Team Name
CareVR
Timeline
Fall 2024 – Spring 2025
Students
- Dustin Dracoules – Software Engineering
- Darshan Bastola – Computer Science
- Andrew Chung – Computer Science
- Enrique Gamboa – Computer Science
- Muhunga Maurice – Computer Science
Sponsor
Shawn Gieser (Professor)
Jennifer Lynn Roye (Nursing Department)
Abstract
The VR simulation is comprised of a Main Menu, Tutorial Area, and Four Scenarios. The Main Menu area serves as a central hub to allow the user to select either the Tutorial Scenario or any of the Four Scenarios. The Tutorial Scenario introduces the user to the basic controls of the simulation, and shows the user how to interact with elements within the world.
In scenario 1 the patient is in a hospital room with the doctor. This is where the nursing student will be introduced to the patient and his condition. By using the text-based dialogue options, the nurse will assess the situation and make decisions on how to proceed caring for the patient.
In scenario 2, the nurse will visit the patient’s home and meet his daughter. The objective of scenario 2 is for the nurse to identify potential hazards in the patient’s house, before he is released into home hospice care. The nursing student will be scored on how many hazards they found during their visit.
In scenario 3, the patient is now at home, and it is the nurse’s job to follow up and perform tests. The Glasgow-Coma Scale, and a focused assessment of the patient, will be required. It will also be important for the nursing student to understand and implement the correct order in which the tests should be administered.
In scenario 4, the patient has died and the nurse is required to perform any final tests and comfort the family. The nurse will also be responsible for preparing to move the body out of the house.
Background
The Care VR team’s VR Nursing system aims to give the nursing program at the University of Texas at Arlington a new tool to teach students about end-of-life care in a way that provides practical experience, rather than the traditional classroom environment’s experience. This is vital as nursing students will be better equipped with the skills, expertise, and emotional support needed for hospice care – through practical experience. Additionally, this project will enhance the reputation of the University of Texas at Arlington’s nursing program, and the experience of the hospice patient, by improving the quality of care given by healthcare professionals graduating from UTA. The system will be integrated into the nursing curriculum to supplement traditional simulation and clinical practice. The end-goal is to improve the quality of palliative care from healthcare professionals.
Project Requirements
The top ten Project Requirements include the following:
Tutorial: The simulation will provide a tutorial that allows the user to practice using the Meta 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 in scenario 2 to add objects to the clipboard.
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 should be able to call the doctor and obtain directions on what medication to use.
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 daughter and examine the house to determine how safe the environment is for Benny. Once the user clicks on the car outside to leave, they will be shown a report with all possible safety hazards to show the user what they missed or did not miss.
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, and perform suction. The user will also perform a Glasgow-Coma Scale test and relay the results of the examination to his daughter.
Scenario 4: The user goes to Benny’s house after he has passed away. The user will perform post-mortem care and prepare the body to be removed from the home. The user will also comfort Benny’s daughter.
Pause Menu: The simulation will have a pause menu that can be accessed at any time during any scenario or tutorial. In the pause menu the user may exit the scene and return to the main menu.
Main Menu: The simulation will start at the main menu and contain several scenarios the user wishes to play through in the form of option tabs. The main menu will also have an options tab for a tutorial so the user can gain familiarity with the controls. In total, the main menu will contain five buttons: Tutorial, Scenario 1, Scenario 2, Scenario 3, and Scenario 4.
Dialogue Options: The user will speak to the patient, a doctor, and the patient’s daughter using text based choices. 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.
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.
Morphine Administration: Scenario 3 will have morphine that can be interacted with. The user will be able to administer the medication via a syringe, but only in the proper dose. The correct dosage must first be calculated before the nurse is allowed to administer the medication. An audible warning sound, with a warning message, will tell the user if they have calculated the wrong dosage. This will be done in scenario 3.
Design Constraints
1) Usability – This is a key aspect of the project, as not all nursing students may be familiar with Virtual Reality simulations. The tutorial scenario is critical to help users understand the 3D environment, and how they can interact with it. Users must be told how to move around, pick up objects, pause, and talk to NPCs. The user must also be made aware of the scenario objectives and how to accomplish them.
2) Accessibility – The simulation must be accessible to a wide range of people, including those with disabilities. The controls should be easy to understand and responsive, as well as not require very fine motor skills. Audio queues should have accompanying visual cues, and the user should be able to access the scenario instructions at any time.
3) Functionality – The simulation should function as close to reality as possible. The nurse should be presented with real-life issues and be required to perform specific assessments and corrections to adjust to varying problems. The system should give feedback to the user if they are accomplishing the tasks properly and should clearly indicate if the user is doing something incorrectly. The system should also suggest simple corrective actions to the user if they inadvertently cause unintended interactions.
