I really should have said anything more because you said it perfectly. So Thanks. um, I've got a question. To what extent have you talked to the games industry? Because as I was listening to everything you were all saying, I had two words going through my head, I suppose. Three words.
One was unity and the other one was Unreal engine. And I was sitting there about the market thinking about the marketplaces they've got. And I was thinking particularly with Unreal engine, about the fact that they have built something to make life easier for architects to use a game engine to do renders and take clients through and stuff like that. And I was just wondering.
Have they paid any attention to the education world, to the teaching world? Is that coming next? What's going on there? Because that seems to be a very interesting place. Um, sure. Happy to. Happy to chime in. I mean, a lot of what you saw was enabled by all the money thrown into video games, right?
Like that was the driving force for a lot of the back end technologies that enabled interactive 3D. So we've absolutely piggybacked on that momentum from a platform and an accessibility standpoint. In terms of the marketplaces you're mentioning. Yeah, like because. Which is odd, right? I mean, health care, as people mentioned, is very risk adverse because at the end of the day, the customers are dealing with patient lives.
So lags innovation wise behind other industries by like 10 to 15 years. So the marketplaces that are out there, including oculus, is still cater almost solely to games. But I do expect that to change over the next few years as all these training and enterprise applications become more mainstream. Time for one more question.
And if not, I want to thank our panel for coming this morning. You guys were terrific. I hope everybody learned something new. Uh, from them. They showed some great demos and it was really interesting to be a part of this process of even bringing this panel together for you guys today at SSP. So please talk to us if you have any questions afterwards. And Thank you for coming.
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