The treatment process frequently involves various invasive operations and procedures, which, in turn, may sometimes cause a feeling of anxiety in patients, negatively affecting the medical outcomes and, in some cases, even leading to treatment refusal. For instance, in dentistry, about 18% of patients experience so-called dental phobia (a form of patient anxiety), according to the Federal University of Rio, which decreases cooperation and work performance during clinic visits. Another paper revealed that 5% of dental patients could completely avoid treatment due to fear of procedures.
One of the most effective ways to handle these conditions is through patient education (PE) – a set of communication methodologies between doctors and patients aimed at increasing the healthcare literacy of the latter.
However, such an approach may be challenging due to the complexity of healthcare information for the average clinic visitor. A study by Australian scientists revealed that about half (40-60%) of patients can not correctly recall conveyed health information. To affect their literacy, we should simplify the vast amount of specific terminology, knowledge of physiological mechanisms, and other complicated medical topics and embody them in an accessible form of images, symbols, text, and voice.
Apart from optimizing communication strategies between treatment process parties, there is also a technological solution for enhancing patient understanding of complex data – Virtual and Augmented Reality software. These tools provide an immersive educational experience by submitting information via a digital interactive environment. Sure thing, such practice also requires a doctor's guidance as a 'mediator' between the user and the simulated computer environment.
In this article, we'll review a list of research papers to define patient education's main advantages and challenges and how AR/VR tools can enhance this process.
Role of the patient education
This approach appeared in the broad discussion at the edge of centuries as a way to improve treatment outcomes by informing patients. In 1998, the World Health Organization even published an "official definition" of the concept that today matches the modern patient education approach's aims:
"therapeutic patient education should enable patients to acquire and maintain abilities that allow them to optimally manage their lives with their disease."
A few comprehensive studies reveal that proper health self-management (developed by participants' education) may help treat – or effectively manage symptoms – of various disorders and conditions, including severe ones like stroke, lung disease, etc.
A more recent paper from Baylor University researchers also claimed that health literacy is essential for proven health prevention measures such as diet, exercise, good oral hygiene habits, etc. Patients need to have a deep understanding of the impacts of such activities to maintain them.
Midland Hospital scientists, in their article, define patient education as a crucial factor in informed consent and correct healthcare decisions. Once people understand the medical necessity of a particular operation or procedure more clearly, they can readily accept it. In that case, dentists should provide information about risks, side effects, possible alternatives, etc.
Thus, we can define two main branches of patient education application:
- Increasing treatment outcomes via promoting opportunities for competent healthcare decision
- Improving patient health with preventive measures
What are the difficulties?
Teaching people with no special training and education about medical topics – is quite a challenging quest for specialists of any caliber.
Research from the Alfa Institute of Biomedical Sciences revealed that, on average, patients understand only about 29% of what doctors say about the treatment details. According to Lisa Mcguire – a psychologist from Allegheny College – patients correctly recall only about 40% of the healthcare information provided.
The main challenges in patient's understanding are linked to:
- High level of stress and anxiety, affecting the patient's ability to listen and understand what the doctor said
- Limited capacities of healthcare providers to explain complex information properly
Additionally, Baylor College specialists found clinicians' tendency to overestimate patients' ability to perceive health-related data. For the average human, medical information may be so complicated that it can 'overload' a patient's brain with an enormous amount of specific data, which makes it difficult to process and remember them, aggravating the complexity of the education process.
How Virtual and Augmented Reality Can Help: Theoretical Background
To break the educational barriers, we should significantly improve and simplify the learning process itself. An ordinary lecture from a doctor may be too complicated for the average patient to perceive, especially considering that some of them may experience fear, pain, and anxiety, decreasing their ability to learn. Novel VR/AR tools – a headset equipped with imaginary software, allowing us to navigate through and interact with a computer-simulated 3D environment – may become a solution.
It's important to know that we still have no "officially recognized" concept of patient education methodology that may be considered a standard. However, plenty of research reveals the exceptional effectiveness of the VR/AR approach for these purposes.
