As virtual reality (VR) headsets have become less expensive and more commonplace in the last decade, medical educators have begun taking advantage of the technology’s educational potential. VR medical simulations are more cost-effective, engaging, and accessible than standard simulations.
However, just like physical simulators, VR headsets require cleaning and maintenance. In addition, they present unique risks and unpleasant side effects that need to be accounted for. Fortunately, these risks are minor with a bit of planning.
This article will cover the basics of VR hygiene and safety to help medical simulation specialists maintain their gear and provide the best possible learning experience for medical professionals.
Why is VR Hygiene so Important?
VR hygiene centers around the fact that VR headsets go on top of users’ heads. This will inevitably cause a build-up of hair and facial oils, or sebum, to build up on the areas on the device that contact the user’s skin and hair. Considering that these are the oiliest areas of many people’s bodies, this creates a significant hygiene issue.
Many people refuse to wear hats that belong to friends and acquaintances for this very reason, so it’s reasonable that an individual wouldn’t feel comfortable wearing a headset after 30 of their colleagues. Therefore, knowing how to clean a VR headset is crucial for specialists running VR medical simulations. Fortunately, keeping VR hygiene is not difficult if you understand what you’re dealing with.
The most direct source of contamination on VR headsets is substances and debris that accumulate on the device, including sebum, sweat, and makeup. In addition, dead skin cells from each user accumulate on the device with every use. The second source of contamination is more insidious.
Bacteria on our skin feasts on all of these substances, so it’s no surprise that a dirty headset is a breeding ground for potentially hazardous microorganisms. Research from the University of Mississippi found that VR headsets used in an undergraduate course built up a substantial microbial population1.
Benjamin Creel, the author of this undergraduate thesis, found that the predominant species was Staphylococcus aureus. The strains of S. aureus found on the headsets were particularly resistant to commonly used antibiotics. In addition, researchers identified a significant population of Moraxella osloensis, a species responsible for the smell of dirty laundry, and Micrococcus luteus, which can sometimes cause opportunistic infections.
Therefore, cleaning should remove debris and kill bacteria that have transferred onto the device. VR headsets should be cleaned before use, between wearers, and after training. Cleaning should begin with the main contact areas, the headset foam, and the straps.
How to Clean VR Headset Foam
Most VR headsets have a foam face cushion that contacts the face around the eyes, forehead, and nose. Foam face cushions prevent abrasion but soak up sweat and sebum. If possible, remove the foam from the headset before cleaning. Depending on the manufacturer’s instructions, wipe down the face cushion with cold water or a non-alcohol sanitizing wipe.
However, this is still less than ideal. A more surefire way to keep the headset foam clean is to cover it up with a first-party or third-party headset cover. Headset covers slide over the headset foam, preventing direct contact.
There are disposable options and medical-grade silicone covers. Disposable hygiene covers are the best bet for training sessions with a high learner throughput. However, silicone covers are a more sustainable and comfortable option if time permits. Remember, however, that your hands are oily too, so wearing gloves during cleaning is essential.
Cleaning the Casing and Straps
Whether you clean the foam or use a replaceable cover, you must clean the casing, with particular attention paid to the plastic adjacent to the foam face cushion. Double-check with the manufacturer’s instructions before using any cleaning substance. Still, the general rule is to avoid alcohol-based wipes or harsh sanitizing wipes. Instead, use sanitizing wipes that are designed for sensitive electronics.
Wearing gloves, wipe all the plastic surfaces on the outer casing and the area near the face cushion. Next, wipe the straps that go over the back and top of the head down with another sanitizing wipe. Finally, wipe the casing on the inside area where the lenses are located, taking care not to contact the lenses with the wipe. Give the headset a few minutes to dry before moving to the next step.
Cleaning VR Lenses
After the device has dried, gently clean each lens with a microfiber cloth to remove debris and dust. Beginning at the center of the lens, carefully wipe the lens with a circular motion. Gradually widen the circular motion until you’ve wiped the entire lens.
