Stepping into Alfred’s reality: Embodying the perspective of your 74-year-old patient

Illustration by Daniela Casas for rehabINK.

News & Reports

By Bismah Khalid 


Imagine that you are a 74-year-old man. You live with macular degeneration, which has caused a loss of vision in the centre of your visual field (1). You get frustrated when you cannot see your family around the table as they sing “Happy Birthday” to you. Your frustration gets worse when they do not understand the troubles you are going through.

Similarly, many healthcare providers may not empathize well with patients because they cannot appreciate the extent of distress patients experience (2). But now there is a technology that may be a breakthrough solution to providing compassionate and patient-centred care (3), and he has a name. Meet Alfred: a virtual patient simulation (1).

The full simulation experience is attained through a virtual reality (VR) headset, headphones, and hand tracking device (4). With Alfred, the user is immersed in a first-person experience of life events, such as birthdays and appointments, while dealing with virtual impairments in the visual field and hearing ability (5). Users subsequently gain insight into the psychosocial complexities accompanying a medical impairment, such as feelings of frustration and distress.

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Macular degeneration affects how Alfred sees and interacts with his world. Photo courtesy of Embodied Labs.

The future of virtual reality in healthcare

Embodied Labs, a start-up company based in Chicago, created this virtual simulation for users to become Alfred, a 74-year-old patient (5). Essentially, they use VR to immerse healthcare providers into the unique perspective of a patient (3). Virtual reality is a relatively new technology that places users in an interactive, three-dimensional, computer-generated environment (6). Although VR quickly dominated the video game industry in 2016, its applications to medicine and rehabilitation are unparalleled (7). Such applications include using VR in the training of healthcare providers and in the implementation of therapies with patients (6).

This VR technology becomes especially valuable as Canada’s healthcare system struggles to address the needs of an aging population, including rising rates of age-related conditions such as dementia, Alzheimer’s disease, and macular degeneration (8). According to 2019 data from Statistics Canada, the proportion of people aged 65 years and older is 17.5% (9). By 2036, this number is expected to rise to 25% (10).

Given these trends, the healthcare system needs to build capacity for the preparation and training of healthcare workers. Researchers, entrepreneurs, and other stakeholders have started to identify new approaches to training healthcare professionals via health technologies (11).

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Life through someone else’s eyes. Photo courtesy of Embodied Labs.

Origin story: From supporting caregivers to training rehabilitation professionals

The origin story of Embodied Labs is a personal one. The Founder and CEO, Carrie Shaw, had difficulty empathizing with her mother who had just been diagnosed with Alzheimer’s disease (3). So Embodied Labs created a simulated environment to help family caregivers understand and appreciate the issues faced by their loved ones; in hopes of nurturing empathy between the caregiver and patient, Embodied Labs used VR to provide caregivers with direct insight into their family member’s living experience (3).

Later realizing that the possibilities of this VR application, Shaw wanted to expand its use to healthcare education, specifically to enhance student experience with patient-centred care (3). Certain medical schools in the United States have already incorporated VR in their training programs as a pilot study to increase the use of active learning strategies (12). Active learning strategies, such as virtual simulation, promote knowledge retention due to their similarity to real-world experience (12). The results of the pilot study indicated that VR application in education had a significant effect on students’ ability to adopt the perspective of an aging patient (12).

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Adopting the perspective of an aging patient. Photo courtesy of Embodied Labs.

If rehabilitation students can use VR to live through a patient’s perspective, they can have richer experiences when learning about age-related conditions, vision impairments, or professional practice. For example, the simulation asks the VR user to perform a cognitive test that Alfred has a difficult time visualizing and hearing (5). This challenging experience enables users to appreciate the sensations and emotions felt by their patient during difficult tasks.

Technology has advanced to where VR has the potential to improve rehabilitation education and practice. However, “the biggest gap right now is the lack of high-quality VR simulations that can be used for training,” explains Erin Washington, a Co-Founder of Embodied Labs. “Watching a 360° video can be beneficial, but it isn’t the same as immersive, interactive training.”

Despite this gap, the results of the pilot study still suggest that the VR simulation improves student learning and perspective-taking (12). A number of American medical schools have since implemented VR simulations into their curriculum; most Canadian schools are distanced from this technology, but this no longer needs to be the case with the increased availability of VR headsets (4).

