Student's Guide to PCS Spark in VR

Using PCS Spark is as easy as 1-2-3! The three short sections below will give you a quick rundown of what you need for a successful virtual simulation experience, so make sure you read these through carefully.

1. VR headset setup

Before you start your simulations with PCS Spark, please make sure of the following:

You have set up your Meta Quest 2 device,
You have connected your Meta Quest 2 to the internet and have an active, stable connection,
You are familiar with your Meta Quest 2 device menu layout and control scheme,
You have enough room and ample light to fully utilize the 6 degrees of freedom provided by your headset:
If you haven't finished setting up your Meta Quest 2 headset, or if you have any usability / technical concerns during the initial setup, visit Meta's
"Getting started with Meta Quest 2" guide using the below link:
https://www.meta.com/help/quest/articles/getting-started/getting-started-with-quest-2/
Before you start your simulation with PCS Spark, launch Meta's First Steps App to learn more about how the controllers work.

2. Tips and Tricks before you get started

Always make sure your Meta Quest 2 is fully charged before you start using it.
Please start the simulation while seated for the best simulation experience.
Set up your Guardian to be Roomscale and try to ensure you have at least 5 feet free space to the sides, and 10 feet free space in front of you (see the picture above).
If during the simulation you'd need to cross the play area boundaries, adjust your Guardian to include more space if your room allows it.
Make sure there are no objects inside your Guardian, and aim to stay inside your Guardian for the duration of your simulation.

If you have any questions about the simulation, reach out to help@pcs.ai for assistance or use the Online Chat Support feature from your personal menu in the top right while on app.pcs.ai.

3. Using PCS Spark in your VR Headset

Before you can jump into the action, you will need to create a PCS Account and use an Access Link, which will be made available to you independently by Faculty. Access Links add different patient scenarios to your PCS Account so you can start them from your headset. It's best to use a computer or phone for this.

HINT: Check out the Accessing PCS Spark section for more information.

Once you have set up your VR headset, open the Meta Quest Browser and log in at https://app.pcs.ai with your PCS Account.

See how Spark works in action in this short introduction video:

The below sections provide a comprehensive description on each individual step for a successful simulation experience. Open the sections to learn more:

What is PCS Spark?

PCS Spark is your virtual patient simulator with different AI powered patients you can talk to in real time. You can check vitals, listen to heart or lung sounds and perform different physical examinations which are all based on the specific case.

Accessing PCS Spark

When you're assigned a virtual simulation, you will receive an email from your Faculty that includes a Spark Access Link, which looks somewhat like this: https://app.pcs.ai/start.html?key=yZSAVboCW. Use that unique link to gain access to the platform.

To use this Access link, follow the steps below:

1. Click on the Access link where you have access to your email, i.e. on your computer or phone. This will take you to app.pcs.ai, where in the next few steps you are going to set up your PCS Account to start virtual simulations on your VR headset.

2. Enter your institutional email address on the Log in page.

3. Click "Yes" to create your PCS Account.
(Alternatively, if you already have a PCS Account, you will be prompted to enter your password and log in)

4. Check your inbox for the "PCS: signup" message and click on the included link to continue your registration

5. Enter your name and a chosen password. Please use a password you do not use anywhere and one that is hard to guess.

6. Accept the Terms and Conditions and the Privacy Policy.

7. Click on your personal profile menu in the top right corner, then click “Generate PIN…”.

Take note of the 6 digit PIN, you will use this shortly.

8. Put on your Meta Quest 2, open the "Meta Quest Browser" app.
9. Go to https://app.pcs.ai, and

10. Click on PIN Login, then enter the PIN you received in step 7.

You are now on the main screen of your PCS Account. You will see your available assignments here.

Starting a Simulation in VR

With your PCS Account created and an Access Key, you can now start virtual simulations with your Meta Quest 2. Select any of the patients in your assignment, read its patient description, and then hit the Start button next to it.

At this point, your Meta Quest Browser will request access to your microphone, and permission to enter an immersive experience and use hand tracking—make sure you allow both, then refresh the browser page if necessary, so the new permissions apply.

A simulation in Spark consists of two modes:

a fully immersive 3D environment
and a control screen where you can access assignment-specific resources, read more about these in the Additional Resources section of this guide

You will be loaded into the simulation through the fully immersive 3D environment.

Carefully read the control instructions on the screen and take some time to adjust. Once you've adapted to the controls, you can hide and recall the popup during the simulation by pressing both Grip buttons simultaneously.

You can exit the immersive 3D environment with the Menu button (three horizontal lines):

If you get motion sickness during the simulation, just exit the fully immersive 3D environment with the Menu button (three horizontal lines), and if necessary, take off your headset for a couple of minutes. Don't worry, if this is your first time with PCS Spark, you will be able to start new simulations from your Assignments tab.

You can go back into the immersive 3D environment by clicking on the blue "Interact with your patient in 3D" button. This video will help you to get familiar with the mode changes:

Simulation Controls

You can look and walk around the room like you would in real life. Be mindful of objects/obstacles in your room!

