Extended reality (XR) in healthcare simulation and beyond is described in any environment as a broad term for technology that alters reality through the addition of digital elements to either the physical or real-world environment. This includes but is not limited to: augmented reality (AR), mixed reality (MR) and virtual reality (VR). New technology that has the ability to blend both physical and virtual worlds is categorized as XR. The terminology of XR includes AR, MR, VR, and includes any technology that has the ability to blend both the physical and the digital world. This article by Erin Carn-Bennett, RN, MSN, will explore XR technologies and the impact that updates in this technological space have on clinical simulation-based education and some products currently available in this space.
SimX Virtual Reality Continues to Push the Boundaries of Simulated Training
SimX, which was recently acquired by Madison Industries, is completely changing the way healthcare simulation training is conducted. For decades, patient manikins have evolved to incorporate varying degrees of sophistication paired with back-end technology to enhance the medical simulation experience. While effective, the clinical simulation manikins require a significant initial investment, as well as comprehensive staff training and maintenance costs. Rather than continuing to support physical manikins, SimX has successfully replaced physical manikin training with virtual patient encounters through customizable Virtual Reality (VR) scenarios. Read more on how SimX Replaces Healthcare Simulation Manikins With Custom VR Scenarios.
Of course, budget is always a key concern for healthcare institutions looking to invest in simulated learning technologies. While the future of Virtual Reality (VR) medical simulation training relies on the successful integration into curricula to stimulate shared clinical experiences, budget considerations often keep many from truly exploring all that VR has to offer. In this HealthySimulation.com article SimX VR: A Cost-Effective Revolution in Medical Simulation Training, the objective is to simplify decision-making by laying out the clear cost benefits of including VR in any training curriculum. Here are some answers to common questions that may be asked to determine the true value of the implementation of a comprehensive and immersive VR program like SimX VR.
Be sure to also check out these exclusive HealthySimulation.com webinars from SimX:
- Customize Your Medical Training with the SimX Virtual Manikin Series
- How the SimX Virtual Reality Platform is Disrupting the Clinical Training Landscape
- Above and Beyond Reality: How Air Methods Elevates Critical Care Training with SimX
- Elsevier Maximizes Nursing Simulation Learning System with SimX VR Training
HTC XR Headsets Help Bring Medical Simulation to Life
Extended Reality (XR) hardware provider HTC VIVE has recently collaborated with HealthySimulation.com to create several key resources for healthcare professionals considering the use of XR in clinical education and training. By sharing open-access resources covering strategies to unlock use cases, VIVE and Healthysimulation.com demonstrate how XR technology is changing the face of clinical education and training. Read more about these resources through our article HTC VIVE: How Healthcare Training is Becoming More Accessible with XR.
Next, HTC’s VIVE Focus Vision headset is the company’s new hybrid standalone PCVR headset. This headset demonstrates the evolution of HTC’s commitment to enhance the virtual learning experience for healthcare professional learners. The VIVE Focus Vision headset offers more features and has some key points that improve the immersive experience and are more useful to support learning. This HealthySimulation.com article on the Revolution of Healthcare Training: How HTC VIVE and SimX Bridge the Education Gap will explore the VIVE Focus Vision headset and SimX’s VR application for healthcare professional learners.
Be sure to also check out these exclusive HealthySimulation.com webinars from the HTC Vive team on How to Transform Medical Simulation Education Curriculum with Generative AI and VR and How to Select the Right VR Headset for Healthcare Simulation Training.
RoadtoVR with Mind-Bending Capabilities
A new project has been completed by researchers at RoadtoVR Reality Labs which is Meta’s XR division. This project demonstrates a way to interact with the world through the lens of augmented reality with mind-bending capabilities. The new Reality Labs research project is described as being so different that the AR project is kind of hard to explain.
The researchers at the Meta Reality Labs Research and University of Duisburg-Essen created a way to make real world objects virtual so these objects are able to be interacted with in real-time. Through the digitization of the objects and seamless erasing of the real counterparts, this method creates a blend between both real and virtual worlds. Researchers Mohamed Kari, Reinhard Schütte, and Raj Sodh have called this concept ‘Scene Responsiveness‘ and have published this work at the ACM Symposium on User Interface Software and Technology.
The method is described by the authors as the creation of a “visual illusion that virtual actions affect the physical scene.” This is of interest as AR demonstrations have previously shown virtual objects that appear to float in the user’s room, attach to walls, or even walk ‘behind’ objects. There has also been the possibility of virtual objects that appear to abide the physics of rooms by movement across furniture to fall off the end of the object for example.
However, the digitization of real objects in the space then gives the user virtual control over the item. The ability to erase the real object from where this sat is interesting as well as virtual characters in the scene that have the ability to appear to be able to interact directly with objects in the real world. Authors also took next steps and demonstrated how to prevent this illusion from breaking.
View the HealthySimulation.com Webinar Mixed Reality XR and Healthcare Education: What Does the Future Hold? to learn more!
