Palliative Care VR

Posted on by cmc3763

Team Name

VR Nursing Team

Timeline

Spring 2023 – Summer 2023

Students

  • Cesar Cantu-Perez
  • Nelson Lam
  • Carlos Cruz
  • Braddock Bresnahan

Sponsor

Jennifer Roye, Assistant Dean of SMART Hospital & Simulation

Dr. Shawn Gieser, Professor (Senior Design)

UTA Nursing Department

UTA Computer Science Department

Abstract

The Nursing and Health Department at the University of Texas at Arlington wishes to train their nurses on hospice care. Currently there is no way to train nurses for hospice care without the need for a real patient. The Nursing Department and the Computer Science Department have teamed up to make a virtual reality simulation designed to help nurses interact with patients in hospice care. The VR simulation called Palliative Care VR, is made up of 5 different scenarios. One scenario is a tutorial designed to teach the nurses the controls and how to interact with objects in the simulation and the other 4 scenarios are at different points in hospice care and require different tasks to complete.

Background

The University of Texas at Arlington’s Department of Nursing wants a simulation in virtual reality that allows its user to take care of a patient on hospice care. The representatives of the Department of Nursing are Jennifer Roye and Shawn Gieser. Shawn Gieser is our main point of contact for any technical questions or issues we may experience effectively serving as our manager. The reason the Department of Nursing has commission this virtual reality simulation is that the Department of Nursing has no effective way to prepare their students for end of life (hospice) care. Hospice care is needed when there is nothing that can be done to save the patient’s life. It is much different than other forms of healthcare as nurses no longer need to think about how to prolong someone’s life. Instead, nurses think about how their patient can live their final days comfortably and without pain. Due to the nature of hospice care, the nurses must also be able to deal with the patient’s families and help them through this difficult time. Hospice care is emotionally difficult for the patient, their family, and for the nurse as well. Watching the patient live out their final moments is exceptionally difficult and nurses need to be trained to be able to handle that sort of situation. Due to this difficulty, it is imperative that nurses be exposed to that type of environment before heading into the real life workforce. The palliative care simulation will give nurses the training they need to be able to excel in a hospice care situation. The nurses will gain experience in taking care of an elderly individual with a terminal disease. The nursing students will also be dealing with the patients family so they can have an understanding of how they should act towards the family. The palliative care simulation will be developed with the nursing students experience in mind so as to be able to recreate the feeling of being in a hospice care scenario and because this will be a virtual reality experience, the nursing students should find that it will be much easier to immerse themselves in the hospice care scenario.

Project Requirements

  1. Main Menu – The simulation will start at the main menu which will include options to select which scenario the user wishes to play through. The main menu will also be have an option for a tutorial so the user knows how to use the controls in order to complete the scenarios efficiently. The main menu will be comprised of five buttons: Tutorial, Scenario 1, Scenario 2, Scenario 3, and Scenario 4.
  2. Tutorial – The simulation will provide a tutorial that allows the user to practice using the Oculus Quest 2 VR controllers. The tutorial should teach the user to pick up objects, interact with NPCs, move around in the environment and teach the user to use the pause menu. It should also teach the user how certain objects work for example: using the grab button on the computer monitor in scenario 1 changes what is displayed on the monitor.
  3. Scenario 1 – The user meets the patient, Benny Russell, for the first time. This scenario takes place in Benny’s hospital room. The user should perform a verbal assessment with Benny including the pain scale and using the pain level Benny gives the user, the user should be able to call the doctor and obtain directions on what medication to use. The user will also administer the medication to Benny via an IV and ensure his safety.
  4. Scenario 2 – The user visits Benny’s home while Benny is still in the hospital. The reason for this visit is to determine if the environment is safe for Benny to receive hospice care at his home. At the house the user will meet Benny’s wife and examine the house in order to determine how safe the environment is for Benny. After walking through the house, the user will speak to Benny’s wife and give her the status on the environment. Once the user leaves, they will be shown a report with all possible safety hazards to show the user what they missed.
  5. Scenario 3 – The user visits Benny at his home to do assessments. Benny is showing signs of impending death. The user is going to perform a pain assessment, take his temperature and blood pressure, perform suction. The user will also perform a Glasgow-Coma Scale test and relay the results of the examination to his wife.
  6. Scenario 4 – The user goes to Benny’s house after he has passed away. The user will perform post-mortem care and move the body away from the house. The user will also comfort Benny’s wife.
  7. Glasgow-Coma Scale – The user will be able to perform the Glasgow Coma Scale. The user will assess the patients state of consciousness. The procedure is divided into three parts: eye opening, motor response, and verbal response.
  8. IV Administration – The simulation will have an IV on the patient that can be interacted with. The user will be able to administer medication via the IV by injecting the medication into the IV. This will be done in scenario 1.
  9. Results Screen – After each scenario, the results will be displayed before going back to the main menu or the next scenario. On the display, the number of wrong interactions will be displayed and tallied to give the user an in-depth report on how the user performed during the scenario.
  10. Dialogue Options – The user will speak to the patient, a doctor, and the patient’s wife using text based choices. In order to advance in the scenarios, the user must choose the correct choice out of various possible dialogue options. When the user chooses an incorrect option, there will be an audible cue so the user understands they chose the wrong option.

System Overview

The VR Palliative Care Simulation is made up four sections (layers). These four layers are “Managers”, “Game Objects”, “Enums”, and “Data Objects”. The Managers layer is the brains of the operation controlling how the game will be run. The Game Objects layer shows the types of game objects that will be used in the game. The Enums layer shows what metrics will be taken into account while the user is playing. And the Data Objects layer shows how the data will be collected and stored. The layers interact
by sending messages/using each other to run the game

Results

Our team was tasked with optimizing the simulation and fixing the remaining bugs the previous team left behind. We reduced the file size of the entire project from 80 GB to about 57.5 GB leading to faster launch times and less stress on the headset during runtime. We changed the controls to teleportation and updated all the Open XR components in the project. We also created a tutorial scenario where the users can learn the controls in order to effectively finish the other 4 scenarios. There are still a few bugs that the next team will have to address before finalizing the project such as the dialogue at the phone in scenario 1 not working or the changing height when the user teleports.

Demo video (link)

Future Work

The next team will have to:

  • Add dialogue to scenario 4
  • Fix dialogue in scenarios 1 and 3
  • Upgrade the visuals in the tutorial scenario
  • Fix small bugs
  • Deployment and testing

Project Files

Project Charter (link)

System Requirements Specification (link)

Architectural Design Specification (link)

Detailed Design Specification (link)

Poster (link)

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