OpenOR – a virtual reality framework for medical education

PURPOSE: Virtual reality (VR) is increasingly recognized as a powerful tool in medical training. It offers immersive, interactive environments ideal for exploring complex anatomy and procedures. With the advent of affordable hardware, VR can provide high-quality, cost-effective training experiences. METHODS: We developed the VR application OpenOR in Unity for medical education. It supports multi-user interaction with customizable avatars and hand-tracking for intuitive control. Designed for medical students and professionals, OpenOR enables the exploration of complete clinical case studies. This includes medical history, a virtual DICOM viewer, visualization of anatomical structures and pathologies derived from MRI segmentations, and the original 3D surgical videos for each case. In addition, the 3D MRI-based models are complemented by CAD (computer-aided design) models of real implants, such as VP shunts or aneurysm clips. A usability test was conducted with 30 medical students using structured questionnaires. RESULTS: The pilot implementation demonstrated OpenOR's educational potential. Students reported increased engagement and a perceived improvement in understanding of anatomy and surgical workflows. The multi-user mode fostered collaborative learning, while hand-tracking supported intuitive interaction. The combination of virtual PACS viewing, interactive 3D models, and surgical 3D videos provided a realistic and integrated learning experience. The evaluation feedback indicated high user satisfaction and confirmed the platform's value for neurosurgical and anatomical training. CONCLUSION: OpenOR represents a significant advancement in VR-based medical education. By integrating immersive technologies with affordable hardware, it offers practical and scalable training solutions for Neurosurgery and Neuroanatomy.