Overview

In 2022, Imperial College London became the first medical school in the UK to use virtual reality as a formal part of its clinical training curriculum. The 360° Interactive VR Emergency Simulations project was developed entirely in-house — a collaboration between the Faculty of Medicine and the Digital Media Lab (DML) — to address a persistent gap in undergraduate medical education: most students reach graduation without ever having been present at or managed an acute emergency.

The scenarios use 360-degree filmed footage of acted-out clinical emergencies, delivered through VR headsets. Students are immersed in a realistic ward environment and prompted with multiple-choice questions at decision points — creating branching pathways that follow different outcomes depending on the choices made. Each scenario runs 10–15 minutes, with a 10-second response window per question to replicate the time pressure of clinical decision-making.

The project piloted in May and June 2022 with final-year students and was fully integrated into the MBBS curriculum by autumn 2022. Since then, the library has grown from the original two scenarios to seven scenarios, now embedded across multiple years and specialties. A desktop version runs in parallel for students unable to attend in person.

“As a medical student you are never put in a position where you are in a team resuscitating a patient who has had a cardiac arrest. But after you graduate you have to do it, so there is a big gap between preparedness and practice in medicine that we have to grapple with.” — Professor Amir Sam, Head of Imperial College School of Medicine

Project at a Glance

Technology & Approach

Each scenario is built using 360-degree filmed footage of professionally acted clinical emergencies — placing students inside the scene rather than watching from outside it. At key decision points, actors break the fourth wall and address the student directly, presenting a clinical question with a 10-second response window. The student’s choice determines which branch plays next, allowing them to experience the consequences of both correct and incorrect decisions in real time.

The branching interaction layer is built in Unreal Engine, developed in-house by Imperial’s Digital Media Lab. Scenarios are designed to run entirely offline — a deliberate technical requirement allowing deployment in any teaching space without dependency on network connectivity. A desktop version of each scenario runs in parallel for students who cannot access a headset session.

The full production pipeline — filming, branching interaction design, and delivery — is maintained entirely within Imperial’s Digital Media Lab, keeping the project’s technical infrastructure institutional rather than dependent on external vendors. This allows scenarios to be updated or replaced when clinical guidelines change.

Team & Collaborators

Dr Risheka Walls — Consultant, Charing Cross Hospital · Digital Development Lead, Imperial School of Medicine · Clinical and academic lead throughout

Adrian Cowell — Innovation Lead, Faculty of Medicine · Production and interaction design lead

Thomas White — Digital Media Lab Lead, Imperial College London · Technical development and delivery

Professor Amir H. Sam — Head of Imperial College School of Medicine · Consultant Physician, Imperial Healthcare NHS Trust

James McVeigh, Wang A, Priyanka Nageswaran, Tunav Sehgal, Stefan Staykov, Paul Basett, Daniel Mitelpunkt — Contributing team members and co-authors on published research

Research & Publications

BMC Medicine · 2024 · Vol. 22(1), p.222
Virtual reality as an engaging and enjoyable method for delivering emergency clinical simulation training: a prospective, interventional study of medical undergraduates
Walls R, Nageswaran P, Cowell A, Sehgal T, White T, McVeigh J, Staykov S, Basett P, Mitelpunkt D, Sam AH
A prospective interventional study (n=116) confirming VR simulation produces significantly higher engagement and enjoyment than desktop-based simulation — with measurable differences in heart rate and eye-tracking attention. 29 citations.

Endocrine Abstracts · 2023 · Vol. 94
Fixing black holes in traditional clinical training: 360° virtual reality emergency simulations
Walls R, McVeigh J, Wang A, Cowell A, Shawcroft T, White T, Ganea C, Trojani G, Miller K, Davis P, Mitelpunkt D, Sam AH

Press Coverage

Evening Standard — London university becomes first to use virtual reality to train doctors in emergency situations · 1 November 2022

iNews — Virtual emergencies: One university using VR to train medical students for cardiac arrests

BBC London — Video report on Imperial’s 360° VR emergency training

The MDU — This is what it’s like inside an emergency medicine VR simulator

France 1 — TV coverage of the project (via YouTube)