Tell us about your educational background what made you join blood transfusion and what aspects of blood grouping amaze you?
I have been a biomedical scientist for 15 years now. My interest in haematology and transfusion stemmed from having a relative diagnosed with a haematological condition, which sparked my passion for this field. As I progressed in my career, I became more focused on the blood transfusion side, which led me to work for NHS Blood and Transplant in one of the specialist labs here in Bristol. Eventually, I transitioned into training others in this area instead. What amazes me about blood grouping is the sheer number of blood groups that exist. Most people are familiar with ABO and antigen D (when referring to being Rh-positive or negative), but there are hundreds of different antigens on red blood cells. In fact, there are over forty different blood group systems. New discoveries are constantly being made in blood transfusion, and that is what makes it such an exciting area to work in.
Explain the main purpose of using virtual reality in the blood grouping programme introduced by NHS?
We brought in the virtual reality training programme as a proof of
concept to show that it is possible to train people in specialist
techniques using virtual reality.
We have found that this package that we developed is useful for various
audiences, from people who have no experience of blood grouping to
experienced scientists because it introduces the techniques to someone
who has not been trained. For experienced scientist, it provides the
patient aspect where they are interacting with a patient in the package,
and it is taking them back to our core purpose of saving lives and
improving patients' lives. Thus, it is beneficial for a variety of
reasons.
Why was the Meta Quest app lab store chosen as a VR training platform?
It was exceedingly difficult to find a suitable platform, particularly in health in healthcare, to host your apps, there is not a national NHS platform available to host things that we could easily access, so we needed to make it available to people nationally and internationally. It was suggested that the Meta Quest app lab store was the only option for us. This makes it an easy, accessible platform. For the future, we are hoping that as we continue to work with Institute of Biomedical Science, there will be a place where we can host all apps to do with biomedical science in one place.
Can you walk us through the experience of using VR training app and what does a training session look like?
The training session is designed to take around 10 to 15 minutes to complete, and it walks you through meeting your patients at the beginning and performing ABO grouping by the tile technique. First, you get all your reagents out of the fridge and prepare them. You can then interpret your test results and compare these to a table. In case you are not sure about what is how to interpret those results, then you go on to select blood for transfusing to your patients and then you take that blood to the patient's bedside and start that transfusion. You see the process from beginning to end, performing the testing through to the transfusion of the units that you selected. Depending on the blood that you chose to get from the fridge, you may save your patient's life, or you may have What we call a negative outcome where you are told that there have been some complications, and you are walked through what happens when there is an incompatible transfusion. What makes this package good for training is that it allows people to fail in a safe way because they can select an incorrect unit for transfusion and no patient will be harmed by that. It is particularly good for helping people to try a process multiple times and learn from it.
Figure 1: Performing ABO grouping by the tile technique 1 .
How does the app enhance the experience of handling lab equipment?
In the experience, we introduce each piece of lab equipment and explained to people what each piece of equipment was and how it is used. For example, they use pipettes in this exercise, and we have managed to use haptic feedback so that people can tell if they are perpetuating too hard and potentially over-dispensing their reagents and when they're mixing their reagents, they are given feedback through the handsets as to whether they are doing it correctly. Users feel as if they are truly performing the test whilst wearing the headsets and using the handsets.
What kind of issues does the VR training software aim to resolve within the field of transfusion?
In the field of transfusion, there is a lot of pressure on the hospital transfusion labs and on our reference labs where there is a shortage of highly qualified biomedical scientists. This is putting a huge training burden on hospitals to train their staff up to an experienced level. The virtual reality packages that we have been working on are trying to address that training gap so that people can enter the blood transfusion laboratory; after completing some virtual reality training They will be much more prepared to learn those individual laboratory processes because they have already been introduced to them over and over in virtual reality. We also hope to develop transfusion laboratory hub where people can have training, can meet in the virtual world. They can meet virtually, and you can train multiple people from different areas, and various parts of the country all at the same time. You can do group training without needing lots of people to all get into one location. The main thing is just trying to provide a self-directed platform for learning about blood transfusion, so people are better prepared to enter the transfusion laboratory.
How did the app help you reduce the risk of associated with mismatched transfusion?
We do not expect the app to fully replace the actual training within the transfusion laboratories, but we hope that the app provides a better understanding of the ABO blood grouping process and the need to select compatible units. Though the app, user experience negative outcome at the end of an incompatible unit is transduced. In a hospital transfusion lab, there are lots of processes in place to prevent an incompatible unit from being issued for a patient. The app reinforces this knowledge, making people aware of the safety repercussions. By practicing frequently in the app, it becomes difficult to make mistakes, particularly in the lab setting.
Have you observed any improvements since the app has launched?
At the moment, we are doing some research into the benefits of virtual reality training and what we found is that it is relieving some of the pressure on laboratories. We have two projects on the go, one that involves the blood identification app and one that involves a cross-matching package. Both have found that people who have completed the virtual reality training were ready and confident when they went into the lab to perform the real test. Those who completed the training came in with prior experience and required less instruction on the technique and procedure, reducing the need for extensive explanations in the laboratory. This frees up time for specialists to focus more on patient work, as well as on training in laboratory processes, rather than having to explain all the foundational knowledge associated with the procedure.
References
1 Evans, R., & NHS Blood and Transport. (2024). Virtual Reality training - Blood typing . Retrieved 29/08/2024 from https://hospital.blood.co.uk/the-update/virtual-reality-training/
2 NHS Blood and Transport. (2024). NHS Blood and Transplant now using virtual reality training for blood transfusion matching. Retrieved 29/08/2024, from https://www.nhsbt.nhs.uk/news/nhs-blood-and-transplant-now-using-virtual-reality-training-for-blood-transfusion-matching/