As time passes and conditions in the world change (not just due to the pandemic), training using virtual reality as the delivery medium is more practical than ever. Just as eLearning replaced default classroom training 20 years ago because of lower cost of delivery and savings as equipment became cheaper and authoring software became more available, virtual reality offers increased advantages over traditional eLearning. There are many examples in current practice from a variety of organizations and industries that demonstrate that:

  • Video-based virtual reality training has fewer built-in production delays
  • Virtual reality training scales to any size implementation
  • Virtual reality training helps employees to master skills faster
  • Virtual reality simulations take less time to deliver than classroom or traditional eLearning modules
  • Virtual reality experiences can be easily integrated into a curriculum, and can be mobile and accessible anywhere any time

The Vanderbilt University School of Nursing has adopted virtual reality to train nursing students how to use ultrasound equipment. Doing this training in a classroom was expensive and time-consuming, complicated to schedule for large numbers of students, and not so practical using traditional eLearning approaches. The implementation won a Gold Award for the School of Nursing from the Brandon Hall Group for Best Use of Virtual Worlds for Learning.

I interviewed John Blackmon, chief technical officer at eLearning Brothers, about the development of the training since it involved use of Cenario VR. When reviewing the interview transcript, I highlighted some of the ways in which virtual reality in this project countered mistaken beliefs about VR use in training.

Myths about virtual reality training

Bill Brandon (BB): John, thank you for your time today. I'd like to ask you about the experience of developing medical training for nursing students at Vanderbilt, and what you learned from it.

John Blackmon (JB): Thanks, Bill. What would you like to know?

Popular media often shows virtual reality set in virtual worlds that resemble Second Life, having nothing to do with the world where people live and work.

BB: Shouldn't VR training be a lot more like the real world than Second Life ever was? Can you describe what the Vanderbilt Nursing School is doing with VR in training medical professionals?

JB: Anytime you go into describing VR, a lot of people have different expectations about what it's going to be. And a lot of it depends on what they have seen before. Many people have seen Second Life and they have the idea of an avatar, a character that is made to represent themselves, walk around and interact with other people. There’s a group of people who have seen Minority Report and think they're gonna be an imitation of what Tom Cruise did. That’s definitely not what the Vanderbilt Nursing School experience was! Definitely not. What we do is try to replicate a real situation. In this case, we were training nurses on how to use ultrasound equipment. We actually filmed a training session that they would go through. Medical is uniquely situated to work well with VR stereotype training because medicine has been training using scenarios and mannequins and so forth for many, many years. It just makes sense to move it into VR, where you're simulating it, and you get to have the best view possible, with a camera-eye view of exactly what's going on.

What benefits does virtual reality training deliver, compared to real-life, hands-on training?

BB: What would you say are the benefits of using virtual reality to deliver this kind of learning experience?

JB: There are lots of benefits to it. You know, the problem the Vanderbilt faculty was trying to solve was many fold. One was the number of ultrasound devices that they wanted to buy. They also, for each table of students that they’re training, need to have a patient there. In this case, it's an actor, not a real patient. They’re definitely training on accuracy when they’re training nursing students, and they have to have at most a one-to-three teacher to student ratio. They had the cost of the machines, the number of teachers, and the number of actors playing patients that would be shown. And then they had to schedule all this out.

By doing this in VR and recording it once they only needed their best instructor, one “patient”, and one machine. By training that way, they got to save all that time and effort of coordination to get through, and they can actually push a whole lot more students through the course, with a lot less money and a lot less time investment.

Doesn't creating VR training take a big crew of specialists and expensive equipment?

BB: Who did you use for the camera operator or operators when you were recording this? Did it take more than one?

JB: No, it was done by Vanderbilt staff. They just set the cameras up.

BB: Speaking of cameras, were these standard video cameras or were they all 360s?

JB: No, it's done with 360s and standard cameras. This particular one used multiple cameras. So you actually had a 360 camera filming the entire scene from the bedside where the student would be standing. In an ultrasound, the best view for a student is directly across from the instructor, and the instructor would be demoing and you'd be looking at it, which is great, but then you also want to be able to see the screen so they actually had one regular camera filming the screen of the ultrasound device, and then we pasted that in. They also had a top-down view but that was another regular video camera. And they put all those onto the scene so that at any moment the student could see them all: Okay, here's what the instructor is looking at. Okay, here's what it looks like on the screen. Okay, here's what it looks like from the top-down. Students actually got a better view sooner than they would have had if they had been there.

All three views are ever-present. By simply turning your head, you actually get to have any view and they're all simultaneously working together at the same time. So as the instructor is working the probe, you get to see exactly what's on the screen. And then from the top-down view, because she's on the other side of the patient, you actually get a better view of where the probe is on the patient's body.

BB: So the cameras themselves were in static positions and didn't have to have anybody move them around.

JB: In 360 video, we really recommend you never move the camera around. One because you don't necessarily need to. And two, because a lot of times you'll get the student nauseous.

