A Virtual Reality Library Space for Health Centered Education and Well-Being

Introduction

The use of virtual reality (VR) applications in health sciences education and, by extension, in health sciences libraries, is growing as VR equipment has become more affordable and the desire to augment and complement student learning is increasing. The release of consumer grade virtual reality equipment has given rise to creating innovative tools that can enhance student learning and discovery. One definition of virtual reality (VR) is that it is:

An immersive and interactive computer-generated experience that transports the user into an entirely virtual 360-degree and three-dimensional environment, most commonly generated by a VR headset with a head-mounted display. Users look, move, and interact with the environment using handheld controllers (1).

Virtual reality in health sciences education

Some topics in health sciences education present challenges when presented only in two dimensions, such as in textbooks, atlases, flashcards or lecture materials. Anatomy, where students require a three-dimensional knowledge of human organ systems and structures, is one example. Students often have limited time for hands-on lessons using cadavers (2). By leveraging VR technology, students have an optimized way to quickly examine the structures from all angles. Similarly, virtual reality is being used for simulations of surgical techniques and for visualizing organs prior to surgery. It allows for learners to have a high level of engagement and to gain knowledge beyond the traditional classroom environment.

Another way in which virtual reality is being employed in health sciences education is to deepen students’ understanding of a topic and enhance their ability to empathize with patients they will encounter in the future. For example, at Temple University, the Department of Nursing used virtual reality to simulate macular degeneration from the patient’s perspective. They found that the simulation was an excellent tool for exploring compassionate care (3). The University of New England’s College of Osteopathic Medicine and College of Health Professions partnered with the libraries to employ VR simulations related to aging, such as hearing loss, Alzheimer’s disease, and end-of-life conversations. They found that students demonstrated increased understanding of and empathy with older adults with age-related conditions (4).

Virtual reality in health sciences libraries

A very recent scoping review identified that libraries are implementing augmented (AR) and virtual reality equipment and projects for a variety of reasons including providing a collaborative learning and research environment, the possibilities for enhancing student learning and enabling institutional members the opportunity to explore and test the technology (5). Other reasons libraries are including virtual reality as a service are to tie in with institutional initiatives or strategic plans, or to be in step with curricular initiatives. As noted by Lessick and Kraft (6):

Health sciences libraries are well poised to play a bigger role in helping clinicians, faculty, students, and researchers discover and leverage the use of VR and AR tools. As VR and AR accelerate in health care and education, health sciences librarians need to keep apprised of these new formats as they will be responsible for managing and sharing this challenging new user-generated content.

Some health sciences libraries have designated spaces for people to use the virtual reality equipment, while others have the option for users to borrow the equipment and use it outside the library (7). By adopting this technology libraries can strengthen collaborative commitments and clinical and research partnerships for their campus communities.

Background

Faculty members from the Medical College of Georgia (MCG) at Augusta University approached the Assistant Director for Research & Education Services at the Robert B. Greenblatt, M.D. Library to propose a collaboration to install a virtual reality space in the library. The MCG faculty had already begun exploring and utilizing VR applications to incorporate into the curriculum to simulate activities for students during their pre-clinical years. The activities are intended to build empathy in students for patients with varying impairments. While the medical college had purchased two VR set-ups, they were not always readily accessible for student use.

The recent ARL publication, Mapping the Current Landscape of Research Library Engagement with Emerging Technologies in Research and Learning, acknowledges the role that libraries can play in furthering learning and student success, and in collaborating with faculty by providing technology-rich learning and information commons that can help campus communities thoughtfully and productively engage with technology (8). In this vein, having a VR space in the Greenblatt Library provides a neutral location in the center of campus, open to all members of the Augusta University campus communities. Additionally, the library has extended open hours, making it an ideal location to host a more publicly available VR space.

The projects already underway at the Medical College of Georgia include a simulation of visual deficits due to macular degeneration, and requires students to carry out a self-medication task from the perspective of the patient (9). More recent simulations include color blindness and diabetic retinopathy. They also developed a VR experience that simulates the symptoms patients with Parkinson’s Disease experience, and the challenges the patients face every day (10). Simulation of hand tremors is the main feature of this application. Students are asked to perform tasks such as turning off an alarm clock, washing hair in the shower, brushing teeth, and making a phone call.

MCG faculty partnered with the Department of Software Engineering and Game Design and Development at Kennesaw State University. Students in the Kennesaw State program worked on building the VR experience programs as part of their coursework (11). Faculty at Augusta University’s School of Computer and Cyber Sciences also advised on and contributed to the projects.

There are other virtual reality projects and services at Augusta University. The Center for Instructional Innovation has staff who can assist faculty members with creating VR experiences to engage students and help achieve course learning objectives. One faculty member who leveraged this service stated that using VR is like bringing gaming into education, and the students love it (12). Two faculty librarians at the Greenblatt Library implemented a virtual reality escape room game for teaching data literacy concepts. They were able to purchase equipment and engage students at Kennesaw State to assist with programming the virtual escape room using funds they were awarded through the Network of the National Library of Medicine. The project described in this column complements and builds upon the other VR work taking place at Augusta University.

