Developing VR for healthcare isn’t just about sophisticated technology - it’s about solving real, high-stakes problems that affect clinicians every day. In this success story, we explore how a research team at Edith Cowan University is using immersive simulation to tackle one of healthcare’s toughest challenges: workplace aggression and the urgent need for effective de-escalation training. Their work blends clinical expertise, behavioral psychology, and advanced VR development, all supported by a version control workflow built to keep an ambitious, multidisciplinary team moving fast.
Tell us about your team and the University behind the project
I’m Wyatt, a Research Assistant and Software Engineer. I have experience developing VR simulations in industry. I draw on this experience to create reliable and easily usable software to facilitate our team's research.
I am part of the Simulation and Immersive Digital Technology Group (SIDTG) at Edith Cowan University in Western Australia. The team has grown over the years, expanding to include people from different schools within the University. Core members of our team traditionally focussed on research and/or education and training of healthcare practitioners using live actors or sophisticated manikins. But with the advent of VR, the team was formed to explore the advantages offered by immersive technologies, including VR, for use for simulation-based training. Working in close consultation with stakeholders and end-users to co-design our immersive educational experiences, VR-enhanced training can be deployed at scale, leveraging a standardised, evidence-based model, cutting through many of the limitations associated with traditional training environments.
Your healthcare VR project
What's the core problem you're trying to solve with this VR application? Can you walk us through the specific healthcare scenarios where professionals need help with de-escalation, and how your VR solution addresses this challenge?
Nine in ten nurses have experienced violence on the job.
Health workforce retention is an enormous problem across the developed world. Post COVID-19, we are now relying on the most junior workforce in recent history. With so much experience working out the door, this places enormous pressure on clinicians being thrust into leadership positions. While the issues contributing to poor workforce retention are multifactorial, one of the core contributors is workplace exposure to aggression and violence. Hospitals are high pressure environments where heightened emotions, stress and physical pain push against the often strained capabilities of healthcare systems. It’s not uncommon for waiting patients to become violent when service doesn’t meet their expectations. Ageing populations and heightened rates of alcohol and other drug abuse also see heightening rates of patients with cognitive dissassociation, also enhancing likelihood of aggression and violence.
Why VR for healthcare training
What makes VR particularly suited for de-escalation training compared to traditional methods? What unique advantages does immersive VR provide for this type of scenario-based learning?
Traditional training can effectively prepare healthcare workers to identify aggression early and improve communication skills, de-escalating incidents before they turn violent. However, busy health systems, lack of coordinated training options, issues with distance (particularly in rural/remote settings), lack of standardisation and disparate access to appropriate resourcing and infrastructure, make traditional face-to-face training problematic. Best case, some staff report access to role play scenarios with peers, but report a lack of buy-in and limited learning value.
By comparison, VR can immerse a user in a simulated environment that replicates an appropriate level of threat response yet maintains psychological safety in training. Scenarios can be replicated and informed by best evidence, delivered in a standardised model, and can actually work to expose a learner (safely) what it is like confronting and de-escalating an aggressive patient, with the opportunity for repetitive practice.
VR also affords economic benefits, with fewer staff and simulation-based infrastructure necessary to deliver training.
Your development workflow
How is your research team organized for development? What does your typical development cycle look like - are you following academic timelines, research milestones, or agile development practices?
We do follow agile development processes. This phase of the project is 12-months, which is a very tight timeline. We incorporate a wide range of expertise into the project team including:
- AI and machine learning
- Full stack development
- Computational engineering
- VR development
- Healthcare education and training
- Frontline clinical expertise
- Behavioural psychology
- Educational pedagogy
- User Experience Design
How you discovered Diversion
Can you walk us through the story of how you found Diversion and decided to use it for this project? What initially caught your attention about it as a potential solution for your team's needs?
Wyatt: I’m in charge of version control for this project. I have experienced the nightmare of working on projects with medium to large teams without robust version control. It has become clear to me that while it can be initially challenging in the setup phase, effective version control solutions pay dividends in excess down the line.
With the majority of my experience being development through the Unity game engine, but this one being based out of Unreal, I did my research on the version control solutions available and came up with three obvious solutions being - Perforce, Diversion or Git.
Perforce was eliminated. We operate as a small team with modest budgets. Perforce appears to be more geared at high budget studios with big teams. It also appears that they are a self-hosted solution. As one of the developers on the project myself, I need to limit the time I spend on version control management. So all up an unattractive solution.
Between Git and Diversion. The common sentiment online was that Git worked but was a headache but Diversion was plug and play. Still, I needed to see this for myself. So I got Git and Diversion both completely working with some test projects. The big difference was the amount of set up steps and bug fixing I had to do with Git. On my own I can handle it but I could foresee the burden of set up and maintenance across the multiple PCs of every current and future team member.
Diversion however was plug and play. Given it paired with generous free usage thresholds for academic use made it the obvious choice.
What you like about Diversion
Since implementing Diversion, what aspects of the tool have been most valuable for your research project? How has it shaped your team's collaborative workflow and ability to iterate on the VR experience?
I’ve been diverted to other work lately but thankfully over the past couple of months the team has had no issues to speak of that have required me to step in. This is the biggest benefit over solutions like Git.
If we’re comparing to no version control at all, then I can predict the software will enable our handful of developers to work concurrently on their own parts of the project with minimal logistical overhead. New features can be implemented and tested in the latest version of the project by any capable team member instead of a limited bottleneck of developers with disparate and clashing unreal projects.
Any links, or social media to get in touch with you?
You can learn more about the I-VADE project here, or get in touch with project lead Dr Brennen Mills (b.mills@ecu.edu.au) or lead developer Wyatt De Souza (w.desouza@ecu.edu.au).