4) Maintainability – The simulation should be documented accurately and thoroughly, to ease the transition from one senior design team to another. As nursing and technology evolve over time, the simulation should continue to be accurate and useful. Adding new scenarios, or interactions, should be simple. A modular design allows this functionality.
5) Safety and Welfare – This simulation deals with real medical issues, and emotional situations, which needs to be considered when making design choices. The user should feel as if they are in a training environment, learning medical procedures, not experiencing a traumatic event. Trigger warnings, emotional support resources, and other concerns such as motion sickness warnings and tripping hazards, should be implemented at appropriate places throughout the scenarios.
Engineering StandardsAuthentication & Encryption/Security Standards
Authentication & Encryption/Security Standards: RIA TR15.606-2016 Collaborative Robots
Building Codes (ADA, County/City/Municipal, etc): Texas Administrative Code (TAC) Title 22, Part 11, Chapter 215, The Regents Rules and Regulations of the University of Texas at Arlington
Common Engineering Standards (IEEE, ISO, NEMA, NIST, etc): IEEE 830: Software Requirements Specification standard, IEEE 12207: Software Lifecycle Processes, IEEE 1490/ISO 21500: Project Management for Systems Development
OSHA Compliance: 29 CFR 1910.22-.30 Slips Trips & Falls
Programming/Web Dev Standards: Meta Horizon VRC Guidelines, Meta Quest 2 Health and Safety Manual, Version Control – Unity Version Control
System Overview
The VR Palliative Care Simulation consists of four sections (layers): “Managers”, “Temporary Game Objects”, “Game Objects”, and “Data Objects”. The Managers layer controls how the game operates. The Game Objects layer displays permanent and static game objects that will be used in the game. Temporary Game Objects displays only game objects that are not static or instanced at runtime, and must be instanced by player interaction. The Data Objects layer shows how the data will be collected and stored. Each layer interacts with each other by sending messages or utilizing each other to run the game.
Results
The team concluded that previous versions of this project were too disjointed to continue to function cohesively; therefore, we recreated the project from the start, including all applicable documentation and systems design work, according to the original specifications of the sponsor. We created a new repository and purchased 15 asset packs for various purposes.
We completed a functional main menu, which allows the user to navigate between scenarios, as well as fully implementing the tutorial scenario, and scenario 2. The logic and functionality of these scenarios are complete. The user may also access the pause menu at any time, allowing them to return to the main menu from within a scenario.
Future Work
Future teams will need to accomplish the following tasks:
1) Finish implementing the dialogue choices for scenario 1. Currently the scenario is set up, and has a hospital, doctor, and all applicable game objects. Future teams will need to make dialogue boxes appear near the doctor, which prompt the user to answer a series of health questions. The user should select 1 of 4 options, and at the end of the questionnaire the user should receive a score for how many correct options they chose.
2) Finish implementing the tests for scenario 3. Currently the scenario has Benny in the house, lying in bed with full animations. Future teams will need to complete the health assessment section, and administer morphine to Benny. The user should have to correctly calculate Benny’s dosage, based on his health chart.
3) Finish implementing the interactables for scenario 4. Currently the scenario already has a clipboard for the user, and the functionality of this scene should be identical to scenario 2. For these reasons this section is nearly finished, and only needs future teams to decide which objects to place so that they can be added to the clipboard script.
Project Files
Project Charter
System Requirements Specification
Architectural Design Specification
Detailed Design Specification
Poster
References
1) Ilana Dubovi and Michal Itzhaki. Playing the role of a nurse in a virtual reality simulation: A safe environment for emotion management. Nurse Educator, 48(1):13–18, 2023.
2) Lindsey Hendrix. Using virtual reality to bridge gaps in nursing – vital record. https://vitalrecord.tamhsc.edu/using-virtual-reality-to-bridge-gaps-in-nursing/, 2022.
3) Sook Kyoung Park and Hyuk Joon Kim. Development and evaluation of virtual reality-based simulation content for nursing students regarding emergency triage. Journal of Korean Academy of Fundamentals of Nursing, 30(2):292–301, 2023.
4) Géraldine Perriguey. Student emotions in virtual reality: The concept of psychopedagogy by design. In Immersive education: Designing for learning, pages 51–69. Springer, 2023.
5) Luis Iván Mayor Silva, Raquel Caballero de la Calle, Miguel Angel Cuevas-Budhart, José Oliver Martin Martin, José María Blanco Rodriguez, and Mercedes Gómez del Pulgar García Madrid. Development of communication skills through virtual reality on nursing school students: Clinical trial. CIN: Computers, Informatics, Nursing, 41(1):24–30, 2023.