To talk to the patient in front of you, press the A or the X button. This will toggle your microphone and allow you to address the patient. You will also hear a beeping sound, signaling that the patient is listening. Your questions, as well as the patient’s responses, will appear in a popup log message.
Make sure you're in an environment with low background noise, as the patient may try to respond to other sounds, conversations, etc.
Press down on one of the thumbsticks to start/stop physical examination. This will move the patient to the examination table.
Walk up to the table and use your hands to examine the patient by pressing the Grip button on the relevant locations on the patient's body. You will see the findings of the relevant areas in popups.
You can dismiss the popup findings by moving your hand over the “X” in the top right corner.
Grab any of the tools from the tray by pressing and holding the Grip button, then press the Trigger button on the relevant locations on the patient's body to access further findings. Examination findings are presented either via audio or visually via popup. When you hover the tool over a position where you can use it, your controller will vibrate.
You can swap tools by stopping to press the Grip button: this will drop the currently held tool and allow you to pick up another.

Below are a couple of examples of virtual examination tool uses. For a complete guide on how each tool can be used, check out this article.

Radial pulse palpation: touch the patient's wrist, then press and hold the Grip button
Auscultation: touch the patient's chest using the stethoscope, then press and hold the Trigger button
Otoscope/ophthalmoscope: move the tools up to the patient's ears/eyes, then press the Trigger button when the controller vibrates

Note: The virtual patient has very limited range of motion at this time, and will not be able to follow your commands when you ask them to raise their hands, open their mouths, etc. Consider using the Physical exam tools at your disposal, or requesting orders for exam results.

Additional Resources

Further resources are also available by pressing the Menu button (three horizontal lines). This button allows you to exit the fully immersive 3D environment and instead gives you a high-level overview of the simulation.

First, move and resize the Browser window so you feel comfortable looking at it.
To move the Browser, grab and move the grey line below the Browser or the toolbar.

To resize the browser, grab and move the edges of the Browser:

While not in the fully immersive 3D environment, you’ll have access to The Patient File Hints and Tips and Diagnose and Treat. Additionally, any physical exam actions that were not available in the fully immersive 3D environment will be available to access through the button in the top right.

When you exit the fully immersive 3D environment, the control scheme changes a little: you can talk to the patient by pointing at the microphone icon, then pressing the Trigger button. To return to the 3D environment, just point at the patient and pull the Trigger button.

The toolbar on the bottom of your Browser may contain the following:

Patient File: Basic information for your assignment.
Vital Signs: Some assignments will allow you to check your patient’s vitals such as heart rate, SpO2, etc.
Sim Log: Logs of every interaction during your simulation. You can review your conversation with the patient, see what physical exams you've performed, and others.
Diagnose and Treat: You can request Imaging, Labs, Medications, etc., and decide about the next steps for the patient.
Hints and Tips: Provides additional learning resources and helpful information for your virtual simulations

Wrapping up your Simulation

There isn't a definite end to a virtual simulation in Spark. Just like when interviewing a real-life patient, your aim is to get critical and valuable information.That will be the basis of your assessment.

When you feel you have collected enough information about the patient, exit the fully immersive 3D environment by pressing the Menu button (three horizontal lines). Then, look for the Stop button in the top right of your browser, take aim and press the Trigger button. After you press the Stop button, you may have to do a post-simulation exercise or a quick survey based on your assignment. Answer all required questions then click OK.

End-of-Simulation Debriefing

After your simulation you will see your evaluation report. Your scores are based on your actions during the simulation session.

You can scroll through the simulation event logs with the Thumbstick, and review the Patient File, as well as all other resources you had access to during the simulation.

Some assignments may allow you to resume the simulation even after you stopped it. To do this, click on the Resume button in the top right.

Troubleshooting

Since commercially available virtual reality devices are also still pretty new, you may run into issues that may require you to troubleshoot your Meta Quest 2 device. You can find troubleshooting tips onMeta's support page.

In some cases, you might also encounter difficulties during your simulations with PCS Spark. Below, we've collected some of the possible issues and methods on how to fix them:

Q: I don’t see any assignments under my PCS Account.

R: You have not used an Access Key with your PCS Account, or the Key has been disabled by your Faculty.

Q: I see an assignment under my PCS Account, but I don’t see any patient scenarios.

R: Your assignment does not include a patient scenario yet. Contact your Faculty for more information.

Q: The patient takes too long to load.

R: Your internet connection may not be fast enough, or your VR headset is low on battery. Consider switching to a network with more bandwidth and a better connection, and let your VR headset fully charge before use.

Q: The patient cannot hear me.

R: 1. Reload app.pcs.ai on your Meta Quest Browser

2.If you see that your browser requests microphone access, make sure you allow it.

3. Listen for a beeping sound when you activate your microphone. If you can’t hear the beeping, wait 5-6 seconds between activating and deactivating your microphone.

4. If you can hear the beeping sound, but the patient cannot hear you, your internet connection may not be fast enough. Consider switching to a network with more bandwidth and a better connection.

Q: I’m in a weird position in the simulation/my hands or controllers disappeared/ The patient or the tools are out of the boundary.

R: Walk back to your original starting position in your room and take a seat if you can, then long press the Meta button to reset your view. Your Meta Quest 2’s built-in tracking system may also encounter glitches sometimes. When this happens, you may need to restart your VR headset.