Table of features comparing different virtual training technologies
Feature | Virtual Reality (VR) | Augmented Reality (AR) | Mixed Reality (MR) |
VR is a computer generated 3D environment in which users can move around and interact freely within the animated environment. | AR refers to digital information that is overlaid within the real world. | MR blends real and virtual objects within a synthetic world utilising chroma key technology similar to CGI rendered in real-time. | |
Able to practice procedures | ✔ | ✔ | ✔ |
Full digital immersion | ✔ | ❌ | ✔ |
Virtual objects over real-world environments | ✔ | ✔ | ✔ |
Hand Tracking | ✔ | ✔ | ✔ |
Able to see real hands and real objects in entirely virtual worlds | ❌ | ❌ | ✔ |
Interaction with both real-world equipment and virtual objects in a fully immersive environment | ❌ | ❌ | ✔ |
Practice fine motor skills | ❌ | ✔ | ✔ |
Fast familiarisation time | ❌ | ❌ | ✔ |
Extended Reality (XR)
Extended Reality (XR) is an umbrella term related to all the below-mentioned technologies consisting of Virtual Reality (VR), Augmented Reality (AR) and Mixed Reality (MR).
Mixed Reality (MR)
Mixed Reality (MR) refers to the ability to blend both real and virtual objects seamlessly. It is often a misused term within the virtual training technology space and is often misrepresented as either Augmented Reality (AR) or passthrough video on a Virtual Reality (VR) headset. The Varjo XR-3 and XR-4 are examples of mixed reality headsets that allow for organic mixed reality, where the user can see their own hands, and use real-world objects as they would in real life while also interacting with virtual objects seamlessly. Commonly used for flight simulators, it allows pilots to see their own hands and touch real-world cockpit controls using a masking system that allows the facilitator to control what the student sees as real and what they see as virtual. Thus the pilot can look down at a replica of a real cockpit, touch the instruments, and use the controls, while when they look outside at the cockpit, they see a fully virtual world that changes as they manipulate the aircraft controls and as the facilitator changes the scenario. Other headsets, such as the Meta Quest 3, can offer limited Mixed Reality capability through the use of their pass-through camera. Examples of this are tactical simulators that allow students to walk through real-world environments holding real weapons connected to virtual triggers and trigger enemy targets to pop up within what appears to be the real world. This is almost a blend between augmented and mixed reality, in our opinion, more similar to Augmented Reality than Mixed Reality (MR).
Chroma Key
Chroma Key is another way that Mixed Reality can be achieved with the Varjo XR-3 and XR-4. The BlueRoom simulator is one example of this being used for medical training along with Joint terminal attack controller (JTAC) simulators. These simulators allow for anything placed on the Chroma Key environment to appear as real: one's own hands, real equipment, medical equipment, tactical equipment, weapons, etc. The student is seeing through the Mixed Reality (MR) headset, looking at a virtual environment that the instructor can control and manipulate. This natural blending of real-world objects on top of virtual worlds while allowing for virtual changes within that environment is the impact and power of Mixed Reality (MR).
Medical training greatly benefits from Mixed Reality (MR) as the students are able to practice real skills with their real hands, having the dexterity to see the writing on the side of a drug ampule, the ability to draw it up via a needle and inject into a real arm or a manikin. Any training that requires the use of fine/gross motor skills combined with virtual environments is where Mixed Reality (MR) shines.
Augmented Reality (AR)
Augmented Reality (AR) is the projection of virtual objects on top of the real world. An example of this would be putting on an Augmented Reality (AR) headset and seeing an elephant run through the room. More practically, using a headset such as the Microsoft Hololens or a Magic Leap to project the location a surgeon needs to drill on top of a real patient lying within an operating theatre. Augmented Reality (AR) has also been used for medical and tactical medical training, allowing the 'augmenting' of injuries on top of a manikin or live actor. This may allow a student to walk through a real-world environment, seeing either virtual casualties that they can triage or virtual injuries on top of real actors/manikins.
Additional examples of Augmented Reality (AR) include digital glasses such as the latest Ray-Ban Meta Wayfarer that allows for a virtual heads-up display. Even modern cars that include a heads-up display may be considered a form of augmented reality, showing something that is not truly there in the real world. Applications for these systems include in the safety space, having safety glasses provide warnings to forklift drivers,
Augmented Reality (AR) has a place in virtual training, but it does not allow the complete transformation into of a virtual world in the same way that Virtual Reality (VR) or Mixed Reality (MR) does.
Virtual Reality (VR)
Virtual Reality (VR) is what most people are familiar with. Virtual Reality (VR) places the user into a fully virtual world where their hands are using controllers or hand tracking, allowing the virtual representation of their hands. Everything they see is virtual, even if it corresponds to a real object using tracking. An example of this would be a Virtual Reality (VR) fire extinguisher experience, where a controller or tracker is on the fire extinguisher, but the user sees a virtual fire extinguisher that is tracked in line with the movements of the real extinguisher.
Virtual Reality (VR) headsets include the Meta Quest 3, HTC Vive, PICO 4 and more. They come either tethered to a computer or standalone.
Games
Virtual Reality (VR) is most popular in gaming; games such as Beat Saber and free-roam VR experiences like Zero Latency have taken the world by storm. Many of these Virtual Reality (VR) games can be purchased through online app stores and played in open rooms of multiple players worldwide.
Pass through Virtual Reality Devices
The latest Virtual Reality (VR) headsets, including the Meta Quest 3 and Apple Vision, have high-quality pass-through cameras, allowing users to see their own hands and a virtual background or foreground. Although elements of this may be considered Mixed Reality (MR) or even Augmented Reality (AR), they blend different technologies that meet specific requirements and can perform particular functionality that blends across categories.
Virtual Reality (VR) Medical Training
In medical training, Virtual Reality (VR) is used for rehearsing procedures protocols, and familiarising someone with anatomy, specific conditions and treatment responses. As an example, Virtual Reality (VR) can be used to see a patient in a specific condition and see how they respond to treatment over time. It may be appropriate for practising a failed intubation checklist or identifying the anatomical site to perform a procedure.
Many of BlueRoom's early projects utilised Virtual Reality (VR), such as the Mass Casualty training program 'Real MCI' or an early MedEvac simulator built on the Meta Quest 2. Additional examples include first aid training scenarios, an emergency evacuation simulator and a Point of Care Ultrasound (POCUS) training simulator built for professional medical responders.
Virtual Reality (VR) is an incredible technology that is revolutionising training in many markets. For medical training requiring fine motor skills, it is not appropriate; a Mixed Reality (MR) approach is needed.
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