Start-up technology companies need to push the future by introducing their VR products into Canadian healthcare education programs. As VR technology becomes widely accessible, Canadian universities could contribute to the ongoing pilot studies being done on VR simulations in healthcare education (12).

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VR immersion. Photo courtesy of Embodied Labs.

As beneficial as VR technology will be for healthcare providers, it also has an important future for informal caregivers such as family and friends. Embodied Labs foresees that “VR will be able to be the most powerful it can be when it can be affordably accessible from someone’s living room.” They add, “We need VR to become reimbursable by insurance companies…we need doctors to be able to ‘prescribe’ VR for their patients and families as part of their care plan.”

“We need VR to become reimbursable by insurance companies…we need doctors to be able to ‘prescribe’ VR for their patients and families as part of their care plan.” – Embodied Labs

Incorporating virtual simulation into healthcare education and practice can better equip healthcare providers to work empathically with Canada’s aging population. The virtual world can help make a better future become everyone’s reality.

Acknowledgements

Featured illustration by Daniela Casas for rehabINK.

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To refer to this article, it can be cited as:

Khalid B. Stepping into Alfred’s reality: Embodying the perspective of your 74-year-old patient. rehabINK. 2020;8. Available from: https://rehabinkmag.com


References

  1. Embodied Labs. We are Alfred – Embodied Labs [Internet]. 2016 May 7 [cited 2020 Jan 15]. Available from: https://www.youtube.com/watch?v=pOW7oG6bIFI&feature=youtu.be
  2. Wijma EM. Veerbeek MA. Prins M. Pot AM. Willemse BM. A virtual reality intervention to improve the understanding and empathy for people with dementia in informal caregivers: results of a pilot study. Aging & Mental Health. 2018;22:1115-1123.
  3. Embodied Labs. About Embodied Labs [Internet]. 2019. Available from: https://embodiedlabs.com/about
  4. Forbes. Using virtual reality to get inside an ailing person’s world [Internet]. Forbes Magazine; 2017 [cited 2019 Nov 7]. Available from: https://www.forbes.com/sites/nextavenue/2017/02/14/using-virtual-reality-to-get-inside-an-ailing-persons-world/#4ffab157298c
  5. Gaines J. How do you make a young doctor really understand what it’s like being 74? Virtual reality. [Internet]. Upworthy. GOOD Inc.; 2019 [cited 2019 Nov 6]. Available from: https://www.upworthy.com/how-do-you-make-a-young-doctor-really-understand-what-its-like-being-74-virtual-reality
  6. What is Virtual Reality? [Internet]. Virtual Reality Society; 2017 [cited 2019 Nov 7]. Available from: https://vrs.org.uk/virtual-reality/what-is-virtual-reality.html
  7. Gaudiosi J. Virtual Reality Video Game Industry to Generate $5.1 Billion in 2016 [Internet]. Fortune. Fortune Media IP Limited; 2016 [cited 2019 Nov 6]. Available from: https://fortune.com/2016/01/05/virtual-reality-game-industry-to-generate-billions/
  8. Jackson GR. Visual dysfunction, neurodegenerative diseases, and aging. Neurologic Clinics. 2003;21(3):709-728.
  9. Statistics Canada. Canada’s population estimates on July 1st, by age and sex, July 1, 2019 [Internet]. Statistics Canada; 2019 [cited 2019 Nov 7]. Available from: https://www150.statcan.gc.ca/t1/tbl1/en/cv.action?pid=1710000501#timeframe
  10. Statistics Canada. An aging population [Internet]. Statistics Canada; 2016 [cited 2019 Nov 7]. Available from: https://www150.statcan.gc.ca/n1/pub/11-402-x/2010000/chap/pop/pop02-eng.htm
  11. Henry TA. How AI is driving new medical frontier for physician training [Internet]. American Medical Association; 2018 [cited 2019 Dec 29]. Available from: https://www.ama-assn.org/education/accelerating-change-medical-education/how-ai-driving-new-medical-frontier-physician
  12. Shaw C, Washington E. The effects of a VR intervention on career interest, empathy, communication skills and learning with 2nd year medical students. In: Branch R. Lee H. Tseng S. (eds). Educational Media and Technology Yearbook. Los Angeles, CA: Springer, Cham; 2019.