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Homegrown Virtual Reality Advances Heath Care in Nursing and Beyond

Marcie McCleary and Nicole Vowell

Utilizing virtual reality (VR) to help train health care providers and students, as well as treat patients, makes perfect sense in our digital world.

The Therapeutic Games and Apps Lab (The GApp Lab) at the University of Utah was established to help achieve this. First, the lab represented a collaboration between the Center for Medical Innovation and the Entertainment Arts and Engineering (EAE) program. Now, The GApp Lab is a free-standing division where clinicians, researchers, graduate students, and staff all collaborate to dream and build the future of education and health care.

“My parents are still amazed that all my time spent dumping quarters into arcade games somehow paid off and I ended up in a career in digital health," said Roger Altizer, PhD, founding director of The GApp Lab.

When Altizer's GApp Lab projects began grabbing headlines nationally for digital health care advancement, University of Utah Health recognized the potential for innovation in health sciences. Now, The GApp Lab plays an integral role in the research, development, and production of interactive, medically focused games and apps. Since 2013, nearly 80 innovative VR research projects have been developed by dozens of faculty members and more than 280 graduate students. Having a games lab on an academic health sciences campus is not only unique but also represents the “One U" vision.

Digital Nursing Advancement at University of Utah Health Using Virtual Reality Simulation

Through this collaboration between The GApp Lab, faculty, and the community, a virtual reality simulation of a real-life patient named Sofia was developed. The goal was to help students and providers understand the realities that many patients face, such as their environment, family situations, finances, physical and mental health, language barriers, and other challenges, often referred to as social determinants of health. While the content of the application is designed to teach equity, diversity, and inclusion, so were the methods used to create it, bringing not only experts but community members into the design process.

“One of our more recent and exciting VR simulations was created with faculty in nursing and support from a grant through the Spencer S. Eccles Health Sciences Library," explained Jesse Ferraro, MFA, MPS, project manager for The GApp Lab. “We collaborated with Nancy Allen, Julie Peila Gee, Kate Doyon, Malek Alnajar, and other faculty and staff to develop 'A Day in the Life of Sofia' to help students and providers learn the many social determinants or obstacles involved in population health."

“We were able to learn so much from this process," said Kate Doyon, PhD, Med, RN, CHPN, an adjunct professor in the College of Nursing at the U and full-time professor at Boise State University School of Nursing. “A fully immersive experience is the best way to learn and understand what vulnerable patients are experiencing in their lives in terms of pain, anxiety, and finances. They often have to make hard choices in order to access their health care. We had two focus groups: one made up of community members and one with professional health care representatives, including a dentist, pharmacist, nurse, social worker, and physicians, including an oncologist and cardiologist. They all contributed to this simulation."

"We believe the best software is built alongside the folks being asked to use it"
Roger Altizer, Ph.D. Founding director of The GApp Lab

"We believe the best software is built alongside the folks being asked to use it," Altizer said. His team studies the end-users and brings the community into the process.

Another role of the training tool is to help health care providers understand why a patient may seem non-compliant because they must make serious decisions or choices before they can even consider their own health care. For example, the patient may need to choose between buying food for her family or paying for prescribed medications.

“What a way to learn about cultural humility," commented Julie Peila Gee, PhD, MSNEd, RN, an associate professor in the University of Utah College of Nursing. “We hope to expand this model to help other departments and specialties. It is a phenomenal experience and The GApp Lab offers an amazing collaboration."

Doyon says that credit is due to Altizer, his staff, and “the amazing graduate students for creating a setting that is both extremely creative and also feels safe and comfortable to be in. Working with The GApp Lab was a tremendous experience. Everyone was kind, helpful, and engaged in our project. We couldn't have asked for more!”

The Future: The GApp Lab and Digital Health Initiative

Extended Reality (XR), the umbrella term for VR and Augmented Reality (AR) simulations, are now very popular in the lab. Currently, projects are being designed for nursing, social work, and other health care disciplines. These XR tools offer users a chance to practice and can teach new innovative techniques or help learners experience new theories.

Rachel Hess, MD, MS, associate vice president of research at University of Utah Health and a professor in the Spencer Fox Eccles School of Medicine, helped launch the Digital Health Initiative in 2022. DHI is designed to take the work being developed by The GApp Lab to the next level. With goals to collaborate, accelerate, innovate, cultivate, and lead, DHI plans to:

    •    Recruit new faculty in digital health
    •    Validate technology in real-world clinical settings
    •    Provide seed money for pilot projects
    •    Create a software development core
    •    Equip faculty, clinicians, students, and staff with the expertise to pursue commercialization opportunities.

“As we approach the 10th anniversary of The GApp Lab, we are excited about bringing our staff, physicians, students, and patients together to collaborate in creating the next generation of virtual reality and playful experiences to help make health care enjoyable and approachable," Altizer said. “If we can pull this off, we can make health care more accessible, less stressful, and open up new opportunities to innovate for the good of us all."

To learn more about the latest health sciences projects from The GApp Lab related to provider and patient education and advancement, click here.