‘More competent clinicians’: justifying the investment in XR in healthcare

After five years as the CEO of the NHS Digital Academy, Rachel Dunscombe is now CEO of OpenEHR International. She is also a Visiting Professor at Imperial College London, Director at ECHAlliance and Non Exec Director at the Digital Health Society. Following the publication of our XR paper, she talks to us about how extended reality technologies can equip healthcare professionals with greater breadth and depth of experience

30th April 2024 about a 5 minute read

Q: What do you perceive as the greatest challenge in this space that we need to overcome? 

I think that the big challenges are around the whole infrastructure that we need to enable us. So it’s about choosing the technology, getting the connectivity, getting the asset tracking, and getting companies that develop content for it. It’s a whole new set of infrastructure that needs to be set up. It’s not something that exists today, and I think that’s out of people’s frame of reference in the education space, and we don’t have specialists that understand this, necessarily. It’s the mindset around what we need to do and the infrastructure to actually enable it – I think that’s the biggest challenge.

Q: What are the most fruitful opportunities that could have the greatest impact? 

 The most fruitful opportunities that I have seen are to be able to give people a much bigger breadth and depth of experience virtually. In people’s training, when they physically see things, they will only have a limited subset, but with augmented reality and everything else they can experience the full breadth that they need to, so a curriculum can be put together, or a set of simulations, which basically allow coverage of all of the areas they need to cover. And so for me, we’re going to get more competent clinicians out of this. I think that’s the most exciting part of it.


Q: What does good look like and how do you measure impact? 

If this was me, I would want to do a study of the clinicians who have been through this versus a baseline of those who haven’t, and both the qualitative and quantitative longitudinal piece to look at their confidence and competence in procedures, in interactions. So I think it could be measured, but what would be really important is to make sure you consider how you measure that as part of the programme or project to implement this because without evidence, it will be really hard to justify the investment versus a traditional education, training and development.

I think it’s also possible to look at, say, procedures – I’ve seen a VR and AR used for, say, putting in lines and things like that. If you actually look at the quality of the work of clinicians that have been through this sort of programme, do they need assistance, do they put the line in the first time, second time, or third time? Those sorts of things. I think the educational establishments or organisations putting this in need to work out what the success metrics are and measure those over time.

Q: What is the most innovative application of extended reality technology in healthcare education you have come across? 

There were a couple that I have come across. One is about training paramedics, and it’s a really nice set of scenarios from things like road traffic accidents. It gives the breadth and depth and a real sense of orientation in a situation on the ground. And for me, paramedics are training in a classroom, yet most of the work is out in the field. And why I feel it’s particularly nice in that case is the way that was done really gave a great immersive sense of the situation. So you’d arrive at a road traffic accident, you’d have a policeman briefing you, you would then immediately be able to go in, and that for me adds so much breadth and depth to the experience compared to being in a classroom, seeing white walls and being told, “You have arrived at a road traffic accident.” It really does vest people in that situation. So for me that was really impactful.

Also with the AR and VR around procedures, I’ve found that quite impactful as well, because what has happened there is that a breadth of different cases have been presented and people can go and put a simple one in or they can look up a complex case – they get a portfolio of experience within a few hours. And the compelling cases there are about taking people into a completely different situation and making them feel immersed, which gets the real reaction and the real sense of situational awareness.

The other example is about being able to perhaps get the clinical experience that you would have on the ground over a month –  what you’d see in a month or a year in terms of complex cases, you can see in a few hours because they’ve been brought to you. So it’s taking, not the rare, but the statistically less frequent and condensing them into one place, so it’s far more effective.

Q:  How does your role and organisation fit into the bigger picture of large-scale adoption?

The roles that I have had with the Digital Academy is to get CIOs and clinicians to enable this technology appropriately. So we’ve certainly spent time on AR and VR – we have spent time looking at use cases. And I think our role is to help make that investment case, help put the infrastructure in place and help use the technology appropriately. Certainly, the work that I did with Ara Darzi, who’s done a lot in AR and VR, who hosts the unit for the Academy, was to broaden people’s horizons as to the possibilities of this technology.


Read associated blogs or download the XR in Healthcare Education paper by clicking here.

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