If you have a lens cleaner that is approved for plastic lenses, you can apply a minimal amount to the microfiber cloth. However, make sure that the cleaner is designed for plastic lenses before applying it to the lens. If you use any approved cleaning solution or premoistened lens wipe, ensure that the cloth is only slightly damp to avoid getting moisture behind the lenses, which could damage the electronics.
Cover the device until it to prevent dust accumulation.
Cleaning the VR Controllers
VR headsets typically use two controllers, one for each hand. Each of these must be sanitized. Thoroughly clean the controllers between each use with the same cleaning wipes used to sanitize the plastic casing. Be sure not to let moisture collect near the edges of the buttons to prevent moisture from damaging the electronics.
How to Set Up a VR Headset
After the headset is sanitized, help the user get the device on their head, as many people are not familiar with the process.
Adjusting the Headband
To start, loosen the headband based on your estimation of the user’s head circumference. Place the device on the user’s head. Taking care not to catch the wearer’s hair, slowly tighten the headband until the device is snug and secure but not constricting. The wearer may move their head rapidly while using the device, so it needs to be tight enough not to fly off during use.
Adjusting the Lenses
Once the headset is secure, make sure the device is turned on. The user should see an image, but it is likely blurry. Each device is different, but there usually are lens adjustment mechanisms on the left and right sides of the device. Adjust the lenses and have the user tell you when the image is in focus. Some users may want to adjust it themselves. If so, guide their hands to the adjustment mechanism and remind them to be gentle and adjust in minor increments.
How to Reduce Motion Sickness
One of the most common VR side effects are symptoms of motion sickness such as nausea, dizziness, and vomiting. In general, these effects, sometimes referred to as cybersickness, occur after using VR for extended amounts of time2. Research suggests that factors like a sense of presence, self-motion, mismatches in observed and expected sensory input, and visual display characteristics are causally associated with symptoms of motion sickness2.
Little research has been done to examine how to prevent cybersickness, but preliminary studies have found that limiting the time of sessions and providing visual guides that demarcate the center of the user’s field of vision can reduce symptoms3,4. Anecdotal evidence suggests that getting up and moving around can help with symptoms5. Other common treatments for motion sickness may provide relief, such as drowsiness-inducing antihistamines, ginger, fresh air, and strong, pleasant scents5.
While VR lets users experience challenging medical scenarios with no risk of harm to actual human patients, there are risks for trainees and those in their vicinity. Users cannot see the area around them and may walk into objects or people during use. In addition, bystanders are at risk of being hit by controllers.
Modern headsets often have built-in mechanisms to help users understand the boundaries of their movable space, but facilitators should show the user where they can walk beforehand and have them walk around that space. Once the headset is on, move the user to the center of the space and step back. Have bystanders do the same. When the simulation is over, have the user stand still and take the device off for them.
SimX VR Training
The SimX VR platform offers the most advanced VR medical training available. It runs on most consumer-grade all-in-one wireless VR headsets. Our simulations are designed for medical professionals, including surgeons, first responders, and battlefield medics.
Our simulations support local and online multi-user training for collaborative exercises. SimX provides numerous scenarios that instructors can modify before or during training. We also design custom cases for clients.
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- Creel B. Bacterial Load in Virtual Reality Headsets: Sally McDonnell Barksdale Honors College, University of Mississippi 2020.
- Weech S, Kenny S, Barnett-Cowan M. Presence and Cybersickness in Virtual Reality Are Negatively Related: A Review. Front Psychol. 2019;10:158.
- Seok KH, Kim Y, Son W, Kim YS. Using Visual Guides to Reduce Virtual Reality Sickness in First-Person Shooter Games: Correlation Analysis. JMIR Serious Games. 2021;9(3):e18020.
- Duzmanska N, Strojny P, Strojny A. Can Simulator Sickness Be Avoided? A Review on Temporal Aspects of Simulator Sickness. Front Psychol. 2018;9:2132.
- Whelan C. What Causes Virtual Reality (VR) Motion Sickness? https://www.healthline.com/health/vr-motion-sickness. Published 2021. Updated June 1. Accessed December 18, 2021.