The primary learning theory applicable to using AR/VR is constructivism, which defines interaction with reflective and authentic learning activities as necessary for understanding. Simply put, this "learning-by-doing" system's main idea is that the learning process should be supported by tools that the user can manipulate to make presented knowledge direct and evident.
These principles are also compatible with Mayer's Cognitive Theory of Multimedia Learning – a concept that describes a physiological baseline of effective digital education. According to it, people can learn more productively using a dual-coding learning system – a theoretical mechanism involving auditory and visual information processing channels. By uniform loading both of them – with a voice and images relatively – we can expect improved outcomes from the education process.
Animated interactive 3D models complemented with doctor's comments and a simple, user-friendly interface embody a working and engaging patient education system, which can be built via AR/VR technology.
There is a paper from Australian scientists led by health scientist Shannen R. van der Kruk analyzing practical research on the impact of VR/AI implementation. Of the 18 reviewed studies, 14 reported a general benefit of using VR in patient education practices, including:
- reduced anxiety
- increased patient engagement
- improved comfort with treatment plans, etc.
Practical Solution
The so-called user-centered design (UCD) is one of the most popular and relevant educational approaches in AR/VR systems’ interface, which makes the viewer the center of the presentation, guaranteeing maximum patient immersion. UCD is not only about the perspective of view but a philosophy of production, where users’ wishes and advice regarding the app’s usability and usefulness are central stimuli of software development.
Remedico.app uses this approach in Dentaverse – the first-ever interactive AR/VR-powered dental treatment presentation software, which aims to help dentists effectively bring important healthcare information to the patient by using usual headsets such as Metaverse from Meta company.
Let’s briefly look at that example of a patient education tool.
Considering the described education methodologies, we have decided to create a virtual environment with a schematically simplified emulation of the patient's oral cavity – a 3D model containing only the necessary elements to focus all users’ attention on particular clinical details.
The procedure simulation will describe step by step what dentists need to do to cure a particular disease. Different types of ‘visual filters’ allow you to make gums transparent to show the inner interaction. A clear and comprehensive step-by-step demonstration combined with a personal dentist’s guide will solve most patient concerns and make a balanced healthcare decision.
Artificial and augmented reality is an effective tandem that benefits businesses of any size. While AR looks more sophisticated and technologically advanced – giant, levitating jaws inside your dental cabinet probably give particular expressions for the users; VR is suitable for small offices, where you just have no place for this ‘hologram.’
Also, there is an opportunity to use STL files to see a particular area of the mouth cavity for a detailed preoperational presentation. Thus, a dentist and patient can explore cases of specified jaw and teeth structure.
Dentaverse offers a flexible simulated reality that can be applied to any dental facility, which allows dentists to explain treatment details clearly and demonstrate a procedure flow to a patient. You can move, rotate, open/close, and apply different settings to your 3D simulated jaws to make the education process flexible and understandable for different treatment cases.
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Let’s Sum Up
The chain of the presented research, along with the numerous other similar papers from different scientific institutions, clearly shows the advantages of the patient education approach and VR/AR implementation for its purposes:
- Patient anxiety may often be a cause of worsen treatment outcomes and sometimes even lead to treatment refusal;
- One of the most effective ways to handle anxiety is patient education – a set of communication methodologies between doctors and patients aiming at increasing the health literacy of the latter;
- Typically, patient education is challenging due to the complexity of healthcare information for the average clinic visitor, and patients can correctly recall quite a small part of what doctors say to them;
- To break educational barriers, we should use immersive digital technology in the form of artificial and augmented reality, allowing us to create interactive and engaging presentational 3D environments;
- By involving audiovisual channels of information perception combined with the doctor’s guidance, we can expect high patient education performance according to the practical research list;
- Dentaverse – is one example of a practical solution for such a task; this VR/AR treatment presentation software allows dentists to demonstrate all the details of the further procedures and operations in the 3D computer-simulated reality with a schematically simplified interactive “hologram” of patients’ jaws;