Methods

Laying the groundwork

The Assistant Director for Research & Education Services at the Robert B. Greenblatt, M.D. Library learned of the opportunity to apply for a Technology Improvement Award from the Network of the National Library of Medicine (NNLM). She contacted the faculty members at the Medical College of Georgia who had approached her a few months prior and informed them that the award application window was open. She also communicated this to the faculty member at the College of Computer and Cyber Sciences who is involved in the ongoing MCG projects, as well as the virtual reality escape room developed by the other faculty librarians at the Greenblatt Library. She discussed the possibility with the Interim Director of University Libraries and the Access Services Librarian at the Greenblatt Library to get buy-in for the project, since the proposed space would have day-to-day oversight from members of the Access Services department. The Access Services department already has responsibility for the library’s Creative Technology Lab (CTL), a makerspace area providing 3D modeling and printing services, a Cricut cutting machine, a laminator and other maker options (13). The proposed VR space would be an extension of the CTL, located on the same floor of the library. Both the Interim Director and the Access Services Librarian agreed to the project and the proposed space. The project team agreed to pursue the funding for the virtual reality space.

Formalizing the project

Once all the parties were in agreement, the Assistant Director for Research & Education Services, who serves as the principal investigator for the project, took the lead on writing the funding proposal. The stated objectives for the project are:

• Implement a virtual reality shared space at the Greenblatt Library on the health sciences campus of Augusta University for use by students, faculty and staff.

• Increase access to new and existing virtual reality learning experiences on the Augusta University health sciences campus to facilitate highly experiential education.

• Promote wellness and relaxation for health sciences professionals and students at Augusta University through the use of immersive relaxation and mediation VR experiences.

As mentioned previously, this project is intended to complement and build upon VR activities already taking place on the health sciences campus of Augusta University. The curriculum-related VR experiences such as the macular degeneration and Parkinson’s Disease simulations, will be made available in the Greenblatt Library’s VR space. The wellness and relaxation component is new and is based on the desire to offset stress and burnout commonly experienced by health sciences students and health care workers. In her 2018 article, Pomputius (14) states that

Those who work in the medical community, where advances in technology and the accompanying information overload have flourished, have begun to pursue wellness training as the answer to increasing resiliency, preventing health care provider burnout and improving work-life balance … Wellness also means reducing anxiety and relieving stress, a valuable commodity in today’s overstimulated environment.

Virtual reality offers a fully immersive, controlled, safe, and peaceful environment that is accessible to those who are experienced with relaxation and mindfulness practices, as well as those for whom it is a new experience. Having these experiences available at the library is an extension of activities already taking place, particularly during finals weeks, such as having therapy dogs on-site, and providing a zen zone with relaxing music, coloring pages, and other relaxation options.

Faculty at the Medical College of Georgia, in partnership with the Computer and Cyber Sciences faculty member, will provide access to the VR experiences currently available for students at MCG and will continue to pursue the development of more VR opportunities. Faculty in the Department of Software Engineering and Game Design and Development at Kennesaw State University agreed to participate in the project by having their students available to build more health sciences curriculum-based VR experiences as part of their coursework.

Funding

The funding application for a Technology Improvement Award from the Network of the National Library of Medicine Southeast Atlantic Region was successfully approved so the virtual reality project at the Greenblatt Library could proceed. The next step was to order equipment. The equipment used for this project was informed by the faculty member at the School of Computer and Cyber Sciences at Augusta University who has extensive experience with virtual and augmented reality project development. It was decided to order two VR kits for use at the Library. For increased security, two lock boxes for the gaming laptops and associated connections for the VR goggles and other peripherals were included as part of the kits. Additionally, since wellness and relaxation are included as part of the scope of the project, two different styles of comfortable seats were ordered (Figure 1).

Figure 1.

List of equipment purchased.

Outcomes

As of this writing, the equipment has just arrived at Augusta University and software will be installed on the gaming laptops very soon. The Assistant Director for Research & Education Services held preliminary meetings with members of the Access Services department to begin determining procedures and policies for the VR space, as well as an appropriate name for it. It was decided that the room should be locked when not in use, so a work order was placed to install a new doorknob. It was also agreed that users will need to reserve the space, at least initially, until there is a sense of demand for the space. A short orientation for first-time users will be required prior to their utilizing the equipment. A marketing and communications plan will be developed, with plans for a soft launch to allow for staff training and skills development, and to work out any potential glitches. A more formal launch with an open house will take place once library staff are confident in working with and troubleshooting the equipment.

Discussion

There was a short turnaround for this project between the time the potential funding was announced and the deadline for completion of the project. This was in part because the Network of the National Library of Medicine office had funds available partway through their fiscal year, so the period of performance was abbreviated. It also took time to get accounts set up at Augusta University once the funder approved the funding application. Additionally, there was some lag time between getting the accounts set up and being able to order the gaming laptops, the foundation for the virtual reality programs, due to some internal administrative issues. This project met its stated deadlines, but just barely, due to these multiple delays. A lesson learned is to allow more time than one thinks they need (at least an additional month or two) to get these types of projects up and running.

The addition of the virtual reality space will enhance the Greenblatt Library’s services and presence on Augusta University’s health sciences campus. Faculty at the Medical College of Georgia are enthusiastic about the project and will continue to contribute as they develop new VR experiences as part of their curriculum. Other disciplines will be invited to add appropriate experiences as well, including the VR escape room developed by faculty librarians in partnership with the Physical Therapy department.

Hospital librarians could consider introducing virtual reality as part of their services. VR may perhaps be used for staff training and professional development, particularly to allow for skills-based practice in a simulated environment. Since hospital libraries are sometimes part of the health care systems’ education departments this is an appropriate role. VR kits can also be set up as mobile units and travel throughout the hospital. As a complement to patient education and consumer health information distribution, VR experiences could be used by patients and their families to learn about the effects of various conditions. Regardless of the setting, libraries are introducing new technologies such as virtual reality as part of their suite of services and resources on an increasing basis. With planning and effective communication and marketing, the implementation of VR experiences can become part of the day-to-day operations for libraries. Virtual reality has a logical place in health sciences education and wellness, as planned for members of the Augusta University campus communities.