TraumaVR by Surgical Science
Surgical Science has a TraumaVR simulator that combines both virtual reality and manikin technologies together. This combination applied together improves airway intubation skill education to improve care for trauma patients. Surgical Science prepares clinicians for the treatment of emergency trauma patients through the combination of manikins and virtual reality in medical simulation.
Patient manikins have some limitations in the versatility of healthcare scenarios and patient anatomies. Education with VR simulators lacks clinical skill and instrument operation realism and tactile haptic feedback mechanisms. Surgical Science’s TraumaVR simulator combines both manikin and clinical instrument based education alongside immersive VR simulation.
TraumaVR is a hybrid VR simulator that combines both hardware and software to be able to optimize the simulation based educational environment. Learners have the opportunity to acquire life-saving procedure skills with realistic visual effects and procedure performance. The TraumaVR platform allows manikins to interface and provide tactile feedback with trackable devices. Tracking occurs with HTC VIVE manikin and goggles. Psychomotor skills, cognitive knowledge, and skill acquisition in airway management are provided in a realistic virtual reality environment that places clinical simulation participants in stressful and realistic situations.
Skill improvement can be tracked and monitored through metrics in the TraumaVR platform in healthcare simulation. Healthcare simulation research has shown that psychomotor skills in combination with VR can be an effective way to promote mastery learning and retention of healthcare skills such as with trauma intubation. Other research has revealed that learner self-confidence, self-efficacy, and competency can improve with manikin and VR experiential learning. Integration of VR in healthcare simulation has also been described in research studies to potentially lead to an increase in rapid learning and lower the cost of education.
MedSim DevKit by Vcom3D
Vcom3D’s MedSim DevKit is a kit of both hardware and software tools that enables users to be able to create individualised interoperable medical simulation solutions. Vcom3D’s MedSim DevKit saves both time and money and supports a number of applications such as physical, VR, AR, and Mixed Reality. With use of the MedSim DevKit, users have the ability to create or adapt healthcare simulation task trainers or models to plug in alongside other MoHSES-compatible clinical simulation modules and be able to build integrated educational systems.
Physical modules may include: manikins, part-task trainers, interchangeable limbs, medical equipment, or wearable simulators. Virtual modules included could be either virtual patients or virtual medical equipment. Full ranges of AR, VR and MR displays have the ability to be supported. MedSim DevKit allows the creation or adaptation of educational content and assessments. There is also functionality to create high-performance trainers through the integration of multiple modules.
Varjo Mixed Reality Headsets and Real Response
Real Response has changed up ways to learn with mixed reality simulation which is a combination of the use of a Varjo virtual reality headset and also provision of care to a physical manikin in the real world. The Australian clinical simulation education provider Real Response makes use of Varjo’s mixed reality options to be able to solve aeromedical military teams’ greatest educational challenge: access to live airframes. Real Response has used this technology to provide educational opportunities to the Australian defense force.
Blue Room software allows a mixture of the virtual and physical worlds to enhance the educational environment for learners. Learners are able to experience enhanced fidelity from the mixed reality headset environment but are also able to complete clinical tasks with the use of physical equipment on a manikin within the clinical simulation environment. Real Response, Blue Room and Varjo have created a highly effective combination of both a virtual and simulated physical environment.
The use of mixed reality in aeromedical military training enables accessibility for learners to learn in environments which can be expensive to access, use, and maintain. The use of mixed reality assists to eliminate any logistical challenges to access real aircraft for education. This also includes access to items such as aircraft and pilot availability and maintenance.
Real Response also works with Garmin to integrate biometrics into the mixed reality experience data. This enables analysis of learner stress levels in healthcare simulations and gives the ability to optimize the clinical scenarios for better learning outcomes. Real Response is also involved in a project on an AI engine that can interpret the baseline stress level of the learner and make recommendations to faculty. These developments in the XR space not only apply to the aeromedical space but also demonstrate visions for healthcare simulation programs across the globe.
In 2021 Laerdal had a short collaboration with Varjo to explore how extended reality technologies could improve medical simulation. This exploration was mostly focused on mixed reality use cases, where visual displays and tactile feedback could be combined to create a rich, immersive simulation environment. This collaborative project ended in 2021 with learnings, and we have incorporated these learnings into new research and development areas, so our collaboration with Varjo is not necessarily ongoing at the moment.
At IMSH 2025, Laerdal also showcased the use of AI and Extended Reality, called Maternity Mixed Reality (MR) with a beta program where customers who purchase Laerdal’s high fidelity simulator, MamaAnne, can utilize the solution and provide the company feedback on usability and value. The Mixed Reality MamaAnne provides the opportunity to conduct peer-to-peer self-led simulation sessions with Mixed Reality, that includes multiple maternity case scenarios, focusing on communication and team collaboration learning objectives. Learn more about Laerdal MR beta program here!
This article has discussed just a handful XR developments in new technologies, as well as some examples of products that are currently available. XR based technology options such as those which combine both a physical manikin with layered VR, MR and AR technology to increase fidelity demonstrate more realistic possibilities for learners to acquire high risk and specialized clinical skills.
Read More: Introduction to XR Technologies in Healthcare Simulation