Isn't distribution of VR training complicated and expensive? Don't users have to have special equipment to view it?

BB: Are the students using a head-up display? Or a flat monitor? How is the student viewing the presentation?

JB: The students actually were given the choice of however they want to view it. That's one of the beauties of doing it with CenarioVR. You publish it once, and then the students can view it in a variety of ways. If they want to, they can take the instruction on the web and see an immersive view on the web and just use their mouse to move around. Some of the students use their phones, which is kind of interesting because of the gyroscope in the phone, moving the phone actually moves the view from side to side. And there were also Oculus Go headsets for the students to configure as well. So the faculty got results from a pretty good smattering of people trying a lot of different ways to view the instruction.

BB: That's interesting. We did a review of CenarioVR back when it first came out so I knew it was pretty flexible about the display. But I hadn't talked to anybody that was using all of the possibilities.

JB: Yeah, it's actually a good way to do it. The choice is up to whoever's taking the content where they want to take the content. Some things it just makes sense to only do on a headset, or some things just to do online. We actually have run times on 10 different headsets now.

Does creation of VR training require special attention to planning and production techniques?

BB: Did you put together a storyboard or a script before you actually shot the video?

JB: Oh, absolutely. The teachers walked through the presentations exactly so we could do both. Now the nice thing is really, almost all of what we've done was what they would have taught previously. There were some additional pieces in there, but a lot of it was just going through the standard simulation they would have done in a classroom-style setting. The problem they had to solve was not that it couldn't be done live. The problem was they couldn't get the number of trainees through the course without purchasing massive amounts of these ultrasound machines. You really can't do training on ultrasound with more than two or three people at a time. And with the number of nurses that Vanderbilt has to train, that would have required them buying, you know, a huge number of these ultrasound devices, which are $75,000 a pop, very expensive. They were looking for a better way to go about it so that they didn't have to buy as many devices. Now they can actually have all the students go through and learn using VR and then they can just test out.

BB: What types of ultrasounds are the students learning to do?

JB: It's a lot. I mean, I'm looking at the thing right now, and there are 10 different modules. Lots of different things to learn, but mostly the midsection.

The nursing students are being trained on about a dozen different skills. Now, there are specialties within ultrasound. Ultrasound of the heart, for example, is a specialty, someone is trained specifically for that. And there are many other specialties, but there are about a dozen or so general things that the nurses are trained on.

BB: How long did you work with the Vanderbilt staff to get ready for this? And did you need to have someone familiar with CenarioVR there to assist?

JB: We had a champion, if you will, for CenarioVR on staff at Vanderbilt, one of the professors there. We just worked with him on what he needed to do and how he could do it. They had originally tried to do this using standard video and Lectora, to use a standard kind of online learning tool. It just didn't give them enough. They weren't able to really go through it. They had tried to create the course and then kind of gave up on it. Then when Cenario VR came out, they were very interested, we talked about it, we looked through the course that they had, and said, okay, you know, here's what can be done, and really walked them through it. Then the actual creation of it was a process that they had to go through, but really just going through what they do normally when they're training.

Does instructional design for VR training require special talent?

BB: Can you say a little more about how the learning experience itself was developed, as compared say to other types of eLearning? Is it different?

JB: Sure. It's definitely different. When you're doing immersive learning, it's a much more visual medium. The creation is much more like filmmaking than it is like eLearning development. You're creating a storyline and even in something like this, which is very procedure-oriented, you're managing a storyline as you're going. Treat it like it's a film and you're going to be doing takes and so forth. And obviously, a much deeper storyboard than you'd normally go through in a traditional eLearning kind of development cycle.

Learning to make virtual reality training

BB: Is anyone doing a session at DevLearn on making training using VR?

JB: Absolutely. And yes, that will be me. I'll be doing a session on the stage. It's called “VROOM! Get Started in VR Training”. The idea is a lot of people are just really still kind of new, it's new to them and they still don't understand the concepts. And so this is just kind of tips and tricks, things we’ve learned along the way as we're creating VR training. I try to put a lot of stuff in there to help people understand how it works, what it does, what sort of things you want to avoid.

DevLearn and virtual reality

John Blackmon will present SELR101 VROOM! Get Started in VR Training on the Expo Stage at 10 am, Wednesday, October 20, 2021 as part of the Emerging Tech Track.

Many companies find it tough to take on completely new training methodologies. This session shares John's experiences in moving to the world of VR training. This will prepare you for taking on the challenges in four areas that are critical to jump-starting your VR training project:

  • Project inspiration
  • Getting management buy-in
  • Filming scenes
  • Scenario creation

To register for DevLearn, including the Expo, go here. If you are not planning to register for the full conference, you can obtain a free Expo+ Pass, which will admit you to the Expo Hall, the Learning Stages (including John's), DemoFest, and the Expo Reception. NOTE: Please read the information about Health and Safety Requirements, including vaccination requirements that apply to all attendees including Expo+ Pass attendees, and exceptions to attend with an on-site COVID-19 test.